Characterizing the MRI signature of hippocampal sclerosis of aging.
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Rådman Gustaf, Denning Amanda E, Ravikumar Sadhana, Spotorno Nicola, Ittyerah Ranjit, Levorse Lisa M, Robinson John L, Schuck Theresa, Lim Sydney A, Chung Eunice, Bedard Madigan, Trotman Winifred, Bahena Alejandra, Del Mar Arroyo-Jiménez María, Vela Alicia, Buendia Esther, de Onzoño Martin Maria Mercedes Iñiguez, Rabal María Pilar Marcos, Muñoz-López Mónica, Olsen Rosanna K, Detre John A, Lee Edward B, Wolk David A, Ohm Daniel T, McMillan Corey T, Insausti Ricardo, Irwin David J, Yushkevich Paul A, Wisse Laura E M, Alzheimer’s Disease Neuroimaging Initiative
Аннотация
METHODS: HS-A (N = 5), ADNC (N = 10), and limited/no pathology (N = 12) cases were compared on postmortem MRI signatures: manually measured cornu ammonis (CA)1/subiculum thickness, grey matter signal intensity, and automated hippocampal subfield thickness metrics. Similar metrics were obtained in T1-weighted antemortem MRI in an initial dataset (HS-A = 4, ADNC = 7, limited/no pathology = 25) for group differences and discrimination (HS-A vs ADNC). T1-weighted metrics were then evaluated in a second dataset (HS-A = 6, ADNC = 18) and in a pooled post-hoc analysis combining HS-A and ADNC cases from both datasets (NHS-A = 10, NADNC = 25).
RESULTS: Postmortem MRI showed hippocampal thinning and grey matter hypointensity in HS-A at the CA1-subiculum junction more severe than in ADNC and limited/no pathology cases. In antemortem MRI, differentiating HS-A and ADNC based on anterior/posterior manual measures of CA1/subiculum thickness and hippocampal volumes displayed good discrimination in dataset 1, but lower discriminative performance in dataset 2. In complementary analyses pooling both datasets and adjusting for age, manual thickness achieved good performance (area under the curve (AUC) = 0.80-0.87), while anterior, posterior, and whole hippocampal volumes showed excellent discrimination (AUC = 0.94-0.98).
LIMITATIONS: The study included a relatively small and neuropathologically heterogeneous sample. The final antemortem analyses were exploratory, reflecting challenges in replicating findings across independent datasets. Classification was limited to HS-A and ADNC, leaving it uncertain how the metrics perform when comparing HS-A with other diagnostic groups. HS-A diagnoses were determined postmortem, often several years after MRI, and most measures relied on standard imaging sequences with limited resolution to assess fine-grained hippocampal subfields.
CONCLUSIONS: HS-A displays distinct changes in the hippocampus that are detectable through structural MRI. Associated quantifiable MRI metrics may serve as promising tools in aiding antemortem HS-A diagnosis but require further validation in larger cohorts and against other dementia-related diseases.