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Research ArticleAdult Brain

Sexual Dimorphism and Hemispheric Asymmetry of Hippocampal Volumetric Integrity in Normal Aging and Alzheimer Disease

B.A. Ardekani, S.A. Hadid, E. Blessing and A.H. Bachman
American Journal of Neuroradiology February 2019, 40 (2) 276-282; DOI: https://doi.org/10.3174/ajnr.A5943
B.A. Ardekani
aFrom Center for Brain Imaging and Neuromodulation, The Nathan S. Kline Institute for Psychiatric Research (B.A.A., S.A.H., A.H.B.), Orangeburg, New York
bDepartment of Psychiatry (B.A.A., E.B.), New York University School of Medicine, New York, New York.
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S.A. Hadid
aFrom Center for Brain Imaging and Neuromodulation, The Nathan S. Kline Institute for Psychiatric Research (B.A.A., S.A.H., A.H.B.), Orangeburg, New York
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E. Blessing
bDepartment of Psychiatry (B.A.A., E.B.), New York University School of Medicine, New York, New York.
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A.H. Bachman
aFrom Center for Brain Imaging and Neuromodulation, The Nathan S. Kline Institute for Psychiatric Research (B.A.A., S.A.H., A.H.B.), Orangeburg, New York
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    Fig 1.

    Axial (left), coronal (middle), and sagittal (right) slices through a 3D structural MR imaging scan of a subject. The right hippocampus probabilistic VOI is superimposed on the image in native space.

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    Fig 2.

    Histogram of the voxels with nonzero probabilities on the VOI in Fig 1 (thin line) along with a fitted Gaussian mixture model (thick line) using the expectation-maximization algorithm. The automatically determined CSF threshold is shown as a vertical line approximately located at the intensity value of 70. The HPF is defined as the fraction of voxels in the VOI whose intensities are greater than the CSF threshold.

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    Fig 3.

    Predicted marginal means of the asymmetry index in different diagnostic groups. AI was found to be significantly different between the CN versus MCI (P < .001), CN versus AD (P < .001), and MCI versus AD (P = .03) groups. AI increased with increasing dementia severity. Error bars indicate 95% CI.

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    Fig 4.

    Predicted marginal means of the asymmetry index in men and women. The AI was found to be significantly higher in men (P < .01) after controlling for age, intracranial volume, and diagnostic group. Error bars indicate 95% CI.

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    Fig 5.

    Predicted marginal means of the HPF (averaged across hemispheres) in different diagnostic groups. The HPF was found to be significantly different between the CN versus MCI (P < .001), CN versus AD (P < .001), and MCI versus AD (P < .001) groups. The HPF decreased with increasing dementia severity. Error bars indicate 95% CI.

Tables

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    Table 1:

    Cohort demographicsa

    GroupCNMCIAD
    CDR00.51 (n = 28), 2 (n = 2)
    No. of subjects987030
    Sex (female:male)72:2639:3120:10
    Age (yr)75.9 ± 9.0 (60–94)76.2 ± 7.2 (62–92)78.0 ± 6.9 (65–96)
    Education (yr)14.5 ± 2.9 (8–23)13.8 ± 3.2 (6–20)12.8 ± 3.2 (7–20)
    ICV (cm3)1439 ± 150 (1132–1818)1485 ± 187 (1171–1992)1480 ± 118 (1274–1732)
    MMSE29.0 ± 1.2 (25–30)25.6 ± 3.5 (14–30)21.2 ± 4.0 (15–29)
    • Note:—CDR indicates Clinical Dementia Rating; MMSE, Mini-Mental State Examination.

    • ↵a Values given are means and range.

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    Table 2:

    Definitions of all mathematic terms used in the mixed-effects model equation (Equation 4)

    iVolume index i = 1, 2, ′, 775
    jSubject identification index j = 1, 2, ′, 198
    yilogit(HPF) or log(AI) for volume i as the response variable
    IDiSubject index of volume i where IDi ∈ (1, 2, ′, 198)
    AgeiAge of subject IDi minus 76.34, the average age of all 198 subjects
    ICViEstimated total intracranial volume of subject IDi minus 1461.5, the average ICV of all 198 subjects
    DXiDiagnostic group of subject IDi, a factor with 3 levels {CN, MCI, AD}
    SexiSex of subject IDi, a factor with 2 levels {Male, Female}
    I{statement}Indicator function that takes on values of 1 or 0 depending on whether the statement is true or false
    β0 ′ β7Model fixed-effects parameters to be estimated and tested against null hypotheses of type Σakβk = 0
    bjModel random effects assumed to be independent and identically distributed Gaussian with mean 0 and variance σb2
    eiRandom residuals assumed to be independent and identically distributed Gaussian with mean 0 and variance σe2
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American Journal of Neuroradiology: 40 (2)
American Journal of Neuroradiology
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B.A. Ardekani, S.A. Hadid, E. Blessing, A.H. Bachman
Sexual Dimorphism and Hemispheric Asymmetry of Hippocampal Volumetric Integrity in Normal Aging and Alzheimer Disease
American Journal of Neuroradiology Feb 2019, 40 (2) 276-282; DOI: 10.3174/ajnr.A5943

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Sexual Dimorphism and Hemispheric Asymmetry of Hippocampal Volumetric Integrity in Normal Aging and Alzheimer Disease
B.A. Ardekani, S.A. Hadid, E. Blessing, A.H. Bachman
American Journal of Neuroradiology Feb 2019, 40 (2) 276-282; DOI: 10.3174/ajnr.A5943
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