The contribution of hippocampal subfields to the progression of neurodegeneration

Mild cognitive impairment (MCI) is often considered the precursor of Alzheimer’s disease. However, MCI is associated with substantially variable progression rates, which are not well understood. Attempts to identify the mechanisms that underlie MCI progression have often focused on the hippocampus, but have mostly overlooked its intricate structure and subdivisions. Here, we utilized deep learning to delineate the contribution of hippocampal subfields to MCI progression. We propose a dense convolutional neural network architecture that differentiates stable and progressive MCI based on hippocampal morphometry with an accuracy of 75.85%. A novel implementation of occlusion analysis revealed marked differences in the contribution of hippocampal subfields to the performance of the model, with presubiculum, CA1, and subiculum showing the most central role. Moreover, the analysis reveals that more than 20% of the hippocampal volume was redundant in the differentiation between stable and progressive MCI.