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A Magnetic Resonance Imaging Analysis

Harald Hampel, MD; Stefan J. Teipel; Gene E. Alexander, PhD; Barry Horwitz, PhD; Diane Teichberg; Mark B. Schapiro, MD; Stanley I. Rapoport, MD

Arch Neurol. 1998;55:193-198.

Background  Pathological studies in Alzheimer disease indicate the specific loss of layer III and V large pyramidal neurons in association cortex. These neurons give rise to long corticocortical connections within and between the cerebral hemispheres.

Objective  To evaluate the corpus callosum as an in vivo marker for cortical neuronal loss.

Method  Using a new imaging technique, we measured region-specific corpus callosum atrophy in patients with Alzheimer disease and correlated the changes with neuropsychological functioning. Total cross-sectional area of the corpus callosum and areas of 5 callosal subregions were measured on midsagittal magnetic resonance imaging scans of 14 patients with Alzheimer disease (mean age, 64.4 years; Mini-Mental State Examination score, 11.4) and 22 healthy age- and sex-matched control subjects (mean age, 66.6 years; Mini-Mental State Examination score, 29.8). All subjects had minimal white matter changes.

Results  The total callosal area was significantly reduced in the patients with Alzheimer disease, with the greatest changes in the rostrum and splenium and relative sparing of the callosal body. Regional callosal atrophy correlated significantly with cognitive impairment in the patients with Alzheimer disease, but not with age or the white matter hyperintensities score.

Conclusions  Callosal atrophy in patients with Alzheimer disease with only minimal white matter changes may indicate loss of callosal efferent neurons in corresponding regions of the cortex. Because these neurons are a subset of corticocortical projecting neurons, region-specific callosal atrophy may serve as a marker of progressive neocortical disconnection in Alzheimer disease.

From the Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Bethesda, Md (Drs Hampel, Alexander, Horwitz, Schapiro, and Rapoport and Mr Teipel and Ms Teichberg); and the Department of Psychiatry, Geriatric Psychiatry Branch, School of Medicine, Ludwig-Maximilian University, Munich, Germany (Dr Hampel and Mr Teipel).

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