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Volumes of Entorhinal Cortex and Hippocampus in Mild Cognitive Impairment and Alzheimer ’ s Disease

INTRODUCTION: Autopsy studies of brains from patients with Alzheimer’s disease (AD) indicate early pathology in entorhinal cortex (ERC) progressing to hippocampus (HP). MRI studies of AD showed volume loss in ERC and HP compared with cognitively normal subjects (CN) (1). MRI measurements of ERC improved discrimination of early AD from CN, compared to measurements of HP (2), indicating that ERC may be a more sensitive marker of AD than HP. However, another study did not show an advantage of ERC over HP measurement (1). ERC has not been measured in nondemented patients with mild cognitive impairment (MCI) thought to precede the diagnosis of AD. Therefore, the major purpose of this study was to measure and compare ERC and HP volumes in MCI subjects, who are known to have an increased risk for AD. Furthermore, we measured the relationship between ERC and HP volumes in AD, MCI, and CN. Our specific goals were to determine if: 1) ERC volume is significantly reduced in MCI compared to CN; 2) ERC is more sensitive than HP to distinguish AD or MCI from CN; 3) ERC and HP volume loss are correlated in MCI and AD. Finally, we explored whether ERC provided a better classification between the groups than HP, and the value of using ERC and HP together for classification.