Regional pattern of hippocampus and corpus callosum atrophy in Alzheimer’s disease in relation to dementia severity: evidence for early neocortical degeneration

Teipel, S.J; Bayer, W; Alexander, G.E; Bokde, A.L.W; Zebuhr, Y; Teichberg, D; Müller-Spahn, F; Schapiro, M.B; Möller, H.-J; Rapoport, S.I; Hampel, H

« Previous Next »Neurobiology of Aging
Volume 24, Issue 1 , Pages 85-94, January 2003

Regional pattern of hippocampus and corpus callosum atrophy in Alzheimer’s disease in relation to dementia severity: evidence for early neocortical degeneration

S.J Teipel
- Dementia and Neuroimaging Section, Department of Psychiatry, Ludwig-Maximilian University, Nussbaumstr. 7, 80336 Munich, Germany
- Corresponding author. Tel.: +11-49-89-5160-5860; fax: +11-49-89-5160-5865.
W Bayer
- Dementia and Neuroimaging Section, Department of Psychiatry, Ludwig-Maximilian University, Nussbaumstr. 7, 80336 Munich, Germany
G.E Alexander
- MRI Morphology Core, Arizona Alzheimer’s Disease Research Center and Department of Psychology, Arizona State University, Tempe, AZ, USA
A.L.W Bokde
- Dementia and Neuroimaging Section, Department of Psychiatry, Ludwig-Maximilian University, Nussbaumstr. 7, 80336 Munich, Germany
Y Zebuhr
- Dementia and Neuroimaging Section, Department of Psychiatry, Ludwig-Maximilian University, Nussbaumstr. 7, 80336 Munich, Germany
D Teichberg
- Section on Brain Physiology and Metabolism, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
F Müller-Spahn
- Department of Psychiatry, University of Basel, Basel, Switzerland
M.B Schapiro
- Department of Pediatric Neurology, Children Hospital Medical Center, Cincinatti, OH, USA
H.-J Möller
- Dementia and Neuroimaging Section, Department of Psychiatry, Ludwig-Maximilian University, Nussbaumstr. 7, 80336 Munich, Germany
S.I Rapoport
- Section on Brain Physiology and Metabolism, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
H Hampel
- Dementia and Neuroimaging Section, Department of Psychiatry, Ludwig-Maximilian University, Nussbaumstr. 7, 80336 Munich, Germany
- Co-corresponding author.

Received 15 August 2001; received in revised form 1 February 2002; accepted 7 March 2002.

Abstract

We used volumetric MRI and analysis of areas under receiver operating characteristic (ROC) curves to directly compare the extent of hippocampus–amygdala formation (HAF) and corpus callosum atrophy in patients with Alzheimer’s disease (AD) in different clinical stages of dementia. Based on neuropathological studies, we hypothesized that HAF atrophy, representing allocortical neuronal degeneration, would precede atrophy of corpus callosum, representing loss of neocortical association neurons, in early AD. HAF and corpus callosum sizes were significantly reduced in 27 AD patients (37% and 16%, respectively) compared to 28 healthy controls. In mildly- and moderately-demented AD patients, the ROC derived index of atrophy was greater for HAF volume than for total corpus callosum area. The index of atrophy of posterior corpus callosum was not significantly different from HAF at mild, moderate or severe stages of dementia. In conclusion, these findings suggest a characteristic regional pattern of allocortical and neocortical neurodegeneraton in AD. Our data indicate that neuronal loss in parietotemporal cortex (represented by atrophy of corpus callosum splenium) may occur simultaneously with allocortical neurodegeneration in mild AD. Moreover, ROC analysis may provide a statistical framework to determine atrophy patterns of different brain structures in neurodegenerative diseases in vivo.

Keywords: Alzheimer’s disease, Disease progression, Clinical stages, Neurodegeneration, Brain atrophy, Hippocampus, Amygdala, Corpus callosum, Allocortex, Neocortex, Magnetic resonance imaging, ROC