Department of Neurology, University of California, Orange, California, USA.
Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, California, USA.
Alzheimers Dement. 2021 May;17(5):847-855. doi: 10.1002/alz.12241. Epub 2020 Dec 7.
Hippocampal sclerosis of aging (HS) is a common pathology often misdiagnosed as Alzheimer's disease. We tested the hypothesis that participants with HS would have a magnetic resonance imaging (MRI)-detectable hippocampal pattern of atrophy distinct from participants without HS, both with and without Alzheimer's disease neuropathology (ADNP).
Query of the National Alzheimer's Coordinating Center database identified 198 participants with MRI and autopsy. Hippocampal subfields were segmented with FreeSurfer v6. Analysis of covariance for subfield volumes compared HS+ participants to those without HS, both with ADNP (HS-/ADNP+) and without (HS-/ADNP-).
HS+ participants (N = 27, 14%) showed atrophied cornu ammonis 1 (CA1; left P < .001, η = 0.14; right P = .001, η = 0.09) and subiculum (left P < .001, η = 0.139; right P = .001, η = 0.085) compared to HS-/ADNP+ (N = 100, 51%). Compared to HS-/ADNP- (N = 71, 36%), HS+ also had atrophy in subiculum (left P < .001, η = 0.235; right P = .002, η = 0.137) and CA1 (left P < .001, η = 0.137; right P = .006, η = 0.070).
Subiculum and CA1 atrophy from clinical MRI may be a promising in vivo biomarker for HS.
衰老性海马硬化（HS）是一种常见的病理学改变，常被误诊为阿尔茨海默病。我们检验了这样一个假设，即患有 HS 的参与者在磁共振成像（MRI）上会出现可检测到的海马萎缩模式，与不患有 HS 的参与者有所区别，且无论这些参与者是否患有阿尔茨海默病神经病理学（ADNP）。
通过国家阿尔茨海默病协调中心数据库查询，确定了 198 名具有 MRI 和尸检结果的参与者。使用 FreeSurfer v6 对海马亚区进行分割。采用协方差分析比较了 HS+参与者和 HS-参与者，包括伴有 ADNP（HS-/ADNP+）和不伴有 ADNP（HS-/ADNP-）的参与者。
HS+参与者（n=27，14%）与 HS-/ADNP+参与者（n=100，51%）相比，左侧 CA1（P<.001，η=0.14；右侧 P=0.001，η=0.09）和右侧 subiculum（P<.001，η=0.139；右侧 P=0.001，η=0.085）萎缩更明显。与 HS-/ADNP-（n=71，36%）相比，HS+参与者的右侧 subiculum（P<.001，η=0.235；右侧 P=0.002，η=0.137）和左侧 CA1（P<.001，η=0.137；右侧 P=0.006，η=0.070）也出现萎缩。
从临床 MRI 中发现的 subiculum 和 CA1 萎缩可能是 HS 的一种有前途的体内生物标志物。
