Skip to main content
Log in

Volumes of hippocampus, amygdala and frontal lobes in the MRI-based diagnosis of early Alzheimer's disease: Correlation with memory functions

  • Full Papers
  • Published:
Journal of Neural Transmission - Parkinson's Disease and Dementia Section

Summary

We studied the usefulness of measuring volumes of the hippocampus, amygdala and frontal lobes with coronal magnetic resonance imaging (MRI) scans in the diagnosis of early Alzheimer's disease (AD). We examined 32 patients diagnosed according to the NINCDS-ADRDA criteria of probable AD and 16 age-matched healthy cognitively normal controls. The AD patients had mild dementia with a mean score of 22.8 in the Mini-Mental Status Examination (MMSE). We used a 1.5T magnetic resonance imager and normalized the volumes for brain area. The AD patients had significantly smaller volumes of the right and the left hippocampus (−38%) (ANOVA, p<0.001) and the left frontal lobe (−16%, p<0.05) compared to controls. The reductions in volumes of the right frontal lobe (−13%), the right amygdala (−14%) or the left amygdala (−18%) were not statistically significant. In the discriminant function analysis which included the volumes of the hippocampus, amygdala, and the frontal lobes and age, the volumes of the left and right hippocampus, the left and right frontal lobe, and the right amygdala entered the model and we could correctly classify 92% of the subjects into AD and control groups (Chi-square 42.6, df 5, p<0.0001). By using the volumes of the hippocampus, the frontal lobes or the amygdala on their alone, the correct classification was achieved in 88%, 65% and 58% of the subjects, respectively. In addition, in AD patients the volumes of the left hippocampus correlated significantly with the MMSE score and with immediate and delayed verbal memory; the smaller the volume the more impaired was their performance. Our data indicate that measurements of volumes of the hippocampus might be useful in diagnosis of early AD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Borkowski JG, Benton AL, Spreen O (1967) Word fluency and brain damage. Neuropsychologia 5: 135–140

    Google Scholar 

  • Bottomley PA, Cousins JP, Pendrey DL, Wagle WA, Hardy CJ, Eames FA, McCaffrey RJ, Thompson DA (1992) Alzheimer dementia: quantification of energy metabolism and mobile phosphoesters with P-31 NMR spectroscopy. Radiology 183: 695–699

    Google Scholar 

  • Bronen RA, Cheung G (1991a) MRI of the temporal lobe: normal variations, with special reference toward epilepsy. Magn Reson Imaging 9: 501–507

    Google Scholar 

  • Bronen RA, Cheung G (1991b) Relationship of hippocampus and amygdala to coronal MRI landmarks. Magn Reson Imaging 9: 449–457

    Google Scholar 

  • Coffey CE, Wilkinson WE, Parashos IA, Soady SAR, Sullivan RJ, Patterson LJ, Figiel GS, Webb MC, Spritzer CE, Djang WT (1992) Quantitative cerebral anatomy of the aging human brain: a cross-sectional study using magnetic resonance imaging. Neurology 42: 527–536

    Google Scholar 

  • Cuénod CA, Denys A, Michot JL, Jehenson P, Forette F, Kaplan D, Syrota A, Boller F (1993) Amygdala atrophy in Alzheimer's disease. Arch Neurol 50: 941–945

    Google Scholar 

  • Dahlbeck SW, McCluney KW, Yeakley JW, Fenstermacher MJ, Bonmati C, Van Horn III G, Aldag J (1991) The interuncal distance: a new MR measurement for the hippocampal atrophy of Alzheimer's disease. AJNR 12: 931–932

    Google Scholar 

  • Davis PC, Gray L, Albert M, Wilkinson W, Hughes J, Heyman A, Gado M, Kumar AJ, Destian S, Lee C, Duvall E, Kido D, Nelson MJ, Bello J, Weathers S, Jolesz F, Kikinis R, Brooks M (1992) The Consortium to Establish a Registry for Alzheimer's Disease (CERAD), part III. Reliability of standardized MRI evaluation of Alzheimer's disease. Neurology 42: 1676–1680

    Google Scholar 

  • DeArmond SJ, Fusco MM, Dewey MM (1989) Structure of the human brain. A photographic atlas, 3rd ed. Oxford University Press, New York

    Google Scholar 

  • DeCarli C, Kaye JA, Horwitz B, Rapoport SI (1990) Critical analysis of the use of computer-assisted transverse axial tomography to study human brain in aging and dementia of the Alzheimer type. Neurology 40: 872–883

    Google Scholar 

  • Doraiswamy PM, McDonald WM, Patterson L, Husain MM, Figiel GS, Boyko OB, Krishnan KR (1993) Interuncal distance as a measure of hippocampal atrophy: normative data on axial MR imaging. AJNR 14: 141–143

    Google Scholar 

  • Duvernoy HM (1988) The human hippocampus: an atlas of applied anatomy. J.F. Bergmann, Munich

    Google Scholar 

  • Erkinjuntti T, Lee DH, Gao F, Steenhuis R, Eliasziw M, Fry R, Merskey H, Hachinski V (1993) Temporal lobe atrophy on magnetic resonance imaging in the diagnosis of early Alzheimer's disease. Arch Neurol 50: 305–310

    Google Scholar 

  • Folstein MF, Folstein SE, McHugh PR (1975) “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12: 189–198

    Google Scholar 

  • Goodglass H, Kaplan E (1972) The assessment of aphasia and related disorders. Lea and Febiger, Philadelphia

    Google Scholar 

  • Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23: 56–62

    Google Scholar 

  • Haxby JV, Grady CL, Duara R, Schlageter N, Berg G, Rapoport SI (1986) Neocortical metabolic abnormalities precede nonmemory cognitive defects in early Alzheimer'stype dementia. Arch Neurol 43: 882–885

    Google Scholar 

  • Helkala E-L, Laulumaa V, Soininen H, Riekkinen PJ (1988) Recall and recognition on memory in patients with Alzheimer's and Parkinson's diseases. Ann Neurol 24: 214–217

    Google Scholar 

  • Huesgen CT, Burger PC, Crain BJ, Johnson GA (1993) In vitro MR microscopy of the hippocampus in Alzheimer's disease. Neurology 43: 145–152

    Google Scholar 

  • Hyman BT, Damasio AR, VanHoesen GW, Barnes CL (1984) Alzheimer's disease: cell-specific pathology isolates the hippocampal formation. Science 225: 1168–1170

    Google Scholar 

  • Jack CR, Sharbrough FW, Colleen KT, Cascino GD, Hirschorn KA, Marsh WR, Zinsmeister AR, Scheithauer B (1990) Temporal lobe seizures: lateralization with MR volume measurements of the hippocampal formation. Radiology 175: 423–429

    Google Scholar 

  • Jack CR Jr, Petersen RC, O'Brien PC, Tangalos EG (1992) MR-based hippocampal volumetry in the diagnosis of Alzheimer's disease. Neurology 42: 183–188

    Google Scholar 

  • Jernigan TJ, Archibald SL, Berhow MT, Sowell ER, Foster DS, Hesselink JR (1991) Cerebral structure on MRI, part I. Localization of age-related changes. Biol Psychiatry 29: 55–67

    Google Scholar 

  • Kaplan E, Goodglass H, Weintraub S (1983) The Boston naming test. Lea and Febiger, Philadelphia

    Google Scholar 

  • Kesslak JP, Nalcioglu O, Cotman CW (1991a) Quantification of magnetic resonance scans for hippocampal and parahippocampal atrophy in Alzheimer's disease. Neurology 41: 51–54

    Google Scholar 

  • Kesslak JP, Nalcioglu O, Cotman W (1991b) MRI quantification (a letter). Neurology 41: 954

    Google Scholar 

  • Killiany RJ, Moss MB, Albert MS, Sandor T, Tieman J, Jolesz F (1993) Temporal lobe regions on magnetic resonance imaging identify patients with early Alzheimer's disease. Arch Neurol 50: 949–954

    Google Scholar 

  • Kirsch SJ, Jacobs RW, Butcher LL, Beatty J (1992) Prolongation of magnetic resonance T2 time in hippocampus of human patients marks the presence and severity of Alzheimer's disease. Neurosci Lett 134: 187–190

    Google Scholar 

  • Klunk WE, Panchalingam K, Moossy J, McClue RJ, Pettegrew JW (1992) N-acetyl-L-aspartate and other amino acid metabolites in Alzheimer's disease brain: a preliminary proton nuclear magnetic resonance study. Neurology 42: 1578–1585

    Google Scholar 

  • Krishnan KRR, Husain MM, McDonald WM, Doraiswamy PM (1990) In vivo stereological assessment of caudate nuclei volume with MRI: effect of normal aging. Life Sci 47: 1325–1329

    Google Scholar 

  • Longo R, Giorgini A, Magnaldi S, Pascazio L, Ricci C (1993) Alzheimer's disease histologically proven studied by MRI and MRS: two cases. Magn Reson Imaging 11: 1209–1215

    Google Scholar 

  • McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM (1984) Clinical diagnosis of Alzheimer's disease: report of NINCDS/ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's disease. Neurology 34: 939–944

    Google Scholar 

  • Millber WP, Hebben N, Kaplan E (1986) The Boston process approach to neuropsychological assessment. In: Grant I, Adams KM (eds) Neuropsychological assessment of neuropsychiatric disorders. Oxford University Press, New York, pp 65–86

    Google Scholar 

  • Miller LA, Munoz DG, Finmore M (1993) Hippocampal sclerosis and human memory. Arch Neurol 50: 391–394

    Google Scholar 

  • Murphy DGM, DeGarli C, Schapiro MB, Rapoport SI, Horwitz B (1992) Age-related differences in volumes of subcortical nuclei, brain matter and cerebrospinal fluid in healthy men as measured with magnetic resonance imaging. Arch Neurol 49: 839–845

    Google Scholar 

  • Naidich TP, Daniels DL, Haughton VM, Williams A, Pojunas K, Palacios E (1987) Hippocampal formation and related structures of the limbic lobe: anatomic-MR correlation. Radiology 162: 747–754

    Google Scholar 

  • Nelson HE (1976) A modified card sorting test sensitive to frontal lobe defects. Cortex 12: 313–324

    Google Scholar 

  • Pearlson GD, Gordon JH, Powers RE, Barta PE, Camargo EE, Chase GA, Noga JT, Tune LE (1992) Quantitative changes in mesial temporal volume, regional cerebral blood flow, and cognition in Alzheimer's disease. Arch Gen Psychiatry 49: 402–408

    Google Scholar 

  • Press GA, Amaral DG, Squire LR (1989) Hippocampal abnormalities in amnesic patients revealed by high-resolution magnetic resonance imaging. Nature 341: 54–57

    Google Scholar 

  • Reisberg B, Schenck MK, Ferris SH (1983) The brief cognitive rating scale (BCRS): findings in primary degenerative dementia (PDD). Psychopharmacol Bull 19: 734–739

    Google Scholar 

  • Reitan RM (1958) Validity of the Trail Making test as an indicator of organic brain damage. Perc Mot Skills 8: 271–276

    Google Scholar 

  • Rosen WG, Terry RD, Fuld PA, Katzman R, Beck A (1980) Pathological verification of ischemic score in differentiation of dementias. Ann Neurol 17: 486–488

    Google Scholar 

  • Russel FW (1975) A multiple scoring method for the assessment of complex memory functions. J Cons Clin Psychology 43: 800–809

    Google Scholar 

  • Scott SA, DeKosky ST, Scheff W (1991) Volumetric atrophy in Alzheimer's disease: quantitative serial reconstruction. Neurology 41: 351–356

    Google Scholar 

  • Seab JP, Jagust WJ, Wong STS, Roos MS, Reed BR, Budinger TF (1988) Quantitative NMR measurements of hippocampal atrophy in Alzheimer's disease. Magn Reson Med 8: 200–208

    Google Scholar 

  • Soininen H, Partanen K, Pitkänen A, Vainio P, Hänninen T, Hallikainen M, Koivisto K, Riekkinen PJ Sr (1994) Volumetric MRI analysis of the amygdala and the hippocampus in subjects with age-associated memory impairment: correlation to visual and verbal memory. Neurology 44: 1660–1668

    Google Scholar 

  • Squire LR, Ojeman JG, Miezin FM, Petersen SE, Videen TO, Raichle ME (1992) Activation of the hippocampus in normal humans: a functional anatomical study of memory. Proc Natl Acad Sci USA 89: 1837–1841

    Google Scholar 

  • Suddath RL, Christinson GW, Torrey EF, Casanova MF, Weinberger DR (1990) Anatomic anomalies in the brains of monozygotic twins discordant for schizophrenia. N Engl J Med 322: 789–794

    Google Scholar 

  • Sulkava R, Haltia M, Paetau A, Wikström J, Palo J (1983) Accuracy of clinical diagnosis in primary degenerative dementia: correlation with neuropathological findings. J Neurol Neurosurg Psychiatry 46: 9–13

    Google Scholar 

  • Tien RD, Felsberg GJ, Crain B (1992) Normal anatomy of the hippocampus and adjacent temporal lobe: high resolution fast spin echo MR images in volunteers correlated with cadaveric histologic sections. AJR 159: 1309–1313

    Google Scholar 

  • Watson C, Andermann F, Gloor P, Jones-Gotman M, Peters T, Evans A, Olivier A, Melanson D, Leroux G (1992) Anatomical basis of amygdaloid and hippocampal volume measurement by magnetic resonance imaging. Neurology 42: 1743–1750

    Google Scholar 

  • Webster DD (1968) Clinical analysis of the disability on Parkinson's disease. Mod Treat 5: 257–262

    Google Scholar 

  • Wechsler D (1981) WAIS-R Manual. Psychological Corporation, New York

    Google Scholar 

  • West MJ, Coleman PD, Flood DG, Troncoso JC (1994) Differences in the pattern of hippocampal neuronal loss in normal aging and Alzheimer's disease. Lancet 344: 769–772

    Google Scholar 

  • Zola-Morgan S, Squire LR, Mishkin M (1982) The neuroanatomy of amnesia: amygdalahippocampus vs temporal stem. Science 218: 1337–1339

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Laakso, M.P., Soininen, H., Partanen, K. et al. Volumes of hippocampus, amygdala and frontal lobes in the MRI-based diagnosis of early Alzheimer's disease: Correlation with memory functions. J Neural Transm Gen Sect 9, 73–86 (1995). https://doi.org/10.1007/BF02252964

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02252964

Keywords

Navigation