Jacy Bezerra Parmera1, Artur Martins Coutinho2, Mateus Rozalem Aranha2,3, Adalberto Studart-Neto1, Camila de Godoi Carneiro2, Isabel Junqueira de Almeida4, Davi J Fontoura Solla5, Carla Rachel Ono2, Egberto Reis Barbosa1, Ricardo Nitrini1, Carlos Alberto Buchpiguel2, Sonia Maria Dozzi Brucki1. 1. Department of Neurology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil. 2. Laboratory of Nuclear Medicine (LIM 43), Center of Nuclear Medicine, Institute of Radiology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil. 3. Laboratory of Magnetic Resonance in Neuroradiology (LIM 44), Institute of Radiology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil. 4. Department of Physical Therapy, Speech, and Occupational Therapy, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil. 5. Department of Neurology, Division of Neurosurgery, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil.
Abstract
BACKGROUND: Corticobasal syndrome (CBS) is an atypical parkinsonian syndrome related to multiple underlying pathologies. OBJECTIVE: To investigate if individual brain [18 F]fluorodeoxyglucose-positron emission tomography (FDG-PET) patterns could distinguish CBS due to Alzheimer's disease (AD) from other pathologies based on [11 C]Pittsburgh Compound-B (PIB)-PET. METHODS: Forty-five patients with probable CBS were prospectively evaluated regarding cognitive and movement disorders profile. They underwent FDG-PET and were distributed into groups: likely related to AD (CBS FDG-AD) or likely non-AD (CBS FDG-nonAD) pathology. Thirty patients underwent PIB-PET on a hybrid PET-magnetic resonance imaging equipment to assess their amyloid status. FDG and PIB-PET images were classified individually based on visual and semi-quantitative analysis, blinded to each other. Quantitative group analyses were also performed. RESULTS: CBS FDG-AD group demonstrated worse cognitive performances, mostly concerning attention, memory, visuospatial domains, and displayed more myoclonus and hallucinations. The non-AD metabolic group presented more often limb dystonia, ocular motor dysfunction, motor perseveration, and dysarthria. All patients classified as CBS FDG-AD tested positive at PIB-PET compared to 3 of 20 in the non-AD group. The individual FDG-PET classification demonstrated 76.92% of sensitivity, 100% of specificity and positive predictive value and 88.5% of balanced accuracy to detect positive PIB-PET scans. Individuals with positive and negative PIB-PET showed hypometabolism in posterior temporoparietal areas and in thalamus and brainstem, respectively, mainly contralateral to most affected side, disclosing possible metabolic signatures of CBS variants. CONCLUSION: FDG-PET was useful to predict AD and non-AD CBS variants depicting their specific degeneration patterns, different clinical features, and brain amyloid deposition.
BACKGROUND: Corticobasal syndrome (CBS) is an atypical parkinsonian syndrome related to multiple underlying pathologies. OBJECTIVE: To investigate if individual brain [18 F]fluorodeoxyglucose-positron emission tomography (FDG-PET) patterns could distinguish CBS due to Alzheimer's disease (AD) from other pathologies based on [11 C]Pittsburgh Compound-B (PIB)-PET. METHODS: Forty-five patients with probable CBS were prospectively evaluated regarding cognitive and movement disorders profile. They underwent FDG-PET and were distributed into groups: likely related to AD (CBS FDG-AD) or likely non-AD (CBS FDG-nonAD) pathology. Thirty patients underwent PIB-PET on a hybrid PET-magnetic resonance imaging equipment to assess their amyloid status. FDG and PIB-PET images were classified individually based on visual and semi-quantitative analysis, blinded to each other. Quantitative group analyses were also performed. RESULTS: CBS FDG-AD group demonstrated worse cognitive performances, mostly concerning attention, memory, visuospatial domains, and displayed more myoclonus and hallucinations. The non-AD metabolic group presented more often limb dystonia, ocular motor dysfunction, motor perseveration, and dysarthria. All patients classified as CBS FDG-AD tested positive at PIB-PET compared to 3 of 20 in the non-AD group. The individual FDG-PET classification demonstrated 76.92% of sensitivity, 100% of specificity and positive predictive value and 88.5% of balanced accuracy to detect positive PIB-PET scans. Individuals with positive and negative PIB-PET showed hypometabolism in posterior temporoparietal areas and in thalamus and brainstem, respectively, mainly contralateral to most affected side, disclosing possible metabolic signatures of CBS variants. CONCLUSION: FDG-PET was useful to predict AD and non-AD CBS variants depicting their specific degeneration patterns, different clinical features, and brain amyloid deposition.
Authors: Sabrina Katzdobler; Alexander Nitschmann; Johannes Levin; Matthias Brendel; Henryk Barthel; Gerard Bischof; Leonie Beyer; Ken Marek; Mengmeng Song; Olivia Wagemann; Carla Palleis; Endy Weidinger; Anne Nack; Urban Fietzek; Carolin Kurz; Jan Häckert; Theresa Stapf; Christian Ferschmann; Maximilian Scheifele; Florian Eckenweber; Gloria Biechele; Nicolai Franzmeier; Anna Dewenter; Sonja Schönecker; Dorothee Saur; Matthias L Schroeter; Jost-Julian Rumpf; Michael Rullmann; Andreas Schildan; Marianne Patt; Andrew W Stephens; Thilo van Eimeren; Bernd Neumaier; Alexander Drzezga; Adrian Danek; Joseph Classen; Katharina Bürger; Daniel Janowitz; Boris-Stephan Rauchmann; Sophia Stöcklein; Robert Perneczky; Florian Schöberl; Andreas Zwergal; Günter U Höglinger; Peter Bartenstein; Victor Villemagne; John Seibyl; Osama Sabri Journal: Eur J Nucl Med Mol Imaging Date: 2022-09-14 Impact factor: 10.057
Authors: Fulvio Lauretani; Yari Longobucco; Giulia Ravazzoni; Elena Gallini; Marco Salvi; Marcello Maggio Journal: Int J Environ Res Public Health Date: 2021-02-28 Impact factor: 3.390
Authors: Julia Schmitt; Carla Palleis; Julia Sauerbeck; Marcus Unterrainer; Stefanie Harris; Catharina Prix; Endy Weidinger; Sabrina Katzdobler; Olivia Wagemann; Adrian Danek; Leonie Beyer; Boris-Stephan Rauchmann; Axel Rominger; Mikael Simons; Peter Bartenstein; Robert Perneczky; Christian Haass; Johannes Levin; Günter U Höglinger; Matthias Brendel Journal: Front Aging Neurosci Date: 2021-05-13 Impact factor: 5.750