Quantitative MRI of the hippocampus reveals microstructural trajectories of aging and Alzheimer’s disease pathology

A Alfie Wearn (Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University) C Christine L. Tardif (Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University) I Ilana R. Leppert (McConnell Brain Imaging Centre, McGill University) G Giulia Baracchini (Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University) C Colleen Hughes (Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University) J Jennifer Tremblay-Mercier (Douglas Mental Health University Institute) J John Breitner (Douglas Mental Health University Institute) B Boris C. Bernhardt (Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University) G Gary R. Turner (Department of Psychology, York University) R R. Nathan Spreng (Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University) S Sylvia Villeneuve (Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University) J Judes Poirier (Douglas Mental Health University Institute) J John C.S. Breitner S Sylvain Baillet A Andrée-Ann Baril P Pierre Bellec V Véronique Bohbot D Danilo Bzdok M Mallar Chakravarty D D. Louis Collins M Mahsa Dadar S Simon Ducharme A Alan Evans C Claudine Gauthier M Maiya R. Geddes R Rick Hoge Y Yasser Ituria-Medina G Gerhard Multhaup L Lisa-Marie Münter A Alexa Pichet Binette N Natasha Rajah P Pedro Rosa-Neto T Taylor Schmitz J Jean-Paul Soucy N Nathan Spreng C Christine Tardif E Etienne Vachon-Presseau C Christian Bocti M Maxime Descoteaux R Robert Laforce P Pierre Etienne S Serge Gauthier V Vasavan Nair J Jens Pruessner D Daniel Auld

Abstract

Hippocampal degeneration is a feature of both normal aging and Alzheimer’s disease (AD). Prior to macroscopic degeneration, microstructural changes occur such as demyelination, iron deposition, or subtle atrophy, which can be characterized in vivo using MRI. We topographically mapped measures of microstructure and macrostructure across the unfolded surface of the hippocampus in 224 healthy older adults at risk for AD (aged 57 to 87) and 37 younger adults (aged 18 to 37). We describe three spatial regions of unique structural covariance between four parameters sensitive to microstructural tissue properties (R1, MTsat, R2*, PD) and macrostructure (surface thickness), with high convergence with previous spatial segmentations. We demonstrate both cross-sectional and longitudinal associations of microstructure with healthy aging across the lifespan, AD pathological hallmarks, genetic risk, and cognition. These associations had subtle variations across different spatial areas of the hippocampus. We report associations between age and qMRI measures sensitive to macromolecular concentration (R1, MTsat) and paramagnetic susceptibility (R2*), consistent with mechanisms of demyelination and increased iron deposition as key hallmarks of the aging hippocampus and in presymptomatic stages of AD. qMRI measures did not explain more variance in delayed recall than global PET measures, suggesting variation in cognitive performance in aging and incipient AD is influenced by factors beyond hippocampal microstructure. We demonstrate the utility of quantitative MRI to provide greater insight into hippocampal health compared to typical macrostructural measures through “in vivo histology,” opening a window to understanding neuropathological mechanisms in the earliest stages of age- and disease-related neurodegeneration.

Article Details

Volume / Issue Vol. 122, Issue 44
Published November 04, 2025
ISSN 0027-8424
Publisher National Academy of Sciences

Authors (45)

A

Alfie Wearn

Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University

C

Christine L. Tardif

Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University

I

Ilana R. Leppert

McConnell Brain Imaging Centre, McGill University

G

Giulia Baracchini

Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University

C

Colleen Hughes

Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University

J

Jennifer Tremblay-Mercier

Douglas Mental Health University Institute

J

John Breitner

Douglas Mental Health University Institute

B

Boris C. Bernhardt

Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University

G

Gary R. Turner

Department of Psychology, York University

R

R. Nathan Spreng

Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University

S

Sylvia Villeneuve

Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University

J

Judes Poirier

Douglas Mental Health University Institute

J

John C.S. Breitner

S

Sylvain Baillet

A

Andrée-Ann Baril

P

Pierre Bellec

V

Véronique Bohbot

D

Danilo Bzdok

M

Mallar Chakravarty

D

D. Louis Collins

M

Mahsa Dadar

S

Simon Ducharme

A

Alan Evans

C

Claudine Gauthier

M

Maiya R. Geddes

R

Rick Hoge

Y

Yasser Ituria-Medina

G

Gerhard Multhaup

L

Lisa-Marie Münter

A

Alexa Pichet Binette

N

Natasha Rajah

P

Pedro Rosa-Neto

T

Taylor Schmitz

J

Jean-Paul Soucy

N

Nathan Spreng

C

Christine Tardif

E

Etienne Vachon-Presseau

C

Christian Bocti

M

Maxime Descoteaux

R

Robert Laforce

P

Pierre Etienne

S

Serge Gauthier

V

Vasavan Nair

J

Jens Pruessner

D

Daniel Auld