Atrophic Pattern of Hippocampal Subfields in Post-Stroke Demented Patient

Article type: Research Article

Authors: Zhao, Zhiyong^{a; 1} | Cai, Huaying^{b; 1} | Zheng, Weihao^a | Liu, Tingting^a | Sun, Di^b | Han, Guocan^c | Zhang, Yi^{a; d} | Wu, Dan^{a; *}

Affiliations: [a] Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China | [b] Department of Neurology, Neuroscience Center, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China | [c] Department of Radiology, Neuroscience Center, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China | [d] Department of Neurology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China

Correspondence: [*] Correspondence to: Dan Wu, PhD, Room 525, Zhou Yiqing Building, Yuquan Campus, Zhejiang University, Hangzhou, 310027, China. Tel.: +86 15825508242; E-mail: danwu.bme@zju.edu.cn.

Note: [1] These authors contributed equally to this work.

Abstract: Background:Previous studies have demonstrated that hippocampal atrophy is a hallmark of dementia and can be used to predict the outcome of post-stroke demented (PSD) patients. The hippocampus consists of several subfields but their involvement in the pathophysiology of the PSD remains unclear. Objective:The present study aimed to investigate volumetric alterations of hippocampal subfields in patients with PSD. Methods:High-resolution T1-weighted images were collected from 27 PSD and 28 post-stroke nondemented (PSND) patients who recovered from ischemic stroke, and 17 age-matched normal control (NC). We estimated the volumes of the hippocampal subfields using FreeSurfer 6.0 which segmented the hippocampus into 12 subfields in each hemisphere. The volumetric differences between the groups were evaluated by the two-sample tests after regressing out the age, sex, education, and total intracranial volume. Results:Compared with NC group, PSD group showed smaller volumes in the entire hippocampus and its subfields, and such differences were not found in PSND group. Moreover, we found the dementia-specific atrophy in the left granule cell layer of dentate gyrus (GC-DG) and CA4 in the PSD patients compared with NC and PSND. Regression analysis showed positive correlations between the changes of cognitive performance and the asymmetry index in the CA3/4 and GC-DG of the PSD group. Furthermore, we found that the volumes of hippocampal subfields provided a better classification performance than the entire hippocampus. Conclusion:Our findings suggest that the hippocampus is reduced in the PSD patients and it presents a selective subfield involvement.

Keywords: Dementia, hippocampal subfields, magnetic resonance imaging, stroke, volume

DOI: 10.3233/JAD-200804

Journal: Journal of Alzheimer's Disease, vol. 80, no. 3, pp. 1299-1309, 2021