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July 1989

Commissural Connections and Symmetry of Degeneration in Alzheimer's Disease

Author Affiliations

Departments of Neurology and Psychiatry University of Rochester Medical Center Box 605 Rochester, NY 14642
Department of Anatomy Boston University School of Medicine Boston, MA 02118
Department of Anatomy University of Iowa College of Medicine Iowa City, IA 52242

Arch Neurol. 1989;46(7):723-724. doi:10.1001/archneur.1989.00520430017011

To the Editor.  —The observations of Moossy et al1 in a recent issue of the Archives on the distribution of the neuropathologic lesions of Alzheimer's disease are of interest, since there appear to be parallels between the symmetry (or lack thereof) of neurofibrillary tangles and the presence (or absence) of interhemispheric neuronal connections. These investigators reported that neuritic plaques are distributed symmetrically in the superior frontal and superior temporal gyri, prosubiculum, and entorhinal cortex, whereas neurofibrillary tangles are distributed symmetrically in neocortical areas but asymmetrically in the prosubiculum and entorhinal cortex.To the extent that these observations are accurate, it is noteworthy that macaques have prominent interhemispheric connections in neocortical association areas2 (S.D., D.L.R., G.W., V.H., unpublished observations, 1989), while such connections are lacking in all but the most rostral part of the hippocampal formation.3,4 Moreover, the entire extent of the prosubiculum lacks interhemispheric connections. Whereas neocortical

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