MRI scans show coronal sections of the brain and right hippocampus at baseline, 9 months, 2 years (when he was diagnosed with mild cognitive impairment) and 3 years from presentation. MRI scans show coronal sections of the brain and right hippocampus at baseline, 9 months, 2 years (when he was diagnosed with mild cognitive impairment) and 3 years from presentation. Excess hippocampal atrophy is seen prior to the onset of objective cognitive impairment (from Archer)26 Jonathan M Schott Pract Neurol 2017;17:172-182 ©2017 by BMJ Publishing Group Ltd