Introduction: 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).
Methods: 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-).
Results: HS+ participants (N = 27, 14%) showed atrophied cornu ammonis 1 (CA1; left P < .001, ηp2 = 0.14; right P = .001, ηp2 = 0.09) and subiculum (left P < .001, ηp2 = 0.139; right P = .001, ηp2 = 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, ηp2 = 0.235; right P = .002, ηp2 = 0.137) and CA1 (left P < .001, ηp2 = 0.137; right P = .006, ηp2 = 0.070).
Discussion: Subiculum and CA1 atrophy from clinical MRI may be a promising in vivo biomarker for HS.
Keywords: Alzheimer's disease; CA1; atrophy; dementia; hippocampal sclerosis of aging; hippocampus; magnetic resonance imaging; subiculum.
© 2020 the Alzheimer's Association.