• Dement Geriatr Cogn Disord · Jan 2011

    Minimal atrophy of the entorhinal cortex and hippocampus: progression of cognitive impairment.

    • Daniel Varon, David A Loewenstein, Elizabeth Potter, Maria T Greig, Joscelyn Agron, Qian Shen, Weizhao Zhao, Maria Celeste Ramirez, Isael Santos, Warren Barker, Huntington Potter, and Ranjan Duara.
    • Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL 33140, USA. dvaron@msmc.com
    • Dement Geriatr Cogn Disord. 2011 Jan 1; 31 (4): 276-83.

    BackgroundIn Alzheimer's disease, neurodegenerative atrophy progresses from the entorhinal cortex (ERC) to the hippocampus (HP), limbic system and neocortex. The significance of very mild atrophy of the ERC and HP on MRI scans among elderly subjects is unknown.MethodsA validated visual rating system on coronal MRI scans was used to identify no atrophy of the HP or ERC (HP(0); ERC(0)), or minimal atrophy of the HP or ERC (HP(ma); ERC(ma)), among 414 participants. Subjects fell into the following groups: (1) ERC(0)/HP(0), (2) ERC(ma)/HP(0), (3) ERC(0)/HP(ma), and (4) ERC(ma)/HP(ma). HP volume was independently measured using volumetric methods.ResultsIn comparison to ERC(0)/HP(0) subjects, those with ERC(0)/HP(ma) had impairment on 1 memory test, ERC(ma)/HP(0) subjects had impairment on 2 memory tests and the Mini Mental State Examination (MMSE), while ERC(ma)/HP(ma) subjects had impairment on 3 memory tests, the MMSE and Clinical Dementia Rating. Progression rates of cognitive and functional impairment were significantly greater among subjects with ERC(ma).ConclusionMinimal atrophy of the ERC results in greater impairment than minimal atrophy of the HP, and the combination is additive when measured by cognitive and functional tests. Rates of progression to greater impairment were higher among ERC(ma) subjects.Copyright © 2011 S. Karger AG, Basel.

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