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Conversion of mild cognitive impairment to Alzheimer disease predicted by hippocampal atrophy maps
Apostolova LG, Dutton RA, Dinov ID, Hayashi KM, Toga AW, Cummings JL, Thompson PM.. Archives of neurology, 2006-05-01
Topic: Amyloid, tau and blood-test diagnosis
Background While most patients with mild cognitive impairment (MCI) transition to Alzheimer disease (AD), others develop non-AD dementia, remain in the MCI state, or improve. Objective To test the following hypotheses: smaller hippocampal volumes predict conversion of MCI to AD, whereas larger hippocampal volumes predict cognitive stability and/or improvement; and patients with MCI who convert to AD have greater atrophy in the CA1 hippocampal subfield and subiculum. Design Prospective longitudinal cohort study. Setting University of California-Los Angeles Alzheimer's Disease Research Center. Patients We followed up 20 MCI subjects clinically and neuropsychologically for 3 years. Main outcome measure Baseline regional hippocampal atrophy was analyzed with region-of-interest and 3-dimensional hippocampal mapping techniques. Results During the 3-year study, 6 patients developed AD (MCI-c), 7 remained stable (MCI-nc), and 7 improved (MCI-i). Patients with MCI-c had 9% smaller left and 13% smaller right mean hippocampal volumes compared with MCI-nc patients. Radial atrophy maps showed greater atrophy of the CA1 subregion in MCI-c. Patients with MCI-c had significantly smaller hippocampi than MCI-i patients (left, 24%; right, 27%). Volumetric analyses showed a trend for greater hippocampal atrophy in MCI-nc relative to MCI-i patients (eg, 16% volume loss). After permutation tests corrected for multiple comparison, the atrophy maps showed a significant difference on the right. Subicular differences were seen between MCI-c and MCI-i patients, and MCI-nc and MCI-i patients. Multiple linear regression analysis confirmed the group effect to be highly significant and independent of age, hemisphere, and Mini-Mental State Examination scores at baseline. Conclusions Smaller hippocampi and specifically CA1 and subicular involvement are associated with increased risk for conversion from MCI to AD. Patients with MCI-i tend to have larger hippocampal volumes and relative preservation of both the subiculum and CA1.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Apostolova, L. G., Dutton, R. A., Dinov, I. D., Hayashi, K. M., Toga, A. W., Cummings, J. L., et al. (2006). Conversion of mild cognitive impairment to Alzheimer disease predicted by hippocampal atrophy maps. Archives of neurology. https://doi.org/10.1001/archneur.63.5.693
Vancouver
Apostolova LG, Dutton RA, Dinov ID, Hayashi KM, Toga AW, Cummings JL, et al. Conversion of mild cognitive impairment to Alzheimer disease predicted by hippocampal atrophy maps. Archives of neurology. 2006. doi:10.1001/archneur.63.5.693. PMID: 16682538.
BibTeX
@article{apostolova2006-16682538,
author = {Apostolova, L. G. and Dutton, R. A. and Dinov, I. D. and Hayashi, K. M. and Toga, A. W. and Cummings, J. L. and Thompson, P. M.},
title = {{Conversion of mild cognitive impairment to Alzheimer disease predicted by hippocampal atrophy maps}},
journal = {Archives of neurology},
year = {2006},
doi = {10.1001/archneur.63.5.693},
pmid = {16682538},
url = {https://doi.org/10.1001/archneur.63.5.693}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Results During the 3-year study, 6 patients developed AD (MCI-c), 7 remained stable (MCI-nc), and 7 improved (MCI-i).
- Patients with MCI-c had 9% smaller left and 13% smaller right mean hippocampal volumes compared with MCI-nc patients.
- Patients with MCI-c had significantly smaller hippocampi than MCI-i patients (left, 24%; right, 27%).
- After permutation tests corrected for multiple comparison, the atrophy maps showed a significant difference on the right.
- Multiple linear regression analysis confirmed the group effect to be highly significant and independent of age, hemisphere, and Mini-Mental State Examination scores at baseline.
Why it matters
Researchers at one UCLA centre scanned 20 people with mild cognitive impairment and followed them for 3 years: 6 developed Alzheimer's, 7 stayed the same and 7 improved. On the starting scans, those who developed Alzheimer's had smaller hippocampi on average, 24–27% smaller than those who improved and 9–13% smaller than those who stayed stable, with more shrinkage in the CA1 region; the authors conclude this is "associated with increased risk" of conversion. The groups were very small and no accuracy for predicting any one person's outcome is reported, so this is early group-level evidence, not a test a patient can rely on.
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Study details
- Study designcohort study
- Evidence strengthModerate
How this study scored 60/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for sample size, effect reported, studied in people and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Archives of neurology) |
| Journal's citation record | 3 / 4 | Archives of Neurology: journal h-index 353 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2006 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 559 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 25.4 citations a year over 22 year(s) since 2006 |
| Impact for its field and year | 4 / 6 | Cited 17.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 51 other studies in this library |
| Still being cited | 3 / 4 | Cited 60 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Paul M. Thompson: h-index 193 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of California, Los Angeles: institution h-index 1,923 (OpenAlex) |
| Multicenter collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 16682538) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 60 / 100 | — |
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