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Small baseline volume of left hippocampus is associated with subsequent conversion of MCI into dementia. The Göteborg MCI study.

Journal article
Authors Carl Eckerström
Erik Olsson
Magnus Borga
Sven Ekholm
Susanne Ribbelin
Sindre Rolstad
Göran Starck
Åke Edman
Anders Wallin
Helge Malmgren
Published in Journal of the Neurological Sciences
Volume 272
Issue 1-2
Pages 48-59
ISSN 0022-510X
Publication year 2008
Published at Institute of Clinical Sciences, Department of Radiation Physics
Institute of Neuroscience and Physiology
Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry
Institute of Biomedicine
Department of Philosophy
Pages 48-59
Language en
Keywords Dementia, Alzheimer's disease, Vascular dementia, Mild cognitive impairment (MCI), Volumetric MRI, Hippocampus, Brain asymmetries
Subject categories Diagnostic radiology, Psychiatry


Background: Earlier studies have reported that hippocampal atrophy can to some extent predict which patients with mild cognitive impairment (MCI) will subsequently convert to dementia, and that converters have an enhanced rate of hippocampal volume loss. Objective: To further validate the hypothesis that hippocampal atrophy predicts conversion from MCI to dementia, to relate baseline hippocampal volume to different forms of dementia, and to investigate the role of hippocampal side differences and rate of volume loss over time. Patients: The subjects (N = 68) include patients with MCI at baseline and progression to dementia at the two-year follow-up (N = 21), stable MCI patients (N = 21), and controls (N = 26). Among the progressing patients, 13 were diagnosed as having AD. Methods: The Göteborg MCI study is a clinically based longitudinal study with biannual clinical assessments. Hippocampal volumetry was performed manually on the MRI investigations at baseline and at the two-year follow-up. Results: Hippocampal volumetry could predict conversion to dementia in both the AD and the non-AD subgroup of converters. Left hippocampal volume in particular discriminated between converting and stable MCI. Cut off points for individual discrimination were shown to be potentially useful. The converting MCI group had a significantly higher rate of hippocampal volume loss as compared to the stable MCI group. Conclusions: In MCI patients, hippocampal volumetry at baseline gives prognostic information about possible development of AD and non-AD dementia. Contrary to earlier studies, we found that left hippocampal volume has the best predictive power. Reliable predictions appear to be possible in many individual cases.

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