Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL 33140, USA.
Dement Geriatr Cogn Disord. 2011;31(4):276-83. doi: 10.1159/000324711. Epub 2011 Apr 13.
In 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.
A 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.
In 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).
Minimal 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.
在阿尔茨海默病中，神经退行性萎缩从内侧颞叶（ERC）进展到海马（HP）、边缘系统和新皮质。在老年受试者中，MRI 扫描显示 ERC 和 HP 非常轻度萎缩的意义尚不清楚。
使用经过验证的冠状 MRI 扫描视觉评分系统，在 414 名参与者中确定 HP 或 ERC 无萎缩（HP(0); ERC(0)）或 HP 或 ERC 轻度萎缩（HP(ma); ERC(ma)）。受试者分为以下几组：(1) ERC(0)/HP(0)，(2) ERC(ma)/HP(0)，(3) ERC(0)/HP(ma)，和 (4) ERC(ma)/HP(ma)。使用体积测量方法独立测量 HP 体积。
与 ERC(0)/HP(0)受试者相比，ERC(0)/HP(ma)受试者在 1 项记忆测试中表现出障碍，ERC(ma)/HP(0)受试者在 2 项记忆测试和 Mini 精神状态检查（MMSE）中表现出障碍，而 ERC(ma)/HP(ma)受试者在 3 项记忆测试、MMSE 和临床痴呆评定中表现出障碍。认知和功能障碍进展率在 ERC(ma)受试者中显著更高。
ERC 的轻度萎缩比 HP 的轻度萎缩导致更大的障碍，并且当通过认知和功能测试测量时，组合是累加的。ERC(ma)受试者进展为更大损害的速度更高。
