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Neurology. 2001 Nov 13;57(9):1669-74.

Beyond the hippocampus: MRI volumetry confirms widespread limbic atrophy in AD.

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  • 1Cognitive Neurology Unit and Research Program in Aging, Sunnybrook & Women's College Health Sciences Centre, Toronto, ON, Canada.

Abstract

OBJECTIVE:

To examine volumetric changes in limbic structures in patients with probable AD using planimetric measures on MRI.

METHOD:

Limbic structures (i.e., hippocampus, amygdala, anterior thalamus, hypothalamus, mamillary bodies, basal forebrain, septal area, fornix, and cingulate, orbitofrontal, and parahippocampal cortices) were traced on 3D T1-weighted MR images of 40 patients with mild to moderate AD and 40 age-, sex-, and education-matched normal control subjects. Limbic volumes were compared between groups and the predictive ability was assessed.

RESULTS:

Overall, limbic structures showed significant atrophy in AD patients compared with normal control subjects. Differences (p < 0.05) were found in all limbic regions except the anterior cingulate cortex. The greatest percentage volumetric losses occurred in the septal area (34%), hippocampus (28%), amygdala (21%), parahippocampal cortex (21%), and posterior cingulate cortex (20%). Combining volumetric measures of amygdala and septal area distinguished patients with AD from normal control subjects with 93% accuracy.

CONCLUSIONS:

These results verify that system-wide limbic degeneration occurs in patients with AD. In addition, atrophy in selected limbic structures was used to distinguish patients with AD from normal elderly individuals with over 90% accuracy in this select clinical sample. The measures require further exploration in samples more representative of those seen by primary care physicians before their utility can be accurately assessed.

PMID:
11706109
[PubMed - indexed for MEDLINE]
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