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NEUROLOGY 2007;68:13-19
© 2007 American Academy of Neurology

Diffusion tensor imaging of cingulum fibers in mild cognitive impairment and Alzheimer disease

Y. Zhang, MD, N. Schuff, PhD, G. -H. Jahng, PhD, W. Bayne, BS, S. Mori, PhD, L. Schad, PhD, S. Mueller, MD, A. -T. Du, MD, J. H. Kramer, PsyD, K. Yaffe, MD, H. Chui, MD, W. J. Jagust, MD, B. L. Miller, MD and M. W. Weiner, MD

From VA Medical Center and UC San Francisco (Y.Z., N.S., G.-H.J., W.B., S. Mueller, A.-T.D., M.W.W.), CA; Johns Hopkins University (S. Mori), Baltimore, MD; German Cancer Research Institute (L.S.), Heidelberg, Germany; UC San Francisco (J.H.K., K.Y., B.L.M.), CA; University of Southern California (H.C.), Los Angeles; and Lawrence Berkeley National Laboratory and UC Berkeley (W.J.J.), CA.

Address correspondence and reprint requests to Dr. Yu Zhang, MR Unit (114M), VA Medical Center, 4150, Clement Street, San Francisco, CA 94121; e-mail: Yu.Zhang{at}ucsf.edu

Background: Neuroimaging in mild cognitive impairment (MCI) and Alzheimer disease (AD) generally shows medial temporal lobe atrophy and diminished glucose metabolism and cerebral blood flow in the posterior cingulate gyrus. However, it is unclear whether these abnormalities also impact the cingulum fibers, which connect the medial temporal lobe and the posterior cingulate regions.

Objective: To use diffusion tensor imaging (DTI), by measuring fractional anisotropy (FA), to test 1) if MCI and AD are associated with DTI abnormalities in the parahippocampal and posterior cingulate regions of the cingulum fibers; 2) if white matter abnormalities extend to the neocortical fiber connections in the corpus callosum (CC); 3) if DTI improves accuracy to separate AD and MCI from healthy aging vs structural MRI.

Methods: DTI and structural MRI were preformed on 17 patients with AD, 17 with MCI, and 18 cognitively normal (CN) subjects.

Results: FA of the cingulum fibers was significantly reduced in MCI, and even more in AD. FA was also significantly reduced in the splenium of the CC in AD, but not in MCI. Adding DTI to hippocampal volume significantly improved the accuracy to separate MCI and AD from CN.

Conclusion: Assessment of the cingulum fibers using diffusion tensor imaging may aid early diagnosis of Alzheimer disease.

Editorial, see page 9

Supported in part by NIH/NIA RO1 AG10897, NIH/NIA PO1 AG012435, NIH/NIA P50 AG23501, and DOD DAMD17-01-1-0764.

Disclosure: The authors report no conflicts of interest.

Received March 15, 2006. Accepted in final form September 1, 2006.


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