Department of Neurology, Medical University of Graz, Graz, Austria.
Dement Geriatr Cogn Disord. 2012;33(1):29-34. doi: 10.1159/000336052. Epub 2012 Feb 24.
BACKGROUND/AIMS: Hippocampal atrophy has been identified as marker for the development of Alzheimer's dementia (AD). To what extent vascular risk factors and white matter hyperintensities (WMH) affect hippocampal volume (HV) in asymptomatic elderly subjects and thus may impact such a predictive capacity is controversial.
We analysed 287 participants of the Austrian Stroke Prevention Study (mean age 66.6 ± 6.6 years) with a Mini Mental State Examination score ≥27 who were free of neuropsychiatric disease and had undergone MRI including coronal T(1)-weighted sequences allowing for semi-automatic assessment of HV. Global brain volume (BV) was measured using SIENAX. WMH were rated according to the Fazekas scale and segmented to obtain WMH volumes.
Higher age was associated with lower absolute and normalized HV, a lower BV and higher WMH volume. None of the vascular risk factors had an impact on HV except for high-density lipoprotein. This effect disappeared after normalization of HV. WMH severity and volume did not affect HV either.
Our data indicate HV loss in parallel with the whole brain and suggest no specific vulnerability towards vascular risk factors or age-related WMH in a cognitively intact normal elderly population. This also supports the utility of HV measurements to identify impending AD.
背景/目的：海马萎缩已被确定为阿尔茨海默病（AD）发展的标志物。血管危险因素和脑白质高信号（WMH）在多大程度上影响无症状老年受试者的海马体积（HV），从而可能影响这种预测能力，这是有争议的。
我们分析了奥地利卒中预防研究（平均年龄 66.6 ± 6.6 岁）的 287 名参与者，这些参与者的 Mini 精神状态检查评分≥27，无神经精神疾病，并且进行了 MRI 检查，包括冠状 T（1）加权序列，允许半自动评估 HV。使用 SIENAX 测量全脑体积（BV）。WMH 根据 Fazekas 量表进行评分，并进行分割以获得 WMH 体积。
年龄越高，绝对和标准化 HV 越低，BV 越低，WMH 体积越高。除了高密度脂蛋白外，血管危险因素均未对 HV 产生影响。这种影响在 HV 标准化后消失。WMH 严重程度和体积也未影响 HV。
我们的数据表明 HV 与全脑平行丢失，并表明在认知正常的老年人群中，没有对血管危险因素或与年龄相关的 WMH 有特定的脆弱性。这也支持使用 HV 测量来识别即将发生的 AD。
