Hippocampal sclerosis in dementia, epilepsy, and ischemic injury: Differential vulnerability of hippocampal subfields

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Abstract

Severe neuronal loss in the hippocampus, that is, hippocampal sclerosis (HS), can be seen in 3 main clinical contexts: dementia (particularly frontotemporal lobar degeneration [FTLD]), temporal lobe epilepsy (TLE), and hippocampal ischemic injury (H-I). It has been suggested that shared pathogenetic mechanisms may underlie selective vulnerability of the hippocampal subfields such as the CA1 in these conditions. We determined the extent of neuronal loss in cases of HS-FTLD (n = 14), HS-TLE (n = 35), and H-I (n = 20). Immunohistochemistry for zinc transporter 3 was used to help define the CA3/CA2 border in the routinely processed human autopsy tissue samples. The subiculum was involved in 57% of HS-FTLD, 10% of H-I, and 0% of HS-TLE cases (p < 0.0001). The CA regions other than CA1 were involved in 57% of HS-TLE, 30% of H-I, and 0% of HS-FTLD cases (p= 0.0003). The distal third of CA1 was involved in 79% of HS-FTLD, 35% of H-I, and 37% of HS-TLE cases (p = 0.02). The distal third of CA1 was the only area involved in 29% of HS-FTLD, 3% of HS-TLE, and 0% of H-I cases (p = 0.019). The proximal-middle CA1 was the only area affected in 50% of H-I, 29% of HS-TLE, and 0% of HS-FTLD cases (p = 0.004). These findings support heterogeneity in the pathogenesis of HS.

Original languageEnglish (US)
Pages (from-to)136-142
Number of pages7
JournalJournal of Neuropathology and Experimental Neurology
Volume73
Issue number2
DOIs
StatePublished - Feb 2014

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Sclerosis
Dementia
Epilepsy
Frontotemporal Lobar Degeneration
Temporal Lobe Epilepsy
Wounds and Injuries
Hippocampus
Autopsy

Keywords

  • Brain ischemia
  • Frontotemporal dementia
  • Frontotemporal lobar degeneration
  • Hippocampal sclerosis
  • Mesial temporal sclerosis
  • Vascular dementia
  • ZNT3

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Clinical Neurology
  • Neurology
  • Cellular and Molecular Neuroscience

Cite this

@article{3a1cdcf8bbdb4c979c66951272505c29,
title = "Hippocampal sclerosis in dementia, epilepsy, and ischemic injury: Differential vulnerability of hippocampal subfields",
abstract = "Severe neuronal loss in the hippocampus, that is, hippocampal sclerosis (HS), can be seen in 3 main clinical contexts: dementia (particularly frontotemporal lobar degeneration [FTLD]), temporal lobe epilepsy (TLE), and hippocampal ischemic injury (H-I). It has been suggested that shared pathogenetic mechanisms may underlie selective vulnerability of the hippocampal subfields such as the CA1 in these conditions. We determined the extent of neuronal loss in cases of HS-FTLD (n = 14), HS-TLE (n = 35), and H-I (n = 20). Immunohistochemistry for zinc transporter 3 was used to help define the CA3/CA2 border in the routinely processed human autopsy tissue samples. The subiculum was involved in 57{\%} of HS-FTLD, 10{\%} of H-I, and 0{\%} of HS-TLE cases (p < 0.0001). The CA regions other than CA1 were involved in 57{\%} of HS-TLE, 30{\%} of H-I, and 0{\%} of HS-FTLD cases (p= 0.0003). The distal third of CA1 was involved in 79{\%} of HS-FTLD, 35{\%} of H-I, and 37{\%} of HS-TLE cases (p = 0.02). The distal third of CA1 was the only area involved in 29{\%} of HS-FTLD, 3{\%} of HS-TLE, and 0{\%} of H-I cases (p = 0.019). The proximal-middle CA1 was the only area affected in 50{\%} of H-I, 29{\%} of HS-TLE, and 0{\%} of HS-FTLD cases (p = 0.004). These findings support heterogeneity in the pathogenesis of HS.",
keywords = "Brain ischemia, Frontotemporal dementia, Frontotemporal lobar degeneration, Hippocampal sclerosis, Mesial temporal sclerosis, Vascular dementia, ZNT3",
author = "Hatanpaa, {Kimmo J.} and Raisanen, {Jack M.} and Emily Herndon and Burns, {Dennis K.} and Chan Foong and Habib, {Amyn A.} and White, {Charles L.}",
year = "2014",
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T1 - Hippocampal sclerosis in dementia, epilepsy, and ischemic injury

T2 - Differential vulnerability of hippocampal subfields

AU - Hatanpaa, Kimmo J.

AU - Raisanen, Jack M.

AU - Herndon, Emily

AU - Burns, Dennis K.

AU - Foong, Chan

AU - Habib, Amyn A.

AU - White, Charles L.

PY - 2014/2

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N2 - Severe neuronal loss in the hippocampus, that is, hippocampal sclerosis (HS), can be seen in 3 main clinical contexts: dementia (particularly frontotemporal lobar degeneration [FTLD]), temporal lobe epilepsy (TLE), and hippocampal ischemic injury (H-I). It has been suggested that shared pathogenetic mechanisms may underlie selective vulnerability of the hippocampal subfields such as the CA1 in these conditions. We determined the extent of neuronal loss in cases of HS-FTLD (n = 14), HS-TLE (n = 35), and H-I (n = 20). Immunohistochemistry for zinc transporter 3 was used to help define the CA3/CA2 border in the routinely processed human autopsy tissue samples. The subiculum was involved in 57% of HS-FTLD, 10% of H-I, and 0% of HS-TLE cases (p < 0.0001). The CA regions other than CA1 were involved in 57% of HS-TLE, 30% of H-I, and 0% of HS-FTLD cases (p= 0.0003). The distal third of CA1 was involved in 79% of HS-FTLD, 35% of H-I, and 37% of HS-TLE cases (p = 0.02). The distal third of CA1 was the only area involved in 29% of HS-FTLD, 3% of HS-TLE, and 0% of H-I cases (p = 0.019). The proximal-middle CA1 was the only area affected in 50% of H-I, 29% of HS-TLE, and 0% of HS-FTLD cases (p = 0.004). These findings support heterogeneity in the pathogenesis of HS.

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KW - Brain ischemia

KW - Frontotemporal dementia

KW - Frontotemporal lobar degeneration

KW - Hippocampal sclerosis

KW - Mesial temporal sclerosis

KW - Vascular dementia

KW - ZNT3

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