Usefulness of MRI measures of entorhinal cortex versus hippocampus in AD

Y. Xu, Clifford R Jr. Jack, P. C. O'Brien, E. Kokmen, G. E. Smith, R. J. Ivnik, Bradley F Boeve, R. G. Tangalos, Ronald Carl Petersen

Research output: Contribution to journalArticle

331 Citations (Scopus)

Abstract

Objective: MRI-based measurements of hippocampal atrophy are a sensitive indicator of the early pathologic degeneration of the medial temporal lobe in AD. However, AD pathology appears first in the transentorhinal/entorhinal cortex, not the hippocampus. The authors tested the hypothesis that MRI-based measurements of the entorhinal cortex are more sensitive than measurements of hippocampal volume in discriminating among three clinical groups; controls, patients with a mild cognitive impairment (MCI), and patients with mild probable AD. Methods: The authors studied 30 controls, 30 patients with MCI, and 30 patients with AD who were matched among clinical groups on age, gender, and education. All underwent a standardized MRI protocol from which the authors made measurements of hippocampal volume, entorhinal cortex volume, and the cumulative length of the medial border of the entorhinal cortex. Results: Pairwise intergroup differences (p < 0.01) were found for all MRI measurements with the exception of the cumulative length of the entorhinal cortex, which did not differentiate controls from MCI patients. Whereas the hippocampal and entorhinal cortex volume measurements provided slightly better intergroup discrimination than the entorhinal distance measurement, overall differences in discriminating ability among the three MRI measurements were minor. Conclusions: Despite the theoretical rationale for the superiority of entorhinal measurements in early AD, the authors found MRI measurements of the hippocampus and entorhinal cortex were approximately equivalent at intergroup discrimination. Measurements of the hippocampus may be preferable because MRI depiction of the boundaries of the entorhinal cortex can be obscured by anatomic ambiguity, image artifact, or both.

Original languageEnglish (US)
Pages (from-to)1760-1767
Number of pages8
JournalNeurology
Volume54
Issue number9
StatePublished - May 9 2000

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Entorhinal Cortex
Hippocampus
Aptitude
Temporal Lobe
Artifacts
Atrophy
Age Groups
Pathology
Education

Keywords

  • AD
  • Dementia
  • Entorhinal cortex
  • Hippocampus
  • Mild cognitive impairment
  • Volumetric MRI

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Xu, Y., Jack, C. R. J., O'Brien, P. C., Kokmen, E., Smith, G. E., Ivnik, R. J., ... Petersen, R. C. (2000). Usefulness of MRI measures of entorhinal cortex versus hippocampus in AD. Neurology, 54(9), 1760-1767.

Usefulness of MRI measures of entorhinal cortex versus hippocampus in AD. / Xu, Y.; Jack, Clifford R Jr.; O'Brien, P. C.; Kokmen, E.; Smith, G. E.; Ivnik, R. J.; Boeve, Bradley F; Tangalos, R. G.; Petersen, Ronald Carl.

In: Neurology, Vol. 54, No. 9, 09.05.2000, p. 1760-1767.

Research output: Contribution to journalArticle

Xu, Y, Jack, CRJ, O'Brien, PC, Kokmen, E, Smith, GE, Ivnik, RJ, Boeve, BF, Tangalos, RG & Petersen, RC 2000, 'Usefulness of MRI measures of entorhinal cortex versus hippocampus in AD', Neurology, vol. 54, no. 9, pp. 1760-1767.
Xu Y, Jack CRJ, O'Brien PC, Kokmen E, Smith GE, Ivnik RJ et al. Usefulness of MRI measures of entorhinal cortex versus hippocampus in AD. Neurology. 2000 May 9;54(9):1760-1767.
Xu, Y. ; Jack, Clifford R Jr. ; O'Brien, P. C. ; Kokmen, E. ; Smith, G. E. ; Ivnik, R. J. ; Boeve, Bradley F ; Tangalos, R. G. ; Petersen, Ronald Carl. / Usefulness of MRI measures of entorhinal cortex versus hippocampus in AD. In: Neurology. 2000 ; Vol. 54, No. 9. pp. 1760-1767.
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abstract = "Objective: MRI-based measurements of hippocampal atrophy are a sensitive indicator of the early pathologic degeneration of the medial temporal lobe in AD. However, AD pathology appears first in the transentorhinal/entorhinal cortex, not the hippocampus. The authors tested the hypothesis that MRI-based measurements of the entorhinal cortex are more sensitive than measurements of hippocampal volume in discriminating among three clinical groups; controls, patients with a mild cognitive impairment (MCI), and patients with mild probable AD. Methods: The authors studied 30 controls, 30 patients with MCI, and 30 patients with AD who were matched among clinical groups on age, gender, and education. All underwent a standardized MRI protocol from which the authors made measurements of hippocampal volume, entorhinal cortex volume, and the cumulative length of the medial border of the entorhinal cortex. Results: Pairwise intergroup differences (p < 0.01) were found for all MRI measurements with the exception of the cumulative length of the entorhinal cortex, which did not differentiate controls from MCI patients. Whereas the hippocampal and entorhinal cortex volume measurements provided slightly better intergroup discrimination than the entorhinal distance measurement, overall differences in discriminating ability among the three MRI measurements were minor. Conclusions: Despite the theoretical rationale for the superiority of entorhinal measurements in early AD, the authors found MRI measurements of the hippocampus and entorhinal cortex were approximately equivalent at intergroup discrimination. Measurements of the hippocampus may be preferable because MRI depiction of the boundaries of the entorhinal cortex can be obscured by anatomic ambiguity, image artifact, or both.",
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AU - Ivnik, R. J.

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