Hippocampal calcification on brain CT: prevalence and risk factors in a cerebrovascular cohort

Abstract

ObjectivesRecently, hippocampal calcification as observed on brain CT examinations was identified in over 20% of people over 50 years of age and a relation between hippocampal calcification and cognitive decline was shown. We determined the prevalence and investigated the vascular risk factors of hippocampal calcification in patients with cerebrovascular disease.MethodsHippocampal calcification was scored bilaterally on presence and severity on CT examinations in a cohort of 1130 patients with (suspected) acute ischaemic stroke. Multivariable logistic regression analysis, adjusting for age and gender as well as adjusting for multiple cardiovascular disease risk factors, was used to determine risk factors for hippocampal calcification.ResultsHippocampal calcification was present in 381 (34%) patients. Prevalence increased with age from 8% below 40 to 45% at 80 years and older. In multivariable logistic regression analysis, age per decile (OR 1.41 [95% CI 1.26–1.57], p < 0.01), hypertension (OR 0.74 [95% CI 0.56–0.99], p = 0.049), diabetes mellitus (OR 1.57 [95% CI 1.10–2.25], p = 0.01) and hyperlipidaemia (OR 1.63 [95% CI 1.20–2.22], p < 0.01) were significantly associated with hippocampal calcification.ConclusionsHippocampal calcification was a frequent finding on CT in this cohort of stroke patients and was independently positively associated with hyperlipidaemia and diabetes mellitus, suggesting an atherosclerotic origin.Key Points • Hippocampal calcification is prevalent in over 30% of cerebrovascular disease patients. • Prevalence increases from 8% below 40 to 45% over 80 years. • Hippocampal calcification is associated with cardiovascular risk factors hyperlipidaemia and diabetes mellitus. Electronic supplementary materialThe online version of this article (10.1007/s00330-018-5372-8) contains supplementary material, which is available to authorized users.

Vascular Risk Factors of Hippocampal Subfield Volumes in Persons without Dementia: The Medea 7T Study

“…3 Current and former smoking were compared to never smoking. 4 Alcohol: data of 241 participants used due to missing data (n = 42). 5 Body mass index, obesity: data of 282 participants on body mass index and obesity (n = 1 missing).…”

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“…Understanding how risk factors contribute to AD etiology may aid in the prevention or treatment of AD. It has been established that vascular risk factors, of which most are modifiable by either lifestyle or medication, play an important role in AD risk [ 3 ], hippocampal calcifications [ 4 ], and hippocampal atrophy [ 5 ]. The hippocampus is one of the first structures to be affected in AD [ 6 ].…”

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Region-specific susceptibility change in cognitively impaired patients with diabetes mellitus

“…In a study using diabetic rats, basal ganglia and thalamic calcifications were noted even without microscopically significant vascular or parenchymal abnormalities, which is in line with our observation of decreased susceptibly in DM patients without cerebrovascular pathology [ 12 ]. Hippocampal calcification is also a common finding in older adults and especially in the patients with cognitive problems, in association with risk factors of vascular disease [ 39 – 41 ]. It may partially explain our observation of decreased susceptibility in the hippocampus of DM+ cognitively impaired patients and its significant correlations with the total Fazekas score and MBs, which represent imaging vascular risk factors [ 31 ].…”