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Stefan J. Teipel, MD; Harald Hampel, MD; Pietro Pietrini, MD; Gene E. Alexander, PhD; Barry Horwitz, PhD; Eileen Daley; Hans-Jürgen Möller, MD; Mark B. Schapiro, MD; Stanley I. Rapoport, MD

Arch Neurol. 1999;56:467-473.

Background  Positron emission tomographic studies of patients with Alzheimer disease (AD) suggest a loss of metabolic functional interactions between different cortical regions. Atrophy of the corpus callosum as the major tract of intracortical connective fibers may reflect decreased cortical functional integration in AD.

Objectives  To investigate whether regional atrophy of the corpus callosum is correlated with regional reductions of cortical glucose metabolism, as shown by positron emission tomography, and whether primary white matter degeneration is a possible cofactor of corpus callosum atrophy in AD.

Patients and Methods  We measured total and regional cross-sectional areas of the corpus callosum on midsagittal magnetic resonance imaging scans from 12 patients with AD and 15 age-matched control subjects. Regional cerebral metabolic rates for glucose in cortical lobes were measured by positron emission tomography using fludeoxyglucose F 18. White matter hyperintensities were rated in T₂-weighted magnetic resonance imaging scans.

Results  The total cross-sectional area of corpus callosum was significantly reduced in patients with AD, with the most prominent changes in the rostrum and splenium and relative sparing of the body of the corpus callosum. Frontal and parietal lobe metabolism was correlated with the truncal area of the corpus callosum in AD. The ratios of frontal to parietal and of frontal to occipital metabolism were correlated with the ratio of anterior to posterior corpus callosum area in the group with AD. White matter hyperintensities did not correlate with corpus callosum atrophy in the patients with AD.

Conclusion  The regional pattern of corpus callosum atrophy correlated with reduced regional glucose metabolism independently of primary white matter degeneration in the patients with AD.

From the Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Bethesda, Md (Drs Teipel, Hampel, Pietrini, Alexander, Horwitz, Schapiro, and Rapoport and Ms Daley); and Department of Psychiatry, Dementia and Neuroimaging Research Group, Ludwig-Maximilian-University, Munich, Germany (Drs Teipel, Hampel, and Möller).

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