The correlation between hippocampal and lateral ventricular asymmetry, atrophy, and white matter hyperintensities in dementia and normal aging: A volumetric magnetic resonance imaging analysis Correlación entre la asimetría hipocampal y ventricular lateral, la atrofia y las hiperintensidades de la sustancia blanca en la demencia y el envejecimiento normal: un análisis volumétrico mediante resonancia magnética

Günay B., KÜSKÜN A., Harun Öztürk H., Gedik E., Savaş Tepe M.

Revista Cientifica de la Sociedad Espanola de Enfermeria Neurologica, ss.500223, 2026 (Scopus)

Özet

Aim: To investigate structural asymmetry patterns on magnetic resonance imaging (MRI) and their associations with hippocampal and lateral ventricular asymmetry, cerebral atrophy, and white matter hyperintensities (WMH) in patients with dementia, mild cognitive impairment (MCI), and cognitively normal controls (CNC). Materials and methods: This retrospective observational study included 103 individuals who underwent 1.5-T brain MRI. Participants were classified into three groups: CNC (n=37), MCI (n=42), and dementia (n=24). Three-dimensional Slicer software was used for volumetric segmentation of the hippocampus, lateral ventricles, and WMH. Cerebral atrophy was assessed using the global cortical atrophy (GCA), medial temporal atrophy (MTA), and Koedam scales, whereas WMH burden was evaluated using both the Fazekas score and volumetric WMH measurements. Asymmetry indices were calculated, and their associations with atrophy and WMH burden were analyzed. Results: The mean age of the 103 participants (68 women, 35 men) was 63.5±13.7 years (range, 28–96 years). Left and right hippocampal volumes were negatively correlated with lateral ventricular volume difference (p=0.002 and p=0.016, respectively). Patients with lateral ventricular asymmetry showed greater interhemispheric ventricular volume differences. In contrast, patients without hippocampal asymmetry had larger bilateral hippocampal volumes and lower hippocampal volume difference, right lateral ventricular volume, and WMH burden. Conclusions: Hippocampal and ventricular asymmetry are sensitive markers of neurodegeneration and white matter disease burden. Early recognition of these structural changes may support earlier diagnosis, closer patient monitoring, and more individualized multidisciplinary care strategies, including neurological nursing interventions.