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Corpus callosum morphology from magnetic resonance images in Tourette's syndrome.

We measured the midline cross-sectional area and other morphologic features of the corpus callosum (CC) from magnetic resonance (MR) images in 14 unmedicated patients with Tourette's syndrome (TS) and 14 normal control subjects matched for age, sex, handedness, and socioeconomic status. Each CC was manually circumscribed on midline images from a T1-weighted sagittal series, and the area of the entire CC and five anatomic subdivisions were measured. CC circumference, regional width, and mean callosal curvature were also measured. CC cross-sectional area correlated positively with brain size and basal ganglia volumes. The magnitude of reduction (17.7%) in total CC area in TS patients compared with control subjects was similar to the reductions seen in all CC subdivision areas. Analyses of covariance with total midsagittal cross-sectional head area as a covariate revealed the reductions to be statistically significant for the overall CC area and all subregion areas. CC width tended to be nonsignificantly thinner in all subdivisions (from 5% to 11%), and the overall length of the center line measured from rostrum to splenium was significantly reduced in the TS group (by 5.3%). Measures of mean callosal curvature suggested that CCs in TS patients are less rounded than those of normal control subjects. Worst-ever motor tic symptoms showed the strongest significant correlation with the length of the CC center line in TS patients (r = 0.88). These findings suggest that structural interhemispheric connectivity may be aberrant in the central nervous systems of TS patients, and they provide indirect supportive evidence for the presence of altered cerebral lateralization in the disorder.

Adolescent↗

Corpus callosum changes following shunting for hydrocephalus: case report and review of the literature.

Diffuse callosal signal changes can rarely occur following successful shunting for obstructive hydrocephalus. We report on a patient who underwent ventriculoperitoneal shunting for aqueductal stenosis and required two revisions for neurological deterioration and presumed shunt malfunction. Extensive changes involving the corpus callosum, periventricular white matter and optic chiasm were noted after the first, and were prominent after second shunt revision. Thus, post-shunting callosal changes may be associated with more extensive white matter disease, and may not imply wide pressure fluctuations. However, they need not prompt further intervention.

Adult↗

In vivo transcranial imaging of connections in mouse visual cortex.

From the moment the mouse model took center stage for studies of cortical arealization and map formation, there was an urgent need for methods to identify areal borders in the living animal. The need was met in part by intrinsic optical signal imaging, which has been successfully applied to map topographic representations in primary visual, auditory and somatosensory cortex. However, the challenge remains to register these maps to the underlying structure. This is especially important for studies of the mouse brain in which cortical areas are often only a few hundred microns across. Here, we show that in visual cortex neuronal tracing with fluororuby and fluoroemerald can be used for transcranial imaging through the intact skull of callosal connections from the opposite side of the brain, and for mapping of topographic striate-extrastriate cortical pathways in living mice. Because callosal connections are important landmarks for cortical areas, the new method will allow registration of functional maps to underlying structures and facilitate targeted single-unit recordings in identified cortical areas.

Animals↗

Modulation of transcallosally mediated motor inhibition in children with attention deficit hyperactivity disorder (ADHD) by medication with methylphenidate (MPH).

Motor hyperactivity is one of the most outstanding symptoms of attention deficit hyperactivity disorder (ADHD) which might be caused by a disturbed inhibitory motor control. Using focal transcranial magnetic stimulation (TMS) we tested the cortico-callosal inhibition (duration and latency of the ipsilateral Silent Period, iSP) in 23 children with ADHD (mean age 11+/-2.6 years) before and on treatment with methylphenidate (MPH). iSP latency was age correlated, whereas iSP duration as well as Conners scores were age independent. Analyses of mean differences revealed a significant prolongation of iSP duration (p=0.001), shortening of iSP latency (p=0.027) and reduction of Conners score (p=0.001) under medication. Increase of iSP duration and reduction of Conners score under medication were significantly correlated (t=-9.87, p=0.016). Reduced iSP duration and prolonged iSP latency in ADHD children could be the result of a disturbed transcallosally mediated inhibition, most probable due to a combination of maturation deficits of callosal fiber tracts as well as neuronal synaptical transmission within the neuronal network between ipsilaterally stimulated cortex layer III--the origin of transcallosal motor-cortical fibers--and contralateral layer V, the origin of the pyramidal tract. MPH may indirectly improve the dysbalance between excitatory and inhibitory interneuronal activities of this neuronal network via dopaminergic modulatory effects of the striato-thalamo-cortical loop.

Adolescent↗

3D mapping of ventricular and corpus callosum abnormalities in HIV/AIDS.

OBJECTIVE: 40 million people worldwide are now infected with HIV/AIDS, an illness that often leads to rapidly progressing dementia and death. Even so, little is known about how AIDS affects the brain. Using computational anatomy techniques, we mapped how AIDS impacts the corpus callosum (CC) and ventricular system, two systems that show prominent changes on MRI. We (1) identified regions with greatest differences between AIDS patients and healthy controls and (2) correlated specific 3D patterns of structural differences with measures of immune system deterioration and cognitive decline. METHODS: 51 3D brain MRI scans from 30 non-demented AIDS patients (age: 43.4 years +/- 7.6 SD) and 21 HIV-seronegative controls (age: 39.5 years +/- 12.2) were aligned to ICBM standard space. 3D surface mesh reconstructions of the lateral ventricles and CC were spatially averaged and compared across diagnostic groups. Structural alterations were correlated with viral load, T cell counts, and cognitive impairment. RESULTS: Statistical maps revealed the 3D profile of ventricular expansion and callosal thinning in AIDS. Specific 3D ventricular changes were linked with immune system decline (CD4+ T cell counts; P < 0.001) and cognitive impairment (P < 0.009), but not viral load. Frontal horn maps distinguished AIDS patients from controls better than occipital and temporal horn measures. T cell decline linked with callosal thinning in anterior regions connecting frontal areas with greatest cortical atrophy. CONCLUSION: These maps (1) reveal how brain changes in HIV/AIDS relate to immune decline and impaired cognition, and, after further validation and testing, (2) may offer possible neuroimaging markers for anti-viral drug trials, which gauge how well treatments oppose disease progression in the brain.

AIDS Dementia Complex↗

Contribution of alcoholism to brain dysmorphology in HIV infection: effects on the ventricles and corpus callosum.

Nonrigid registration and atlas-based parcellation methods were used to compare the volume of the ventricular system and the cross-sectional area of the midsagittal corpus callosum on brain MRIs from 272 subjects in four groups: patients with HIV infection, with and without alcoholism comorbidity, alcoholics, and controls. Prior to testing group differences in regional brain metrics, each measure was corrected by regression analysis for significant correlations with supratentorial cranial volume and age, observed in 121 normal control men and women, whose age spanned six decades. Disregarding HIV disease severity, we observed a graded pattern of modest enlargement of the total ventricular system (0.28 SD for uncomplicated HIV, 0.65 SD for HIV comorbid with alcoholism, and 0.72 SD for the alcoholism group). The pattern of callosal thinning showed a similar but small ( approximately 0.5 SD) graded effect. A different pattern emerged, however, when HIV severity in the context of alcoholism comorbidity was factored into the analysis. Substantially greater volume abnormalities were present in individuals with a history of an AIDS-defining event or low CD4+ T cell counts (<or=200 mm(3)) irrespective of alcoholism comorbidity, and the effect of HIV severity was disproportionately exacerbated by alcoholism comorbidity, with 1 SD size deficit in the genu of corpus callosum and nearly 2 SD greater volume of the frontal and body regions of the ventricles for the AIDS + alcohol comorbid group. The differences in brain volumes between the AIDS groups with vs. without alcoholism could not be attributed to differences in HIV disease severity, defined by CD4+ count, viral load, or Karnofsky score. The substantial effect of the alcoholism-AIDS interaction on ventricular and callosal dysmorphology, in the context of the modest changes observed in non-AIDS, nonalcohol abusing HIV-infected individuals, highlight the need to consider alcohol use disorders as a major risk factor for neuropathology among HIV-infected persons.

Adult↗

Functional brain asymmetry, attentional modulation, and interhemispheric transfer in boys with Tourette syndrome.

We tested the hypothesis that children with Tourette syndrome (TS) would exhibit aberrant brain lateralization compared to a healthy control (HC) group in an attention-modulation version of a verbal dichotic listening task using consonant-vowel syllables. The modulation of attention to focus on the right ear stimulus in the dichotic listening situation is thought to involve the same prefrontal attentional and executive functions that are involved in the suppression of tics, whereas, performance when focusing attention on the left ear stimulus additionally involves a callosal transfer of information. In light of presumed disturbances in transfer of information across the corpus callosum, we hypothesized that children with TS would, however, have difficulty modulating the functional lateralization that ensues through a shift of attention to the left side. This hypothesis was tested by exploring the correlations between CC size and left ear score in the forced-left condition. Twenty boys with TS were compared with 20 age- and handedness-matched healthy boys. Results indicated similar performance in the TS and HC groups for lateralization of hemispheric function. TS subjects were also able to shift attention normally when instructed to focus on the right ear stimulus. When instructed to focus attention on the left ear stimulus, however, performance deteriorated in the TS group. Correlations with CC area further supported the hypothesized presence of deviant callosal functioning in the TS group.

Adolescent↗

Investigation of corpus callosum in schizophrenia with diffusion imaging.

BACKGROUND: Corpus callosum (CC) is the main white matter commissure between the two cerebral hemispheres. Abnormalities of CC have been shown in schizophrenia patients by magnetic resonance imaging (MRI) studies. We here further investigated CC organization with diffusion imaging (DWI) in a sample of schizophrenia patients recruited from the epidemiologically defined catchment area of South Verona, Italy. METHODS: Sixty-seven patients with schizophrenia and 70 normal controls were studied. Regions of interests (ROIs), standardized at 5 pixels, were placed in CC on the non-diffusion weighted echoplanar images (b = 0) and were then automatically transferred to the corresponding maps to obtain the apparent diffusion coefficient (ADC) of water molecules. RESULTS: ADC measures for all callosal subregions in schizophrenia patients were significantly greater compared to normal controls (ANCOVA, p < 0.05). Positive symptoms significantly correlated with anterior callosal ADC measures (partial correlation analyses, p < 0.05). CONCLUSIONS: These findings support the existence of widespread microstructure disruption of CC in schizophrenia, which may ultimately lead to inter-hemispheric misconnection, and also suggest a specific role of anterior transcallosal disconnectivity in underlying positive symptoms. Future longitudinal MRI studies in high risk and first-episode patients together with neurophysiological tests are indicated to further examine CC anatomical abnormalities and inter-hemispheric transmission in schizophrenia.

Adult↗

Nonconvulsive status epilepticus with an unusual EEG: a fresh look at lateralities of motor control and awareness.

This article is an account of a patient with nonconvulsive status epilepticus associated with an unusual EEG. The importance of recording speed in lateralizing the hemisphere of onset of epilepsy is emphasized, on the basis of one-way callosal traffic theory. From this vantage point, the following were deemed responsible for the currently divergent views on the lateralizing significance of various signs and symptoms in epilepsy: (1) the dichotomous nature of laterality of motor control, which is the same as that of seizure onset; (2) the probabilistic nature of the availability of the callosal channel for transfer of epileptiform discharges from the major to the minor hemisphere (i.e., the random variability of synaptic transfer); (3) the dynamic (varying) expanse of the epileptic region within the major hemisphere. Other data reviewed indicated that measuring the reaction time of two symmetrically located effectors is the most robust way of determining the laterality of the major hemisphere, with the side of shorter reaction time being opposite to the major hemisphere. Clinical presentations of seizures reflect the probabilistic involvement of different regions of the major hemisphere by the epileptic process and the spread of the epilepsy to the minor hemisphere via the callosum. Termination of seizure activity with diazepam was associated with simultaneous recovery of awareness and speech in this case.

Aged↗

Magnetic resonance imaging study of corpus callosum abnormalities in patients with bipolar disorder.

BACKGROUND: This study was conducted to further examine the hypothesis of abnormalities in size of corpus callosum in subjects with bipolar disorder. METHODS: Sixteen right-handed DSM-IV bipolar I patients and 27 right-handed healthy control subjects were studied. A 1.5-T GE Signa magnet was used, and three-dimensional gradient echo imaging (spoiled gradient recall acquisition) was conducted. Area measurements of corpus callosum were obtained blindly, with a semi-automated software, by a well-trained rater. RESULTS: Right-handed bipolar I patients had significantly smaller total corpus callosum, genu, posterior body, and isthmus areas compared with right-handed healthy control subjects (analysis of covariance with age, gender, and intracranial volume as covariates, p <.05). Partial correlation analyses, controlled for intracranial volumes, found a significant inverse relationship between age and total callosal, genu, anterior body, isthmus, and circularity in healthy control subjects (p <.05) but not in bipolar patients (p >.05). CONCLUSIONS: Smaller callosal areas may lead to altered inter-hemispheric communication and be involved in the pathophysiology and cognitive impairment found in bipolar disorder.

Adult↗

Corpus callosum damage and interhemispheric transfer of information following closed head injury in children.

We evaluated the relationship of corpus callosum atrophy and/or lesions on magnetic resonance imaging (MRI) to functional hemispheric disconnection following closed head injury (CHI) in 51 pediatric patients, including mild CHI, moderate to severe CHI with extracallosal lesions, and moderate to severe CHI with callosal atrophy and/or lesions. Interhemispheric transfer of information was assessed using auditory, motor, tactile, and visual tests in patients and in 16 uninjured children. Total and regional callosal areas were measured from the midsagittal MRI slice by morphometry. The corpus callosum lesion group demonstrated a greater right ear advantage on verbal dichotic listening than all other groups. Areas of the posterior corpus callosum were negatively correlated with laterality indices of verbal dichotic listening performance and tachistoscopic identification of verbal material. The relationship of corpus callosum atrophy and/or lesions to asymmetry in dichotic listening is consistent with previous investigation of posttraumatic hemispheric disconnection effects in adults.

Adolescent↗

Corpus callosum atrophy and cerebral blood flow in chronic alcoholics.

The corpus callosum atrophy and cerebral blood flows were investigated in chronic alcoholics without Marchiafava-Bignami disease. Fifteen cases of chronic alcoholics and 15 age-matched healthy controls were studied. The sagittal plane of magnetic resonance imaging of the head was scanned into a computer and the corpus callosum was measured and the callosal index was calculated. Cerebral blood flows were measured using stable xenon computed tomography (CT) method. Regional cerebral blood flows in the frontal, temporal, parietal and occipital cortex, frontal, temporal and occipital white matter, caudate nucleus, putamen and thalamus were measured. The corpus callosum area, the thickness of the genu, the thickness of the trunk, the thickness of the splenium, and the callosal index were significantly smaller in the chronic alcoholic group than in the healthy control group. Blood flows in the cerebral cortex, thalamus and putamen were significantly lower in the chronic alcoholic group than in the healthy control group. Significant positive correlations were present between the corpus callosum atrophy and the cerebral cortex blood flows. Corpus callosum atrophy and decreased cerebral blood flows may be seen in chronic alcoholics without Marchiafava-Bignami disease.

Alcoholism↗

The dynamic nature of language lateralization: effects of lexical and prosodic factors.

In dichotic listening, a right ear advantage for linguistic tasks reflects left hemisphere specialization, and a left ear advantage for prosodic tasks reflects right hemisphere specialization. Three experiments used a response hand manipulation with a dichotic listening task to distinguish between direct access (relative specialization) and callosal relay (absolute specialization) explanations of perceptual asymmetries for linguistic and prosodic processing. Experiment 1 found evidence for direct access in linguistic processing and callosal relay in prosodic processing. Direct access for linguistic processing was found to depend on lexical status (Experiment 2) and affective prosody (Experiment 3). Results are interpreted in terms of a dynamic model of hemispheric specialization in which right hemisphere contributions to linguistic processing emerge when stimuli are words, and when they are spoken with affective prosody.

Analysis of Variance↗

Split-brain patients neglect left personal space during right-handed gestures.

Since some patients with right hemisphere damage or with spontaneous callosal disconnection neglect the left half of space, it has been suggested that the left cerebral hemisphere predominantly attends to the right half of space. However, clinical investigations of patients having undergone surgical callosal section have not shown neglect when the hemispheres are tested separately. These observations question the validity of theoretical models that propose a left hemispheric specialisation for attending to the right half of space. The present study aims to investigate neglect and the use of space by either hand in gestural demonstrations in three split-brain patients as compared to five patients with partial callosotomy and 11 healthy subjects. Subjects were asked to demonstrate with precise gestures and without speaking the content of animated scenes with two moving objects. The results show that in the absence of primary perceptual or representational neglect, split-brain patients neglect left personal space in right-handed gestural demonstrations. Since this neglect of left personal space cannot be explained by directional or spatial akinesia, it is suggested that it originates at the conceptual level, where the spatial coordinates for right-hand gestures are planned. The present findings are at odds with the position that the separate left hemisphere possesses adequate mechanisms for acting in both halves of space and neglect results from right hemisphere suppression of this potential. Rather, the results provide support for theoretical models that consider the left hemisphere as specialised for processing the right half of space during the execution of descriptive gestures.

Adult↗

Redundancy gain in simple reaction time following partial and complete callosotomy.

Four subjects with partial or complete section of the corpus callosum were tested on simple reaction time (RT) to visual stimuli presented either singly in one or other visual field, or simultaneously in both visual fields. The subject with posterior callosal section showed evidence of redundancy gain with bilateral stimuli beyond that attributable to probability summation ("enhanced" redundancy gain), and prolonged interhemispheric transfer. One of the two subjects with anterior section, like normals, showed little evidence of enhanced redundancy gain, and no evidence of prolonged interhemispheric transfer. The other did show some enhanced redundancy gain at the fast end of the RT distribution. These and other results suggest that the posterior corpus callosum provides the principal route or routes of interhemispheric transfer of the information required for simple visuomotor responses, and is also responsible for the much reduced redundancy gain in normal subjects relative to that in split-brained subjects. The subject with complete callosal section was unusual in that he responded only very rarely to stimuli in the left visual field (LVF), yet he showed markedly reduced RTs to bilateral relative to right visual field (RVF) stimuli.

Adult↗

High level object recognition without an anterior inferior temporal lobe.

Seven individuals with unilateral anterior inferior temporal (AIT) lobectomies performed two types of shape recognition tasks with line drawing of 3D objects briefly presented in either the left or the right visual field. In one task, subjects named familiar objects in a name priming paradigm. In the other task, subjects judged whether two objects, presented sequentially with an intervening mask, were the same or different in shape, disregarding differences in orientation of up to 60 degrees in depth. They could not use names or basic level concepts to do the matching as the stimuli were either nonsense objects or, if familiar objects, were of same name-different-shaped exemplars on different trials. The disadvantage of presenting an image to the lobectomized hemisphere was negligible in both tasks. Two non-exclusive possibilities are suggested by this result: (a) Object recognition is completed posterior to AIT, likely at the temporal-occipital boundary, with no deleterious retrograde effects on object recognition from the AIT section, or (b) Callosal transfer of object information prior to AIT is completely efficient. These results, along with results of single unit recording and lesion experiments in the monkey, PET and MRI imaging in humans, and a plausibility argument based on the pattern of callosal connections suggest both are correct. Rather than mediating real-time object recognition, AIT may code representations for visual episodes and scenes.

Adult↗

Hemispheric asymmetry and interhemispheric transfer in reaching programming.

The purpose of this study was to explore the intrahemispheric processes and the interhemispheric transfer that occur during the programming of a pointing movement. Twenty five subjects participated in this experiment: 12 were right-handed (Rhr), 12 left-handed (Lhr), and 1 was left-handed with a posterior callosal lesion. The task consisted in producing an open loop pointing response toward a visual target appearing briefly on the right or the left of a central fixation point. Reaction times (RTs) were shorter for the Rhrs when reaching with the left hand than with the right hand. No such hand-related difference was observed in the Lhrs. The left hand advantage indicates that one process was faster in the right hemisphere of Rhrs. This faster process appears not to be visual but motor or visuomotor. For either hand, responses were faster when the target appeared in the visual field homolateral to the pointing hand (uncrossed condition) than when it appeared contralaterally to the hand (crossed condition). The crossed vs uncrossed difference did not vary between Rhrs and Lhrs or between the hands. The transfer time between the hemispheres was symmetrical whatever its direction. The partially callosotomized left-handed subject was two-fold slower than the control Lhrs. His uncrossed responses were faster than the crossed ones, but his interhemispheric transfer time was very asymmetrical: it was normal from right to left hemisphere but was highly increased in the opposite direction. An attempt at modelling the RT data is proposed and the possibility of different callosal locations for the interhemispheric transfer is discussed.

Adult↗

[Alien hand syndrome due to a corpus callosum infarct: a case report].

A 64-year-old man with alien hand syndrome presented with abnormal feelings in the left upper limb, associated with an intermanual conflict. There were no clinical signs of frontal or parietal apraxia. This syndrome was induced by an infarct localized in the right posterior area of the splenium, subsequent to a cardiogenic embolus. This observation enlightens the rising syndrome of callosal type alien syndrome due to a posterior callosal infarct.

Brain↗