Minimal atrophy of the entorhinal cortex and hippocampus: Progression of cognitive impairment

Daniel Varon, David A. Loewenstein, Elizabeth Potter, Maria T. Greig, Joscelyn Agron, Qian Shen, Weizhao Zhao, Maria Celeste Ramirez, Isael Santos, Warren Barker, Huntington Potter, Ranjan Duara

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Background: In Alzheimer's disease, neurodegenerative atrophy progresses from the entorhinal cortex (ERC) to the hippocampus (HP), limbic system and neocortex. The significance of very mild atrophy of the ERC and HP on MRI scans among elderly subjects is unknown. Methods: A validated visual rating system on coronal MRI scans was used to identify no atrophy of the HP or ERC (HP 0; ERC0), or minimal atrophy of the HP or ERC (HP ma; ERCma), among 414 participants. Subjects fell into the following groups: (1) ERC0/HP0, (2) ERC ma/HP0, (3) ERC0/HPma, and (4) ERCma/HPma. HP volume was independently measured using volumetric methods. Results: In comparison to ERC0/HP0 subjects, those with ERC0/HPma had impairment on 1 memory test, ERCma/HP0 subjects had impairment on 2 memory tests and the Mini Mental State Examination (MMSE), while ERCma/HP ma subjects had impairment on 3 memory tests, the MMSE and Clinical Dementia Rating. Progression rates of cognitive and functional impairment were significantly greater among subjects with ERCma. Conclusion: Minimal atrophy of the ERC results in greater impairment than minimal atrophy of the HP, and the combination is additive when measured by cognitive and functional tests. Rates of progression to greater impairment were higher among ERC ma subjects.

Original languageEnglish (US)
Pages (from-to)276-283
Number of pages8
JournalDementia and Geriatric Cognitive Disorders
Issue number4
StatePublished - May 2011


  • Alzheimer disease
  • Brain MRI
  • Cognitive and functional impairment
  • Dementia
  • Entorhinal and hippocampal atrophy
  • Progression
  • Visual rating

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Geriatrics and Gerontology
  • Cognitive Neuroscience


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