title: Different patterns of fornix damage in idiopathic normal pressure hydrocephalus and Alzheimer disease.
abstract: OBJECTIVE
  The fornix contains efferent fibers of the hippocampus and is in close contact with the corpus callosum. Part of the fornix is directly attached to the corpus callosum, and another part is suspended from the corpus callosum via the septum pellucidum. DTI can be used to evaluate the morphology and microstructural integrity of the fornix. We examined the pattern of fornix damage in patients with iNPH or AD.
  
  
  METHODS
  We enrolled 22 patients with iNPH, 20 with AD, and 20 healthy controls. DTI data were obtained. The morphology (volume, length, and mean cross-sectional area) and FA values of the fornix were evaluated by using tract-specific analysis and compared among groups.
  
  
  RESULTS
  The volume, cross-sectional area, and FA value of the fornix were significantly smaller in patients with iNPH than in controls, whereas the length was significantly greater. In patients with AD, the volume, mean cross-sectional area, and FA value of the fornix were significantly smaller than those in controls, whereas the length was not altered. The fornix was significantly longer in patients with iNPH than in patients with AD, whereas the volume and cross-sectional areas were significantly smaller.
  
  
  CONCLUSIONS
  Our results suggest that the different pathogeneses of these diseases lead to fornix damage through different mechanisms: through mechanical stretching due to lateral ventricular enlargement and corpus callosum deformation in patients with iNPH, and through degeneration secondary to hippocampal atrophy in patients with AD.
authors.affiliation: Department of Neurology and Neurological Sciences, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan. takaaki-hattori@umin.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Hattori
authors.forename: R
authors.initials: R
authors.lastname: Sato
authors.forename: S
authors.initials: S
authors.lastname: Aoki
authors.forename: T
authors.initials: T
authors.lastname: Yuasa
authors.forename: H
authors.initials: H
authors.lastname: Mizusawa
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000473:pathology*; D056324:Diffusion Tensor Imaging; D005260:Female; D020712:Fornix, Brain / Q000473:pathology*; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000473:pathology*; D008297:Male
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