atrophy of the posterior subiculum is associated with ... · oskar hansson at lund university, eric...
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Atrophy of the Posterior Subiculum Is
Associated with Memory Impairment,
Tau- and Ab Pathology in
Non-Demented Individuals
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Hippocampal atrophy is key feature in many
neurodegenerative diseases
10 nov Olof Lindberg 2
However several diseases
display volume decline in
the same range
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10 Nov Olof Lindberg 3
AD BvFTD SD
Shape analysis of the hippocampus. A step
to recognize different diseases?
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Selective measurement of hippocampal
subfields is another approach.
19 november 2018 Namn Efternamn 4
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Subfields measurements is usually not
considering anterior vs. posterior volumetric
differences within one field (which we may find in
shape analysis).
Olof Lindberg 5
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19 november 2018 Namn Efternamn 6
But the anterior & posterior part of the
same subfield may be parts of
different brain networks
Object
recognition Scene discrimination
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Deficits in episodic memory & scene
processing which are symptoms
associated with Alzheimer´s disease is
potentially more dependent on brain
systems connected to the posterior
hippocampus.
10 Nov Olof Lindberg 7
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10 Nov Olof Lindberg 8
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Subdivision of the subiculum
From Freesufer 5.3
10 Nov Olof Lindberg 9
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Participants from
The Swedish Biofinder Study
http://biofinder.se/
19 november 2018 Namn Efternamn 10
SCD was defined as being referred to a memory clinic
due to cognitive complaints but not showing signs of objective
cognitive impairment in the neuropsychological battery.
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CSF analysis
10 Nov Olof Lindberg 11
CSF followed the Alzheimer’s Association Flow Chart for CSF
biomarkers.
CSF total tau (T-tau), and Aβ42 were analyzed
by EUROIMMUN (EI) enzyme-linked immunosorbent assays
(ELISAs) (EUROIMMUN AG, Lübeck, Germany).
Tau phosphorylated at Thr181 (P-tau) were analyzed with
INNOTEST (IT) ELISAs (Fujirebio Europe, Ghent, Belgium).
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MRI
19 november 2018 Namn Efternamn 12
T1-weighted images were obtained on a single 3 tesla
MR scanner (Trio, Siemens, Germany). Volumetric
analysis was performed on T1-weighted 3D MP-RAGE
image
Hippocampal subfield segmentation in Freesufer 5.3
(http://surfer.nmr.mgh.harvard.edu/)
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n=398 high- compared with n=258 low levels
of Aβ42 in cerebral spinal fluid (CSF)
Cutoff <527 nanogram/liter (ng/l)
10 Nov Olof Lindberg 13
left right
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Correlation with phosphor tau (p-tau) in CSF
in all included subjects n=656
10 Nov Olof Lindberg 14
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Subjective cognitive decline n=183
10 Nov Olof Lindberg 15
Cutoff <52 ng/l
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Mild cognitive impairment n=171
10 Nov Olof Lindberg 16
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Delayed recall of 10-items (ADAS-cog)
10 Nov Olof Lindberg 17
All participants n=656 Control & SCD n=473
* *
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In conclusion, AD pathologies and mild
memory dysfunction are mainly associated
with atrophy of the posterior parts of the
subicular subfields of the hippocampus in
non-demented individuals.
In light of these findings we suggest that segmentation of the HC subfields
may benefit from considering the volume of the different anterior-posterior
subsections of each subfield.
10 Nov Olof Lindberg 18
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Thickness correlation with posterior vs.
anterior subiculum (left hemisphere) 302 ctl
19 november 2018 Namn Efternamn 19
Anterior Posterior
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H70 Left hemisphere n=630 non-demented
participants, age of 70-years of age.
H70-study
19 november 2018 Namn Efternamn 20
Posterior
40%
Anterior
40%
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19 november 2018 Namn Efternamn 21
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BA23 och 31
Scatterplot of multiple variables against lh_BA23_31_ThickAvg
L_total_subiculum_1_2_3_4 L_total_subiculum_7_8_9_10
1,6 1,8 2,0 2,2 2,4 2,6 2,8 3,0
lh_BA23_31_ThickAvg
100
150
200
250
300
350
400
450
500
550
R_total_subiculum_7_8_9_10 R_total_subiculum_1_2_3_4
1,9 2,0 2,1 2,2 2,3 2,4 2,5 2,6 2,7 2,8
rh_BA23_31_ThickAvg
50
100
150
200
250
300
350
400
450
500
H70 all
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Decline in MMSE baseline – 4 year in 100
SCD
19 november 2018 Namn Efternamn 23
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Thanks to:
All participants and collaborators in the Swedish
biofinder & H70 study.
In particularly to:
Oskar Hansson at Lund university, Eric Westman &
Lars-Olof Wahlund & Gustav Mårtensson at
Karolinska institute and Ingmar Skog at Gothenburg
university,
and Svenska Hjärnfonden.
10 november Olof Lindberg 24
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15 patients semantic dementia – the anterior
40%
19 november 2018 Namn Efternamn 25