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In clinical practice, the diagnosis of Alzheimer's disease (AD) is based on typical features of the disease and exclusion of other conditions causing dementia. In AD, the hippocampus is atrophied early in the course of the disease, [1,2] and the atrophy can be reliably detected by volumetric MRI for diagnostic purposes. [3,4] With this technique, AD patients can be sensitively separated not only from cognitively normal control subjects, but also from subjects suffering from differentially important conditions, such as age-associated memory impairment [5] and depressive pseudodementia. [6] However, the specificity of MRI volumetry in the evaluation of hippocampal atrophy in dementing diseases other than AD has not been determined.
In the diagnostic process of dementias, AD and vascular dementias (VaD) constitute the largest and thus differentially most important groups of dementias. These two types of dementia together account for as much as 90% of all dementias. [7,8] Moreover, one of the most common diseases in the elderly that may be associated with dementia is Parkinson's disease (PD). In PD, the proportion of demented patients varies from 40 to 70%, the percentage increasing with age. [9]
In this study, we investigate the specificity of hippocampal atrophy by comparing hippocampal volumes of AD patients and cognitively normal control subjects with volumes of patients with VaD and PD with dementia (PDD) and without dementia. Our working hypothesis was that the volume loss of hippocampus would be most pronounced in AD and not present in PD.
Methods.
We evaluated the volumes of hippocampus in 113 subjects: 50 patients with early probable AD according to National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria [10]; 9 patients with VaD according to the DSM-III-R criteria [11]; 20 patients with idiopathic PD, of whom 8 were demented; and 34 cognitively …
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