INTRODUCTION: Measurement of an- hippocampal area or volume is useful in clinical practice as a supportive aid for diagnosis of Alzheimer's disease. Since it is time-consuming and not simple, it is not being used very often. We present a simplified protocol for hippocampal atrophy evaluation based on a single optimal slice in Alzheimer's disease. METHODS: We defined a single optimal slice for hippocampal measurement on brain magnetic resonance imaging (MRI) at the plane where the amygdala disappears and only the hippocampus is present. We compared an absolute area and volume of the hippocampus on this optimal slice between 40 patients with Alzheimer disease and 40 age-, education- and gender-mateched elderly controls. Furthermore, we compared these results with those relative to the size of the brain or the skull: the area of the optimal slice normalized to the area of the brain at anterior commissure and the volume of the hippocampus normalized to the total intracranial volume. RESULTS: Hippocampal areas on the single optimal slice and hippocampal volumes on the left and right in the control group were significantly higher than those in the AD group. Normalized hippocampal areas and volumes on the left and right in the control group were significantly higher compared to the AD group. Absolute hippocampal areas and volumes did not significantly differ from corresponding normalized hippocampal areas as well as normalized hippocampal volumes using comparisons of areas under the receiver operating characteristic curves. CONCLUSION: The hippocampal area on the well-defined optimal slice of brain MRI can reliably substitute a complicated measurement of the hippocampal volume. Surprisingly, brain or skull normalization of these variables does not add any incremental differentiation between Alzheimer disease patients and controls or give better results.

Department of Anatomy 3rd Faculty of Medicine Charles University Prague Czech Republic

Department of Neurology 3rd Faculty of Medicine University Hospital Kralovske Vinohrady Charles University Prague Czech Republic

Department of Surgery and Translational Medicine Neurosurgery Unit Florence School of Neurosurgery University of Florence Florence Italy

Institute of clinical Clinical and Experimental Medicine Prague Czech Republic

National Institute of Mental Health Topolová 748 250 67 Klecany Czech Republic

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Harper L., Barkhof F., Fox N. C., Schott J. M. Using visual rating to diagnose dementia: a critical evaluation of MRI atrophy scales. Journal of Neurology, Neurosurgery & Psychiatry. 2015;86(11):1225–1233. doi: 10.1136/jnnp-2014-310090. PubMed DOI

Bigler E. D., Blatter D. D., Anderson C. V., et al. Hippocampal volume in normal aging and traumatic brain injury. AJNR. American Journal of Neuroradiology. 1997;18(1):11–23. PubMed PMC

Bartos A., Gregus D., Ibrahim I., Tintěra J. Brain volumes and their ratios in Alzheimer´s disease on magnetic resonance imaging segmented using Freesurfer 6.0. Psychiatry Research: Neuroimaging. 2019;287:70–74. doi: 10.1016/j.pscychresns.2019.01.014. PubMed DOI

Giesel F. L., Hahn H. K., Thomann P. A., et al. Temporal horn index and volume of medial temporal lobe atrophy using a new semiautomated method for rapid and precise assessment. AJNR. American Journal of Neuroradiology. 2006;27(7):1454–1458. PubMed PMC

Giesel F. L., Thomann P. A., Hahn H. K., et al. Comparison of manual direct and automated indirect measurement of hippocampus using magnetic resonance imaging. European Journal of Radiology. 2008;66(2):268–273. doi: 10.1016/j.ejrad.2007.06.009. PubMed DOI

Menendez-Gonzalez M., de Celis A. B., Salas-Pacheco J., Arias-Carrion O. Structural neuroimaging of the medial temporal lobe in Alzheimer's disease clinical trials. Journal of Alzheimer's Disease. 2015;48(3):581–589. doi: 10.3233/JAD-150226. PubMed DOI

Menéndez-González M., López-Muñiz A., Vega J. A., Salas-Pacheco J. M., Arias-Carrión O. MTA index: a simple 2D-method for assessing atrophy of the medial temporal lobe using clinically available neuroimaging. Frontiers in Aging Neuroscience. 2014;6:p. 23. doi: 10.3389/fnagi.2014.00023. PubMed DOI PMC

Menendez-Gonzalez M., Suarez-Sanmartin E., Garcia C., Martinez-Camblor P., Westman E., Simmons A. Manual planimetry of the medial temporal lobe versus automated volumetry of the hippocampus in the diagnosis of Alzheimer's disease. Cureus. 2016;26(8, article e544) doi: 10.7759/cureus.544. PubMed DOI PMC

Schoemaker D., Buss C., Pietrantonio S., et al. The hippocampal-to-ventricle ratio (HVR): presentation of a manual segmentation protocol and preliminary evidence. Neuroimage. 2019;203, article 116108 doi: 10.1016/j.neuroimage.2019. PubMed DOI

Geroldi C., Akkawi N. M., Galluzzi S., et al. Temporal lobe asymmetry in patients with Alzheimer’s disease with delusions. Journal of Neurology, Neurosurgery & Psychiatry. 2000;69(2):187–191. doi: 10.1136/jnnp.69.2.187. PubMed DOI PMC

Thompson P. M., Hayashi K. M., De Zubicaray G. I., et al. Mapping hippocampal and ventricular change in Alzheimer disease. NeuroImage. 2004;22(4):1754–1766. doi: 10.1016/j.neuroimage.2004.03.040. PubMed DOI

Bartos A., Raisova M. The Mini-Mental State Examination: Czech norms and cutoffs for mild dementia and mild cognitive impairment due to Alzheimer's disease. Dementia and Geriatric Cognitive Disorders. 2016;42(1-2):50–57. doi: 10.1159/000446426. PubMed DOI

McKhann G. M., Knopman D. S., Chertkow H., et al. The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer’s and Dementia. 2011;7(3):263–269. doi: 10.1016/j.jalz.2011.03.005. PubMed DOI PMC

Fischl B., Salat D. H., Busa E., et al. Whole brain segmentation: automated labeling of neuroanatomical structures in the human brain. Neuron. 2002;33(3):341–355. doi: 10.1016/S0896-6273(02)00569-X. PubMed DOI

Reuter M., Schmansky N. J., Rosas H. D., Fischl B. Within-subject template estimation for unbiased longitudinal image analysis. NeuroImage. 2012;61(4):1402–1418. doi: 10.1016/j.neuroimage.2012.02.084. PubMed DOI PMC

Malone I. B., Leung K. K., Clegg S., et al. Accurate automatic estimation of total intracranial volume: a nuisance variable with less nuisance. NeuroImage. 2015;104:366–372. doi: 10.1016/j.neuroimage.2014.09.034. PubMed DOI PMC

Sargolzaei S., Sargolzaei A., Cabrerizo M., et al. A practical guideline for intracranial volume estimation in patients with Alzheimer's disease. BMC Bioinformatics. 2015;16(S7):p. S8. doi: 10.1186/1471-2105-16-S7-S8. PubMed DOI PMC

Fung Y. L., Ng K. E. T., Vogrin S. J., et al. Comparative utility of manual versus automated segmentation of hippocampus and entorhinal cortex volumes in a memory clinic sample. Journal of Alzheimer's Disease. 2019;68(1):159–171. doi: 10.3233/JAD-181172. PubMed DOI

Takashima A., Petersson K. M., Rutters F., et al. Declarative memory consolidation in humans: a prospective functional magnetic resonance imaging study. Proceedings of the National Academy of Sciences of the United States of America. 2006;103(3):756–761. doi: 10.1073/pnas.0507774103. PubMed DOI PMC

Porter B. S., Schmidt R., Bilkey D. K. Hippocampal place cell encoding of sloping terrain. Hippocampus. 2018;28(11):767–782. doi: 10.1002/hipo.22966. PubMed DOI PMC

Li F., Takechi H., Saito R., et al. A comparative study: visual rating scores and the voxel-based specific regional analysis system for Alzheimer's disease on magnetic resonance imaging among subjects with Alzheimer's disease, mild cognitive impairment, and normal cognition. Psychogeriatrics. 2019;19(2):95–104. doi: 10.1111/psyg.12370. PubMed DOI

Estévez-Santé S., Jiménez-Huete A., ADNI group Comparative analysis of methods of volume adjustment in hippocampal volumetry for the diagnosis of Alzheimer disease. Journal of Neuroradiology. 2020;47(2):161–165. doi: 10.1016/j.neurad.2019.02.004. PubMed DOI

Hu X., Meiberth D., Newport B., Jessen F. Anatomical correlates of the neuropsychiatric symptoms in Alzheimer's disease. Current Alzheimer Research. 2015;12(3):266–277. doi: 10.2174/1567205012666150302154914. PubMed DOI

Klasson N., Olsson E., Eckerström C., Malmgren H., Wallin A. Estimated intracranial volume from FreeSurfer is biased by total brain volume. European Radiology Experimental. 2018;2(1) doi: 10.1186/s41747-018-0055-4. DOI

Klasson N., Olsson E., Eckerström C., Malmgren H., Wallin A. Delineation of two intracranial areas and the perpendicular intracranial width is sufficient for intracranial volume estimation. Insights Into Imaging. 2018;9(1):25–34. doi: 10.1007/s13244-017-0583-0. PubMed DOI PMC

Salk I., Atalar M. H., Sezer F., Egilmez H., Cetin A., Arslan M. An MRI study of age-related changes in the dimensions related temporal lobe. International Journal of Clinical and Experimental Medicine. 2014;7(3):515–522. PubMed PMC

Macdonald K. E., Bartlett J. W., Leung K. K., Ourselin S., Barnes J. The value of hippocampal and temporal horn volumes and rates of change in predicting future conversion to AD. Alzheimer Disease and Associated Disorders. 2013;27(2):168–173. doi: 10.1097/WAD.0b013e318260a79a. PubMed DOI PMC

Hippocampo-Horn Percentage and Parietal Atrophy Score for Easy Visual Assessment of Brain Atrophy on Magnetic Resonance Imaging in Early- and Late-Onset Alzheimer's Disease