 | THE PARAHIPPOCAMPAL REGION: IMPLICATIONS FOR NEUROLOGICAL AND PSYCHIATRIC DISEASES
Copyright © 2000 by the New York Academy of Sciences
description
Annals of the New York Academy of Sciences 911:240-253 (2000)
© 2000 New York Academy of Sciences
From Healthy Aging to Early Alzheimer's Disease: In Vivo Detection of Entorhinal Cortex Atrophy
LEYLA DE TOLEDO-MORRELLa,b,c,f,
IRINA GONCHAROVAa,d,
BRADFORD DICKERSONa,e,
ROBERT S. WILSONa,b,c AND
DAVID A. BENNETTa,c
aDepartment of Neurological Sciences, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612
bDepartment of Psychology, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612
cRush Alzheimer's Disease Center, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612
dCurrent address: Wadsworth Center, New York State Department of Health, Albany, NY.
eCurrent address: Brigham and Women's Hospital, Harvard University, Boston, MA.
fAddress for correspondence: Leyla deToledo-Morrell, Department of Neurological Sciences, Rush-Presbyterian-St. Luke's Medical Center, 1653 W. Congress Parkway, Chicago, IL 60612. Tel.: (312) 942-5399; fax: (312) 942-2238.
e-mail: leylat{at}neuro.rush.edu
Using quantitative structural MRI protocols, we examined the effects of age on alterations in entorhinal cortex (EC) volume. The left EC was found to be smaller than the right in both young and healthy aged subjects. More importantly, the right EC, but not the left, was significantly smaller in elderly participants compared to young controls. In an attempt to determine the earliest sites of involvement in mild and incipient Alzheimer's disease (AD), we compared entorhinal and hippocampal volume in (1) healthy elderly controls, (2) patients with very mild AD, and (3) elderly patients who were evaluated for cognitive complaints, but did not meet criteria for dementia. Both patient groups differed from controls in EC volume, but not from each other. In contrast, the two patient groups differed in hippocampal volume from controls, as well as from each other, with the mild AD cases showing the greatest atrophy. These results suggest that degeneration of the EC and hippocampal formation occurs before the onset of overt dementia. In fact, follow-up clinical evaluations available on 23 of 28 nondemented patients indicated that 12 of 23 had converted to AD. Converters could be best differentiated from nonconverters on the basis of entorhinal volume.
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