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Dementia & Neuropsychologia

Print version ISSN 1980-5764

Dement. neuropsychol. vol.2 no.1 São Paulo Jan./Mar. 2008

http://dx.doi.org/10.1590/S1980-57642009DN20100008 

Original Articles

Hippocampal atrophy and verbal episodic memory performance in amnestic mild cognitive impairment and mild Alzheimer's disease: A preliminary study

Atrofia hipocampal e desempenho na memória verbal episódica no comprometimento cognitivo leve amnéstico e na doença de Alzheimer leve

Nathalia Carollina Peruzza Marchiani 1  

Marcio Luiz Figueredo Balthazar 2  

Fernando Cendes 3  

Benito Pereira Damasceno 4  

1Graduate student.

2MD, PhD student.

3MD, PhD, Associate Professor.

4MD, PhD, Professor. Department of Neurology; Medical School, State University of Campinas (UNICAMP).


Abstract

To evaluate hippocampal volume in patients with AD and aMCI, and correlate its atrophy with verbal episodic memory performance. Methods: We studied 42 individuals older than 50 years, including 14 with amnestic mild cognitive impairment (aMCI), 14 with mild Alzheimer's disease (AD) and 14 normal controls. All individuals were submitted to the Rey auditory verbal learning test (RAVLT) to evaluate episodic memory. They were also submitted to the forward (FDS) and backward digit span (BDS) subtest of WAIS-R to evaluate working memory and attention, and to the Mini Mental State Examination (MMSE). Hippocampal volumetric measurements were performed according to anatomic guidelines from a standard protocol using high-resolution T1-inversion recovery 3-mm coronal MRI slices. Hippocampal volumes (HV) were corrected for the variation in total intracranial volume. There was no significant difference between the three groups concerning age and education. Results: On RAVLT, there was a continuum between the three groups, with AD recalling less words, controls more, and aMCI subjects showing an intermediate performance on all sub-items. We found an asymmetry between HVs, with smaller mean left HV for all groups. ANOVA and post hoc Tukey's test for comparisons of HV showed a significant difference among groups, with difference between controls and both AD and aMCI, although there was no significant difference between AD and aMCI groups. Conclusions: There was a significant correlation between hippocampal volumes and scores on RAVLT, confirming that medial temporal structures are closely associated with memory performance in normal ageing as well as in aMCI and AD.

Key words: hippocampal atrophy; MRI; memory; Alzheimer's disease; mild cognitive impairment

Resumo

Avaliar os volumes hipocampais (VH) em pacientes com doença de Alzheimer (DA) leve e comprometimento cognitivo leve amnéstico (aCCL). Métodos: Estudamos 42 sujeitos maiores de 50 anos, incluindo 14 com DA leve, 14 com aCCL e 14 controles. Todos foram submetidos ao teste de aprendizado auditivo verbal de Rey (TAAVR) para avaliação de memória episódica, ao teste de extensão de dígitos direto e indireto do WAIS-R, para avaliação de memória operacional e atenção e ao Mini Exame do Estado Mental (MEEM). As medidas de volumetria hipocampal foram obtidas de acordo com as diretrizes anatômicas de um protocolo padrão usando imagens coronais ponderadas T1 inversion-recovery de 3 mm. Os VH foram corrigidos para a variação do volume intracraniano total. Não houve diferença significativa entre os 3 grupos quanto a idade e escolaridade. Resultados: No TAAVR houve um continuum no desempenho dos 3 grupos, com os pacientes com DA leve evocando menos palavras, os controles mais e os aCCL mostrando um desempenho intermediário em todos os subitens. Encontramos também uma assimetria entre os VH, com o lado esquerdo menor que o direito nos 3 grupos. O teste de análise de variância (ANOVA) seguido do teste post hoc de Tukey para comparações entre os VH dos grupos mostrou diferença significativa entre controles e DA e aCCL, mas não entre DA e aCCL. Encontramos também correlação estatística significativa entre os VH e o desempenho no TAAVR. Conclusões: As estruturas do lobo temporal medial estão intimamente ligadas ao desempenho de memória episódica tanto no envelhecimento normal quanto no aCCL e DA.

Palavras-chave: atrofia hipocampal; MRI; memória; doença de Alzheimer; transtorno cognitivo leve

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Received: January 25, 2008; Revised: February 15, 2008; Accepted: February 16, 2008

Benito Pereira Damasceno - Department of Neurology / Medical School / State University of Campinas - Box 6111 - 13083-970 Campinas SP - Brazil. E-mail: damascen@unicamp.br

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