In vivo Analysis of Hippocampal Subfield Atrophy in Mild Cognitive Impairment via Semi-Automatic Segmentation of T2-Weighted MRI
Journal of Alzheimer's Disease
The measurement of hippocampal volumes using MRI is a useful in-vivo biomarker for detection and monitoring of early Alzheimer's Disease (AD), including during the amnestic Mild Cognitive Impairment (a-MCI) stage. The pathology underlying AD has regionally selective effects within the hippocampus. As such, we predict that hippocampal subfields are more sensitive in discriminating prodromal AD (i.e., a-MCI) from cognitively normal controls than whole hippocampal volumes, and attempt to
... e this using a semi-automatic method that can accurately segment hippocampal subfields. High-resolution coronal-oblique T2-weighted images of the hippocampal formation were acquired in 45 subjects (28 controls and 17 a-MCI (mean age: 69.5 ± 9.2; 70.2 ± 7.6)). CA1, CA2, CA3, and CA4/DG subfields, along with head and tail regions, were segmented using an automatic algorithm. CA1 and CA4/DG segmentations were manually edited. Whole hippocampal volumes were obtained from the subjects' T1-weighted anatomical images. Automatic segmentation produced significant group differences in the following subfields: CA1 (left: p=0.001, right: p=0.038), CA4/DG (left: p=0.002, right: p=0.043), head (left: p=0.018, right: p=0.002), and tail (left: p=0.019). After manual correction, differences were increased in CA1 (left: p<0.001, right: p=0.002), and reduced in CA4/DG (left: p=0.029, right: p=0.221). Whole hippocampal volumes significantly differed bilaterally (left: p=0.028, right: p=0.009). This pattern of atrophy in a-MCI is consistent with the topography of AD pathology observed in postmortem studies, and corrected left CA1 provided stronger discrimination than whole hippocampal volume (p=0.03). These results suggest that semiautomatic segmentation of hippocampal subfields is efficient and may provide additional sensitivity beyond whole hippocampal volumes.