MRI based volumetric analysis of entorhinal cortex in elderly subjects with mild cognitive impairment and in subjects with normal cognition to see effects of aging on volume of ERC


  • Sarita Jilowa Department of Radio-Diagnosis, ABVIMS and Dr. RML Hospital, New Delhi, India
  • Hitesh Kumar Department of Radio-Diagnosis, ABVIMS and Dr. RML Hospital, New Delhi, India
  • Yashvant Singh Department of Radio-Diagnosis, ABVIMS and Dr. RML Hospital, New Delhi, India
  • K. S. Anand Department of Neurology, ABVIMS and Dr. RML Hospital, New Delhi, India



Cognition, Dementia, Entorhinal, Impairment, MR volumetry


Background: MCI is a transitional period between normal ageing and clinically probable early Alzheimer’s Dementia (AD). ERC volumes show early reduction in cases of MCI in comparison to the normal ageing subjects. Early cognitive impairment can be documented with ERC atrophy on MR volumetry. Aim of the study was to evaluate the volume of entorhinal cortex in patients of MCI and  to compared the volume with patients of normal cognition. Secondarily, we studied changes in the volume of entorhinal cortex with increasing age

Methods: In this study 30 patients of 60 years and above with MCI and 30 controls of normal cognition (age and sex matched) underwent brain examination on 3T MRI. Volume of entorhinal cortex was measured on 1 mm thick T1 coronal oblique MR scans by manually tracing the boundaries defined by two widely used methods i.e. Insausti et al and Goncharova et al.

Results: Patients with MCI showed 17.2% decline in the entorhinal cortex volume compared to controls (p value = 0.001). Patients of older age showed significantly more ERC volume reduction, reaching up to 30.4% in comparison to younger subjects suggesting atrophy of ERC in normal aging and in MCI both, but more so in patients with cognitive impairment.

Conclusions: ERC atrophy was found in MCI cases more than controls, increase atrophy trend was noted with increasing age. MR volumetry may play a role for documentation of ERC atrophy in cases of MCI.


Petersen RC. Mild cognitive impairment as a diagnostic entity. J Int Med. 2004;256(3):183-94.

Petersen RC, Smith GE, Waring SC, Ivnik RJ, Kokmen E, Tangelos EG. Aging, Memory, and Mild Cognitive Impairment. Int Psychogeriatr. 1997;9(S1):65-9.

Petersen RC, Caracciolo B, Brayne C, Gauthier S, Jelic V, Fratiglioni L. Mild cognitive impairment: a concept in evolution. J Intern Med. 2014;275(3):214-28.

Grundman M, Petersen RC, Ferris SH, Thomas RG, Aisen PS, Bennett DA, et al. Mild Cognitive Impairment Can Be Distinguished From Alzheimer Disease and Normal Aging for Clinical Trials. Arch Neurol. 2004;61(1):59-66.

Du AT, Schuff N, Zhu XP, Jagust WJ, Miller BL, Reed BR, et al. Atrophy rates of entorhinal cortex in AD and normal aging. Neurol. 2003;60(3):481-6.

Winblad B, Palmer K, Kivipelto M, Jelic V, Fratiglioni L, Wahlund LO, et al. Mild cognitive impairment- beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. J Intern Med. 2004;256(3):240-6.

Juottonen K, Laakso M, Insausti R, Lehtovirta M, Pitkänen A, Partanen K, et al. Volumes of the Entorhinal and Perirhinal Cortices in Alzheimer’s Disease. Neurobiol Aging. 1998;19(1):15-22.

Goncharova II, Dickerson BC, Stoub TR, deToledo-Morrell L. MRI of human entorhinal cortex: a reliable protocol for volumetric measurement. Neurobiol Aging. 2001;22(5):737-45.

Varon D, Loewenstein DA, Potter E, Greig MT, Agron J, Shen Q, et al. Minimal Atrophy of the Entorhinal Cortex and Hippocampus: Progression of Cognitive Impairment. Dement Geriatr Cogn Disord. 2011;31(4):276-83.

Bakker A, Tran T, Speck CL, Gallagher M. Lateral entorhinal cortex hypoactivation in amnestic mild cognitive impairment. Alzheimer's Dementia: J Alzheimer's Assoc. 2016;12(7):1169.

Canto CB, Wouterlood FG, Witter MP. What Does the Anatomical Organization of the Entorhinal Cortex Tell Us? Neural Plast. 2008:1-18.

Insausti R, Juottonen K, Soininen H, Insausti AM, Partanen K, Vainio P, et al. MR volumetric analysis of the human entorhinal, perirhinal, and temporopolar cortices. Am J Neuroradiol. 1998 Apr 1;19(4):659-71.

Price JL, Ko AI, Wade MJ, Tsou SK, McKeel DW, Morris JC. Neuron number in the entorhinal cortex and CA in preclinical Alzheimer disease. Arch Neurol. 2001 1;58(9):1395-402.

Mourao RJ, Mansur G, Malloy-Diniz LF, Castro Costa E, Diniz BS. Depressive symptoms increase the risk of progression to dementia in subjects with mild cognitive impairment: systematic review and meta-analysis: MCI, depression and risk of dementia. Int J Geriatr Psychiatr. 2016;31(8):905-11.

Du AT, Schuff N, Chao LL, Kornak J, Jagust WJ, Kramer JH, et al. Age effects on atrophy rates of entorhinal cortex and hippocampus. Neurobiol Aging. 2006;27(5):733-40.

Tward DJ, Sicat CS, Brown T, Bakker A, Gallagher M, Albert M, et al. Entorhinal and transentorhinal atrophy in mild cognitive impairment using longitudinal diffeomorphometry. Alzheimers Dement Diagn Assess Dis Monit. 2017;9:41-50.

deToledo-Morrell L, Stoub TR, Bulgakova M, Wilson RS, Bennett DA, Leurgans S, et al. MRI-derived entorhinal volume is a good predictor of conversion from MCI to AD. Neurobiol Aging. 2004 Oct 1;25(9):1197-203.

Killiany RJ, Hyman BT, Gomez-Isla TM, Moss MB, Kikinis R, Jolesz F, et al. MRI measures of entorhinal cortex vs hippocampus in preclinical AD. Neurol. 2002;58(8):1188-96.

Du AT. Magnetic resonance imaging of the entorhinal cortex and hippocampus in mild cognitive impairment and Alzheimer’s disease. J Neurol Neurosurg Psychiatr. 2001;71(4):441-7.

Devanand DP, Pradhaban G, Liu X, Khandji A, De Santi S, Segal S, et al. Hippocampal and entorhinal atrophy in mild cognitive impairment: Prediction of Alzheimer disease. Neurol. 2007;68(11):828-36.

Price CC, Wood MF, Leonard CM, Towler S, Ward J, Montijo H, et al. Entorhinal cortex volume in older adults: Reliability and validity considerations for three published measurement protocols. J Int Neuropsychol Soc. 2010;16(5):846-55.




How to Cite

Jilowa, S., Kumar, H., Singh, Y., & Anand, K. S. (2020). MRI based volumetric analysis of entorhinal cortex in elderly subjects with mild cognitive impairment and in subjects with normal cognition to see effects of aging on volume of ERC. International Journal of Research in Medical Sciences, 8(7), 2487–2494.



Original Research Articles