Medial temporal lobe (MTL) atrophy is an important marker for the clinical diagnosis of Alzheimer's disease at its prodromal stages. Several brain lesions have been associated with MTL atrophy including hippocampal sclerosis, neurodegenerative neuronal loss, and vascular pathology. To better explore the relationship between MTL volume on MRI and age-related degenerative and microvascular hippocampal pathology, we compared MTL volume on postmortem whole brain MRI and stereological estimates of the total number of neurons, cortical microinfarcts (CMIs), and neurofibrillary tangles (NFTs) in a consecutive autopsy series of 21 older individuals (11 females and 10 males, mean age 83.3 ± 5.8; range: 74-93 years, 7 demented and 14 nondemented). Our results revealed a very high percentage of cases with hippocampal CMIs (52%), particularly in the CA1 field. MTL volume was closely related to neuronal loss in both the CA1 area of the hippocampus (p = 0.0109) and the entorhinal cortex (p = 0.0272). MTL volume was not related to total CMI volume or to the total number of NFTs in our sample. In conclusion, hippocampal CMIs are very common in old age. MTL volume is determined essentially by the number of neurons in the hippocampus and does not appear to be related to the presence of NFTs or CMIs in this region.

中文翻译：

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内侧颞叶体积与神经元丢失有关，但与海马微梗死无关，尽管它们在老化的大脑中频率很高

内侧颞叶（MTL）萎缩是阿尔茨海默病前驱期临床诊断的重要标志。一些脑部病变与 MTL 萎缩有关，包括海马硬化、神经退行性神经元丢失和血管病变。为了更好地探索 MRI 上的 MTL 体积与年龄相关的退行性和微血管海马病理之间的关系，我们比较了死后全脑 MRI 上的 MTL 体积和神经元总数、皮质微梗死 (CMI) 和神经原纤维缠结 (NFT) 的体视估计) 在 21 名老年个体（11 名女性和 10 名男性，平均年龄 83.3 ± 5.8 岁；范围：74-93 岁，7 名痴呆和 14 名非痴呆）的连续尸检系列中。我们的结果显示海马 CMI 的病例比例非常高 (52%)，特别是在 CA1 领域。MTL 体积与海马 CA1 区 (p = 0.0109) 和内嗅皮层 (p = 0.0272) 的神经元丢失密切相关。MTL 体积与 CMI 总体积或我们样本中的 NFT 总数无关。总之，海马 CMI 在老年时非常常见。MTL 体积主要由海马中的神经元数量决定，似乎与该区域中 NFT 或 CMI 的存在无关。