title: Marchiafava-Bignami disease: literature review and case report.
abstract: OBJECTIVE
  We postulated that disruption of callosal pathways as occurs in Marchiafava-Bignami disease (MBD) is associated with marked impairment in brain functioning as measured by cognitive assessment and neuroimaging.
  
  
  BACKGROUND
  MBD is considered to be a rare and severe complication of chronic alcoholism. It is characterized by necrosis and subsequent atrophy of the corpus callosum, which is the major brain structure connecting corresponding areas of both hemispheres.
  
  
  METHODS
  We review the existing literature on MBD with respect to conceptualization, theories of pathogenesis, forms of the disease, and neuroimaging and neuropsychological findings. We then present the case of a middle-aged man with MBD who underwent extensive clinical, neuropsychological, and neuroimaging studies.
  
  
  RESULTS
  Neuropsychological evaluation revealed a pattern of severe global dementia. Magnetic resonance imaging showed moderate atrophy of anterior callosal regions and severe atrophy of posterior callosal regions in the setting of cortical and subcortical atrophy. Resting metabolism positron emission tomography revealed decreased glucose metabolism most pronounced in subcortical and mesial frontal regions. The differential diagnosis, function of the corpus callosum, and potential limitations of our case study are discussed.
  
  
  CONCLUSIONS
  On account of the history, clinical presentation, and results of magnetic resonance imaging of the brain, we diagnosed our patient with chronic MBD.
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia 19104-4283, USA.
authors.forename: C G
authors.initials: CG
authors.lastname: Kohler
authors.forename: B M
authors.initials: BM
authors.lastname: Ances
authors.forename: A R
authors.initials: AR
authors.lastname: Coleman
authors.forename: J D
authors.initials: JD
authors.lastname: Ragland
authors.forename: M
authors.initials: M
authors.lastname: Lazarev
authors.forename: R C
authors.initials: RC
authors.lastname: Gur
mesh_terms: D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000503:physiopathology*; D001284:Atrophy; D003337:Corpus Callosum / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D000431:Ethanol / Q000009:adverse effects; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009483:Neuropsychological Tests; D013577:Syndrome; D014055:Tomography, Emission-Computed
chemical_list: D000431:Ethanol