Hippocampal size may contribute to prospective diagnosis of age-related dementia


Dr Tomoyuki Nishizaki, MD, PhD, Department of Neurophysiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Japan. Email: tomoyuki@hyo-med.ac.jp


Background:  The hippocampus is a center of cognitive function and therefore hippocampal atrophy is the major factor in cognitive decline. Analysis of hippocampal size may make it possible to predict progression in cognitive impairment. To address this point, the present study investigated the relationship between hippocampal atrophy and dementia using magnetic resonance (MR) images and the Hasegawa Dementia Scale-Revised (HDS-R).

Methods:  The present study was performed on 274 subjects (14–97 years old; average, 66 years; 106 male and 168 female) who had no focal neurological deficit. Hippocampal area and whole brain area were measured in three series of coronal MR images taken from a 5-mm slice rostrally along dorsal edge of the pons, and hippocampal size normalized by calculating summated hippocampal areas as percentages of summated whole brain areas. Dementia was screened for using HDS-R.

Results:  Hippocampal size decreased and HDS-R reduced with age. Hippocampal atrophy was highly correlated with cognitive deterioration; a critical normalized hippocampal size for HDS-R of less than 20, which corresponds with mild cognitive impairment and dementia, was found in 65% of over 60-years old subjects and 98% of subjects with HDS-R of less than 20 were over 60 years old.

Conclusion:  There is a high probability that over 60-year-old people with a normalized hippocampal size of less than 1.0 would develop dementia in the future, even though their HDS-R might presently be over 20. Measurement of hippocampal size with coronal MR imaging may therefore contribute to prospective diagnoses of age-related dementia.