Volumetric Analysis and Segmentation of the Hippocampus in Patients with Alzheimer’s Disease

Abstract

 Introduction: Alzheimer’s disease (AD) is a leading cause of dementia worldwide, representing a growing public health and socioeconomic burden. Despite advances in diagnostic criteria, effective treatments capable of halting disease progression remain unavailable. As AD’s most vulnerable brain structure, the hippocampus is crucial in understanding disease development and monitoring therapeutic outcomes. Automated segmentation methods, such as the VolBrain platform, provide objective and reproducible measurements of hippocampal and subfield volumes using high-resolution magnetic resonance imaging (MRI). In addition, cerebrospinal fluid (CSF) biomarkers, including Aβ amyloid, phosphorylated tau (pTAU), and total tau (tTAU), are recognized as important indicators of AD-related neurodegeneration.

 Aim: To compare hippocampal and subfield volumes between patients with Alzheimer’s disease and healthy controls, and to examine potential correlations with CSF biomarkers (Aβ, pTAU, tTAU).

 Materials and Methods: The study included 15 patients with clinically diagnosed AD and 15 age- and sex-matched healthy controls. All participants underwent 3 Tesla MRI scanning. Automated hippocampal segmentation and volumetric analysis were performed using the VolBrain platform. CSF biomarker levels were analyzed and compared with hippocampal volumes.

 Results: Patients with AD showed significantly reduced total and left hippocampal volumes compared to controls (p < 0.01). Additional significant volume reductions were found in the CA1 and CA4-DG subfields (p < 0.01). No significant correlations were observed between hippocampal volumes and CSF biomarker levels.

 Conclusion: Automated hippocampal volumetry revealed notable atrophy in Alzheimer’s disease, especially in the CA1 and CA4-DG subfields. These findings support the potential role of hippocampal volumetry as a complementary biomarker for assessing neurodegeneration in AD.