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Cerebral Cortex Advance Access originally published online on January 4, 2006
Cerebral Cortex 2006 16(12):1701-1708; doi:10.1093/cercor/bhj105
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© The Author 2006. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Differential Regional Atrophy of the Cingulate Gyrus in Alzheimer Disease: A Volumetric MRI Study

Bethany F. Jones1, Josephine Barnes2, Harry B.M. Uylings3,4, Nick C. Fox2, Chris Frost2,5, Menno P. Witter3 and Philip Scheltens1

1 Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands, 2 Dementia Research Centre, Institute of Neurology, University College London, Queen Square, London, UK, 3 Department of Anatomy, VU University Medical Centre, Amsterdam, The Netherlands, 4 Netherlands Institute for Brain Research, KNAW, Amsterdam, The Netherlands, 5 Medical Statistics Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK

Address correspondence to Bethany F. Jones, Department of Neurology, VU University Medical Center, Postbus 7057, 1007 MB Amsterdam, The Netherlands. Email: b.jones{at}vumc.nl.

Magnetic resonance imaging–based volumetric measurements provide a useful technique for quantifying in vivo regional cerebral atrophy in Alzheimer disease (AD). Histopathological studies have shown the cingulate cortex, a cytoarchitectonically heterogeneous region, to be severely affected in AD. In this study, we developed and validated a manual segmentation protocol, based on macroscopic characteristics such as gyri and sulci patterns, in order to assess volumetric changes in 4 cingulate regions of interest. Cingulate cortical volumes of 10 familial AD patients were compared with 10 age- and sex-matched controls. Inter- and intrarater reliability coefficients were high for all cingulate regions (91.9–99.4%). All 4 cingulate regions were significantly smaller (P < 0.05) in AD cases compared with controls: rostral anterior cingulate gyrus (22.5% smaller), caudal anterior cingulate gyrus (20.7% smaller), posterior cingulate gyrus (44.1% smaller), and retrosplenial cortex (21.5% smaller). The atrophy in the posterior cingulate region was significantly greater than that in other cingulate regions (P < 0.001), suggesting a higher vulnerability for this region in familial AD. Considering the functional and connectional differences of these 4 cingulate regions, detection and monitoring of their atrophy may provide insights into the natural history of AD and may help in the search for diagnostic markers for early AD.

Key Words: anterior cingulate cortex • dementia • posterior cingulate cortex • retrosplenial cortex • volumetry


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