The Dynamics of Cortical and Hippocampal Atrophy in Alzheimer Disease

Abstract

Cognitive decline and the dementia stage of Alzheimer disease (AD) are the clinical manifestations of the cumulative burden of multiple neuropathologic insults. Postmortem studies^1,2 indicate that an evolution of neuropathologic insults can be observed during the initial stages of AD, with intracellular tau-associated neurofibrillary tangles first appearing in medial temporal and limbic isocortical regions and extracellular amyloid-β (Aβ)–associated plaques affecting heteromodal association cortices.