Montandon Marie-Louise, Haller Sven, Scheffler Max, Giannakopoulos Panteleimon, Herrmann François R, Gold Gabriel, Kövari Enikö
Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Thônex, Switzerland; Department of Psychiatry, Geneva University Hospitals and University of Geneva, Chêne-Bourg, Switzerland.
CIRD Centre d'Imagerie Rive Droite, Geneva, Switzerland; Department of Surgical Sciences, Radiology, Uppsala University, Sweden.
Neurobiol Aging. 2020 Nov;95:9-14. doi: 10.1016/j.neurobiolaging.2020.06.008. Epub 2020 Jun 16.
Medial temporal lobe (MTL) atrophy is an important marker for the clinical diagnosis of Alzheimer's disease at its prodromal stages. Several brain lesions have been associated with MTL atrophy including hippocampal sclerosis, neurodegenerative neuronal loss, and vascular pathology. To better explore the relationship between MTL volume on MRI and age-related degenerative and microvascular hippocampal pathology, we compared MTL volume on postmortem whole brain MRI and stereological estimates of the total number of neurons, cortical microinfarcts (CMIs), and neurofibrillary tangles (NFTs) in a consecutive autopsy series of 21 older individuals (11 females and 10 males, mean age 83.3 ± 5.8; range: 74-93 years, 7 demented and 14 nondemented). Our results revealed a very high percentage of cases with hippocampal CMIs (52%), particularly in the CA1 field. MTL volume was closely related to neuronal loss in both the CA1 area of the hippocampus (p = 0.0109) and the entorhinal cortex (p = 0.0272). MTL volume was not related to total CMI volume or to the total number of NFTs in our sample. In conclusion, hippocampal CMIs are very common in old age. MTL volume is determined essentially by the number of neurons in the hippocampus and does not appear to be related to the presence of NFTs or CMIs in this region.
内侧颞叶（MTL）萎缩是阿尔茨海默病前驱期临床诊断的重要标志。几种脑损伤与MTL萎缩有关，包括海马硬化、神经退行性神经元丢失和血管病变。为了更好地探索MRI上MTL体积与年龄相关的退行性和微血管海马病变之间的关系，我们比较了21名老年人（11名女性和10名男性，平均年龄83.3±5.8岁；范围：74 - 93岁，7名痴呆患者和14名非痴呆患者）连续尸检系列中死后全脑MRI上的MTL体积以及神经元总数、皮质微梗死（CMIs）和神经原纤维缠结（NFTs）的体视学估计值。我们的结果显示，海马CMIs病例的比例非常高（52%），特别是在CA1区。MTL体积与海马CA1区（p = 0.0109）和内嗅皮质（p = 0.0272）的神经元丢失密切相关。在我们的样本中，MTL体积与总CMI体积或NFTs总数无关。总之，海马CMIs在老年时非常常见。MTL体积主要由海马中的神经元数量决定，似乎与该区域NFTs或CMIs的存在无关。
