Differential effects of aging and Alzheimer's disease on medial temporal lobe cortical thickness and surface area

Bradford C. Dickerson, Eric Feczko, Jean C. Augustinack, Jenni Pacheco, John C. Morris, Bruce Fischl, Randy L. Buckner

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231 Scopus citations


The volume of parcellated cortical regions is a composite measure related to both thickness and surface area. It is not clear whether volumetric decreases in medial temporal lobe (MTL) cortical regions in aging and Alzheimer's disease (AD) are due to thinning, loss of surface area, or both, nor is it clear whether aging and AD differ in their effects on these properties. Participants included 28 Younger Normals, 47 Older Normals, and 29 patients with mild AD. T1-weighted MRI data were analyzed using a novel semi-automated protocol (presented in a companion article) to delineate the boundaries of entorhinal (ERC), perirhinal (PRC), and posterior parahippocampal (PPHC) cortical regions and calculate their mean thickness, surface area, and volume. Compared to Younger Normals, Older Normals demonstrated moderately reduced ERC and PPHC volumes, which were due primarily to reduced surface area. In contrast, the expected AD-related reduction in ERC volume was produced by a large reduction in thickness with minimal additional effect (beyond that of aging) on surface area. PRC and PPHC also showed large AD-related reductions in thickness. Of all these MTL morphometric measures, ERC and PRC thinning were the best predictors of poorer episodic memory performance in AD. Although the volumes of MTL cortical regions may decrease with both aging and AD, thickness is relatively preserved in normal aging, while even in its mild clinical stage, AD is associated with a large degree of thinning of MTL cortex. These differential morphometric effects of aging and AD may reflect distinct biologic processes and ultimately may provide insights into the anatomic substrates of change in memory-related functions of MTL cortex.

Original languageEnglish (US)
Pages (from-to)432-440
Number of pages9
JournalNeurobiology of Aging
Issue number3
StatePublished - Mar 2009
Externally publishedYes

Bibliographical note

Funding Information:
This study was supported by grants from the NIA (K23-AG22509, P50-AG05681, P01-AG03991), the NCRR (P41-RR14075 R01 RR16594-01A1, the NCRR BIRN Morphometric Project BIRN002, U24 RR021382 & U24-RR021382), and the Mental Illness and Neuroscience Discovery (MIND) Institute. Additional support was provided by the National Institute for Biomedical Imaging and Bioengineering (R01 EB001550), the National Institute for Neurological Disorders and Stroke (R01 NS052585-01) and the National Alliance for Medical Image Computing (NAMIC), funded by the National Institutes of Health through the NIH Roadmap for Medical Research, Grant U54 EB005149.


  • Aging
  • Alzheimer's disease
  • Entorhinal cortex
  • Magnetic resonance imaging
  • Parahippocampal cortex
  • Perirhinal cortex


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