Life sciences · Journal article
Frontiers in Neurology · November 2, 2026
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Background The corpus callosum (CC) is the largest white matter structure and is often affected in neurological and neuroimmunological disorders. However, previous studies mainly used group-level comparisons. This limits patient-level magnetic resonance imaging (MRI) assessment. Methods In this multicenter retrospective study, 3D T 1 -weighted MRI data from 24,305 healthy controls aged 4–85 years were used to construct age-,sex-, and estimated total intracranial volume (eTIV)- adjusted normative references for the whole CC and five subregions. Deviation scores were calculated and applied to 4,081 patients with multiple sclerosis (MS, n = 573), neuromyelitis optica spectrum disorder (NMOSD, n = 389), mild cognitive impairment (MCI, n = 308), Alzheimer’s disease (AD, n = 623), Parkinson’s disease (PD, n = 1,285), and cerebral small vessel disease (CSVD, n = 903). Classification, clinical correlation, and prognostic analyses were performed as exploratory applications. Results The volume of CC subregions peaked from early adulthood (central, 26.0 years) to midlife (posterior, 47.2 years; anterior, 47.5 years), forming a “centre-to-periphery” pattern. MS showed negative deviations mainly in central and mid-anterior regions (Cohen’s d = −0.28 to −0.30, p FDR<0.001), while CSVD and AD showed widespread negative deviations ( d = −0.13 to −0.49). NMOSD, MCI, and PD showed relatively small or regionally limited deviations. Deviation score based classification performance ranged from AUC = 0.598–0.775. Exploratory analyses identified weak correlations between deviation scores and processing speed in MS (Spearman’s ρ up to 0.22, p < 0.05) and cognition in CSVD ( ρ = 0.12–0.19, p < 0.05) and AD ( ρ = 0.10–0.16, p < 0.05). None survived FDR correction. Baseline deviation-based risk groups stratified subsequent relapse and disability outcomes in MS and NMOSD ( p < 0.001). An exploratory comparison suggested a nominal difference in baseline CC deviation burden between MCI converters and non-converters to AD. Conclusion Lifespan normative references of the CC provide a quantitative framework for characterizing individual structural deviations across neurological and neuroimmunological disorders. Exploratory clinical analyses suggest potential applications that require further validation.