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. 2024 Jul;14(7):e3576.
doi: 10.1002/brb3.3576.

Exploring the cognitive assessment potential of MRI-based volumetric hippocampal segmentation in Parkinson's disease

Merve Tarhan  1 , Başak Atalay  1 , Ayşenur Buz Yaşar  2 , Fatma Betül Özdilek  3
Affiliations

Exploring the cognitive assessment potential of MRI-based volumetric hippocampal segmentation in Parkinson's disease

Merve Tarhan et al. Brain Behav. 2024 Jul.

Abstract

Purpose: To investigate the potential of magnetic resonance imaging (MRI)-based total and segmental hippocampus volume analysis in the assessment of cognitive status in Parkinson's disease (PD).

Methods: We divided participants into three groups Group A-Parkinson patients (Pp) with normal cognitive status (n = 25), Group B-Pp with dementia (n = 17), and Group C-healthy controls (n = 37). Three-dimensional T1W Fast Spoiled Gradient Recalled Echo images were used for Volbrain hippocampus subfield segmentation. We used the "Winterburn" protocol, which divides the hippocampus into five segments, Cornu Ammonis (CA),CA2/CA3, CA4/dentate gyrus, stratum radiatum, lacunosum, and moleculare, and subiculum.

Results: A total of 79 participants were included in the study, consisting of 42 individuals with PD (64.2% male) and 37 healthy controls (54.1% male). The mean age of PD was 60.9 ± 10.7 years and the mean age of control group was 59.27 ± 12.3 years. Significant differences were found in total hippocampal volumes between Group A and B (p = .047. Statistically significant group differences were found in total, right, and left CA1 volumes (analysis of variance [ANOVA]: F(2,76) = 8.098, p = .001; F(2,76) = 7.628, p = .001; F(2,76) = 5.084, p = .008, respectively), as well as in total subiculum volumes (ANOVA: F(2,76) = 4.368, p = .016). Post hoc tests showed that total subiculum volume was significantly lower in individuals with normal cognitive status (0.474 ± 0.116 cm3) compared to healthy controls (0.578 ± 0.151 cm3, p = .013).

Conclusion: Volumetric hippocampal MRI can be used to assess the cognitive status of Pp. Longitudinal studies that evaluate Pp who progress from normal cognition to dementia are required to establish a causal relationship.

Keywords: Parkinson disease; hippocampus; magnetic resonance imaging.

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Conflict of interest statement

The authors declare that they have no conflicts of interest. All authors have actively participated in this manuscript and approved the final article.

Figures

FIGURE 1
FIGURE 1
Hippocampus segmentation according to the Winterburn protocol (13): The hippocampus is divided into five segments: Cornu Ammonis (CA)1, CA2/CA3, CA4/dentate gyrus (DG), stratum radiatum, lacunosum, and moleculare (SR/SL/SM) subiculum.
FIGURE 2
FIGURE 2
Hippocampal segmentation according to Winterburn protocol for control group. Red: Cornu Ammonis (CA)1, Green: CA2/CA3, Yellow: CA4/dentate gyrus (DG), Blue: stratum radiatum, lacunosum, and moleculare (SR/SL/SM), Pink: Subiculum.
FIGURE 3
FIGURE 3
Hippocampal segmentation according to Winterburn protocol for patients with Parkinson's disease. Red: Cornu Ammonis (CA)1, Green: CA2/ CA3, Yellow: CA4/dentate gyrus (DG), Blue: stratum radiatum, lacunosum, and moleculare (SR/SL/SM), Pink: Subiculum.
FIGURE 4
FIGURE 4
MR image of the hippocampus in healthy control and Parkinson's disease: (a and b) sagittal (c and d) coronal (e and f) axial Fast Spoiled Gradient Recalled Echo (FSPGR) sequence shows the hippocampus (yellow arrow). Compared to the healthy control group (a, c, and e), the hippocampus volume decreases, and atrophy and degeneration occur in Parkinson's disease (PD) (b, d, and f). It is also noteworthy that the subiculum (S) and parahippocampal gyrus (PHG) are also atrophic in PD. In PD, secondary to the hippocampus and cerebral hemisphere atrophy, enlargement of the lateral ventricular temporal horn (TH) and sylvian fissure (SF) is observed. M, mesencephalon; P, pons.
FIGURE 5
FIGURE 5
The number of cases participating in different study groups and their average ages.
FIGURE 6
FIGURE 6
MR image of the right and left hippocampus in a patient with Parkinson's disease (PD): (a) right and (b) left hippocampus (yellow arrow) in the sagittal Fast Spoiled Gradient Recalled Echo (FSPGR) sequence. The left hippocampus volume is less than the right. In both images, enlargement of the lateral ventricular temporal horn (TH) and sylvian fissure (SF) is evident due to hippocampal atrophy.
FIGURE 7
FIGURE 7
Receiver operating characteristic (ROC) curve analysis of the ability of hippocampal atrophy to predict dementia in Parkinson's disease (PD) (area under the curve [AUC]:.753, cut‐off value 3.86 cm3 with a sensitivity of 0.80 and specificity of 0.647).
See this image and copyright information in PMC

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