Comparison of Brain Perfusion in Corticobasal Degeneration and Alzheimer’s Disease

Abstract

To compare brain perfusion between corticobasal degeneration (CBD) and Alzheimer’s disease (AD), we measured regional cerebral blood flow (rCBF) semiquantitatively with single-photon emission computed tomography in 10 patients with CBD and 16 with AD. There was no significant difference in age or illness duration between the patients with CBD and AD. Mini-Mental State Examination scores were significantly lower in the AD patients than in the CBD patients. All CBD patients showed asymmetric akinetic-rigid syndrome and limb apraxia. Four CBD patients were demented, and 1 AD patient had parkinsonism. Compared with 12 age-matched control subjects, the average of the left and right rCBF values for the CBD patients was significantly reduced in the prefrontal, anterior cingulate (AC), medial premotor, sensorimotor (SM), posterior parietal (PP) and superior temporal (ST) cortices as well as in the basal ganglia (BG) and thalamus (Th), while the prefrontal, PP and ST cortices were significantly hypoperfused in the AD patients. In the CBD patients, rCBF was significantly less in the AC and SM cortices, and in the Th and BG, and significantly greater in the PP cortex than in the AD patients. Interhemispheric differences of rCBF in the inferior prefrontal and SM cortices were significantly greater in the CBD patients than the AD patients. It is concluded that rCBF comparison may aid in differentiating CBD from AD.

Corticobasal degeneration and Parkinson's disease assessed by HmPaO SPECT: The utility of factorial discriminant analysis

“…33 Hypometabolism or a reduction in CBF in the temporal lobe has sometimes been reported in SPECT studies. 21,22 However, the cortical atrophy mainly affects the superior frontal gyrus and the pre-and postcentral regions; involvement of the inferior parietal lobulus has also often been observed in SPECT studies. 19 Consequently, the reductions in CBF in the temporoparietal and in the temporoinsular regions are better explained by an involvement of the inferior parietal lobulus rather than the temporal lobulus.…”

“…A symmetric involvement of the thalamus is mentioned in other SPECT studies using HmPaO 19 and IMP. 21,22 An asymmetry of "deep nuclei" (with no further details provided) was reported in certain SPECT studies using perfusion tracers (such as HmPaO 20 23 ].…”

“…15 HmPaO SPECT is useful for discriminating PD from dementia with Lewy bodies and AD. 18 HmPaO and 123 I-N-isopropyl-iodoamphetamine (IMP) SPECT studies in CBD have principally underlined the asymmetry of the condition, which involves the perirolandic cortex, 19 -21 the posterior parietal cortex, [21][22][23] or the inferior prefrontal cortex 21 contralateral to the more affected side of the body. To date, only one study has compared CBD and PD using SPECT in order to specify its precise value for differential diagnosis of the two conditions.…”

Apport de la scintigraphie de perfusion cérébrale dans l’exploration du syndrome cortico-basal

“…En TEMP de perfusion cérébrale, différentes études mettent en évidence une perfusion asymétrique [41][42][43][44][45][46][47][48] avec des hypoperfusions régionales d'étendue variable, concernant le cortex fronto-pariétal [41][42][43]46,49,50], en particulier péri-rolandique [50], parfois le cortex temporal [41,44,46,47,49], les ganglions de la base et le thalamus [41,42,44,46,[49][50][51].…”

“…Les ratios tau/Ab42, p-tau/Ab42 et le Innotest Amyloid Tau coupure : 0,4 cm À1 ) puis corrigées de l'atténuation par la méthode de Chang (m = 0,12 cm À1 ). Afin d'augmenter la puissance statistique des analyses et puisque les profils lésionnels des SCB sont généralement asymétriques prédominant du côté opposé à l'atteinte clinique [33][34][35]41,49,[56][57][58], les scintigraphies des patients présentant la latéralisation de la symptomatologie minoritaire eurent une rotation de 1808 selon un axe vertical (« flip » droite-gauche) pour des analyses complémentaires. Les flips concernaient 4 patients (1 patient SCB-MA et 3 patients SCB-nonMA) qui présentaient une symptomatologie dominante de l'hémicorps gauche (les 11 autres patients présentaient une symptomatologie dominante de l'hémicorps droit).…”