Hippocampal sclerosis of aging (HS) is a common pathology often misdiagnosed as Alzheimer's disease. We tested the hypothesis that participants with HS would have a magnetic resonance imaging (MRI)-detectable hippocampal pattern of atrophy distinct from participants without HS, both with and without Alzheimer's disease neuropathology (ADNP).
Query of the National Alzheimer's Coordinating Center database identified 198 participants with MRI and autopsy. Hippocampal subfields were segmented with FreeSurfer v6. Analysis of covariance for subfield volumes compared HS+ participants to those without HS, both with ADNP (HS–/ADNP+) and without (HS–/ADNP–).
HS+ participants (N = 27, 14%) showed atrophied cornu ammonis 1 (CA1; left P < .001, ηp2 = 0.14; right P = .001, ηp2 = 0.09) and subiculum (left P < .001, ηp2 = 0.139; right P = .001, ηp2 = 0.085) compared to HS–/ADNP+ (N = 100, 51%). Compared to HS–/ADNP– (N = 71, 36%), HS+ also had atrophy in subiculum (left P < .001, ηp2 = 0.235; right P = .002, ηp2 = 0.137) and CA1 (left P < .001, ηp2 = 0.137; right P = .006, ηp2 = 0.070).
Subiculum and CA1 atrophy from clinical MRI may be a promising in vivo biomarker for HS.
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