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Automated Volumetry of Medial Temporal Lobe Subregions in Mild Cognitive Impairment and Alzheimer Disease

Hata, Kaori MD*,†,‡; Nakamoto, Kazunori PhD§; Nunomura, Akihiko MD, PhD∥,¶; Sone, Daichi MD, PhD*; Maikusa, Norihide PhD*; Ogawa, Masayo MSc*; Sato, Noriko MD, PhD#; Matsuda, Hiroshi MD, PhD*

Alzheimer Disease & Associated Disorders: July–September 2019 - Volume 33 - Issue 3 - p 206–211
doi: 10.1097/WAD.0000000000000318
Original Articles

Purpose: Hippocampal subfield volumetry should be more useful than whole hippocampal (WH) volumetry for diagnosing Alzheimer disease (AD). This study sought to confirm this.

Methods: We investigated cognitively normal (CN) participants and patients with mild cognitive impairment (MCI) or AD using high-resolution T2-weighted and 3-dimensional T1-weighted magnetic resonance imaging. Using medial temporal subregion volumetry, we investigated discriminative power for MCI and AD versus CN.

Patients: We recruited 30 CN participants, 30 amnestic MCI patients, and 49 AD patients between April 2015 and October 2016.

Results: For AD, discriminative power of the combined volumes of the subiculum, entorhinal cortex, and cornu ammonis 1 was highest [area under the curve (AUC)=0.915; 85.7% sensitivity, 86.7% specificity, 86.1% accuracy], and was significantly higher than that of the WH volume (AUC=0.887; 90.0% sensitivity, 75.5% specificity, 84.5% accuracy) (P=0.019). For MCI, discriminative power of the subiculum volume was highest (AUC=0.747; 80.0% sensitivity, 73.3% specificity, 76.7% accuracy), but was only slightly higher than that of the WH volume (AUC=0.730; 56.7% sensitivity, 90.0% specificity, 73.3% accuracy).

Conclusions: Using the combined volumes of the subiculum, entorhinal cortex, and cornu ammonis 1 may enable greater diagnostic accuracy compared with the WH volume or any single subfield in AD patients.

*Integrative Brain Imaging Center

#Department of Radiology, National Center of Neurology and Psychiatry

Department of Psychiatry, Inokashira Hospital

Department of Psychiatry, Jikei University School of Medicine, Tokyo

Division of Advanced Medical Science, Interdisciplinary Graduate School of Medicine and Engineering

§Center for Medical Education and Sciences, Faculty of Medicine

Department of Neuropsychiatry, Graduate School of Medical Science, University of Yamanashi, Yamanashi, Japan

Supported by an Intramural Research Grant (27-9) for Neurological and Psychiatric Disorders from the National Center of Neurology and Psychiatry.

The authors declare no conflicts of interest.

Reprints: Hiroshi Matsuda, MD, PhD, Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8511, Japan (e-mail:

Received October 25, 2018

Accepted March 18, 2019

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