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Cerebral Cortex Advance Access published online on January 4, 2006
Cerebral Cortex, 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

Article

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

Bethany F. Jones 1 *, Josephine Barnes 2, Harry B.M. Uylings 3, Nick C. Fox 2, Chris Frost 4, Menno P. Witter 5, and Philip Scheltens 1

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

* To whom correspondence should be addressed.
Bethany F. Jones, E-mail: b.jones{at}vumc.nl


  Abstract

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.

Keywords: anterior cingulate cortex; dementia; posterior cingulate cortex; retrosplenial cortex; volumetry.
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