FDG-PET patterns associated with underlying pathology in corticobasal syndrome

Matteo Pardini, Edward D. Huey, Salvatore Spina, William C. Kreisl, Silvia Morbelli, Eric M. Wassermann, Flavio Nobili, Bernardino Ghetti, Jordan Henry Grafman

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To evaluate brain 18Fluorodeoxyglucose PET (FDG-PET) differences among patients with a clinical diagnosis of corticobasal syndrome (CBS) and distinct underling primary pathologies. METHODS: We studied 29 patients with a diagnosis of CBS who underwent FDG-PET scan and postmortem neuropathologic examination. Patients were divided into subgroups on the basis of primary pathologic diagnosis: CBS-corticobasal degeneration (CBS-CBD) (14 patients), CBS-Alzheimer disease (CBS-AD) (10 patients), and CBS-progressive supranuclear palsy (CBS-PSP) (5 patients). Thirteen age-matched healthy patients who underwent FDG-PET were the control group (HC). FDG-PET scans were compared between the subgroups and the HC using SPM-12, with a threshold of pFWE < 0.05. RESULTS: There were no differences in Mattis Dementia Rating Scale or finger tapping scores between CBS groups. Compared to HC, the patients with CBS presented significant hypometabolism in frontoparietal regions, including the perirolandic area, basal ganglia, and thalamus of the clinically more affected hemisphere. Patients with CBS-CBD showed a similar pattern with a more marked, bilateral involvement of the basal ganglia. Patients with CBS-AD presented with posterior, asymmetric hypometabolism, including the lateral parietal and temporal lobes and the posterior cingulate. Finally, patients with CBS-PSP disclosed a more anterior hypometabolic pattern, including the medial frontal regions and the anterior cingulate. A conjunction analysis revealed that the primary motor cortex was the only common area of hypometabolism in all groups, irrespective of pathologic diagnosis. DISCUSSION AND CONCLUSIONS: In patients with CBS, different underling pathologies are associated with different patterns of hypometabolism. Our data suggest that FDG-PET scans could help in the etiologic diagnosis of CBS.

Original languageEnglish (US)
Pages (from-to)e1121-e1135
JournalNeurology
Volume92
Issue number10
DOIs
StatePublished - Mar 5 2019
Externally publishedYes

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Pathology
Positron-Emission Tomography
Gyrus Cinguli
Basal Ganglia
Progressive Supranuclear Palsy
Parietal Lobe
Motor Cortex
Temporal Lobe
Thalamus
Fingers
Dementia
Autopsy
Control Groups
Brain

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Pardini, M., Huey, E. D., Spina, S., Kreisl, W. C., Morbelli, S., Wassermann, E. M., ... Grafman, J. H. (2019). FDG-PET patterns associated with underlying pathology in corticobasal syndrome. Neurology, 92(10), e1121-e1135. https://doi.org/10.1212/WNL.0000000000007038
Pardini, Matteo ; Huey, Edward D. ; Spina, Salvatore ; Kreisl, William C. ; Morbelli, Silvia ; Wassermann, Eric M. ; Nobili, Flavio ; Ghetti, Bernardino ; Grafman, Jordan Henry. / FDG-PET patterns associated with underlying pathology in corticobasal syndrome. In: Neurology. 2019 ; Vol. 92, No. 10. pp. e1121-e1135.
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Pardini, M, Huey, ED, Spina, S, Kreisl, WC, Morbelli, S, Wassermann, EM, Nobili, F, Ghetti, B & Grafman, JH 2019, 'FDG-PET patterns associated with underlying pathology in corticobasal syndrome', Neurology, vol. 92, no. 10, pp. e1121-e1135. https://doi.org/10.1212/WNL.0000000000007038

FDG-PET patterns associated with underlying pathology in corticobasal syndrome. / Pardini, Matteo; Huey, Edward D.; Spina, Salvatore; Kreisl, William C.; Morbelli, Silvia; Wassermann, Eric M.; Nobili, Flavio; Ghetti, Bernardino; Grafman, Jordan Henry.

In: Neurology, Vol. 92, No. 10, 05.03.2019, p. e1121-e1135.

Research output: Contribution to journalArticle

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T1 - FDG-PET patterns associated with underlying pathology in corticobasal syndrome

AU - Pardini, Matteo

AU - Huey, Edward D.

AU - Spina, Salvatore

AU - Kreisl, William C.

AU - Morbelli, Silvia

AU - Wassermann, Eric M.

AU - Nobili, Flavio

AU - Ghetti, Bernardino

AU - Grafman, Jordan Henry

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N2 - OBJECTIVE: To evaluate brain 18Fluorodeoxyglucose PET (FDG-PET) differences among patients with a clinical diagnosis of corticobasal syndrome (CBS) and distinct underling primary pathologies. METHODS: We studied 29 patients with a diagnosis of CBS who underwent FDG-PET scan and postmortem neuropathologic examination. Patients were divided into subgroups on the basis of primary pathologic diagnosis: CBS-corticobasal degeneration (CBS-CBD) (14 patients), CBS-Alzheimer disease (CBS-AD) (10 patients), and CBS-progressive supranuclear palsy (CBS-PSP) (5 patients). Thirteen age-matched healthy patients who underwent FDG-PET were the control group (HC). FDG-PET scans were compared between the subgroups and the HC using SPM-12, with a threshold of pFWE < 0.05. RESULTS: There were no differences in Mattis Dementia Rating Scale or finger tapping scores between CBS groups. Compared to HC, the patients with CBS presented significant hypometabolism in frontoparietal regions, including the perirolandic area, basal ganglia, and thalamus of the clinically more affected hemisphere. Patients with CBS-CBD showed a similar pattern with a more marked, bilateral involvement of the basal ganglia. Patients with CBS-AD presented with posterior, asymmetric hypometabolism, including the lateral parietal and temporal lobes and the posterior cingulate. Finally, patients with CBS-PSP disclosed a more anterior hypometabolic pattern, including the medial frontal regions and the anterior cingulate. A conjunction analysis revealed that the primary motor cortex was the only common area of hypometabolism in all groups, irrespective of pathologic diagnosis. DISCUSSION AND CONCLUSIONS: In patients with CBS, different underling pathologies are associated with different patterns of hypometabolism. Our data suggest that FDG-PET scans could help in the etiologic diagnosis of CBS.

AB - OBJECTIVE: To evaluate brain 18Fluorodeoxyglucose PET (FDG-PET) differences among patients with a clinical diagnosis of corticobasal syndrome (CBS) and distinct underling primary pathologies. METHODS: We studied 29 patients with a diagnosis of CBS who underwent FDG-PET scan and postmortem neuropathologic examination. Patients were divided into subgroups on the basis of primary pathologic diagnosis: CBS-corticobasal degeneration (CBS-CBD) (14 patients), CBS-Alzheimer disease (CBS-AD) (10 patients), and CBS-progressive supranuclear palsy (CBS-PSP) (5 patients). Thirteen age-matched healthy patients who underwent FDG-PET were the control group (HC). FDG-PET scans were compared between the subgroups and the HC using SPM-12, with a threshold of pFWE < 0.05. RESULTS: There were no differences in Mattis Dementia Rating Scale or finger tapping scores between CBS groups. Compared to HC, the patients with CBS presented significant hypometabolism in frontoparietal regions, including the perirolandic area, basal ganglia, and thalamus of the clinically more affected hemisphere. Patients with CBS-CBD showed a similar pattern with a more marked, bilateral involvement of the basal ganglia. Patients with CBS-AD presented with posterior, asymmetric hypometabolism, including the lateral parietal and temporal lobes and the posterior cingulate. Finally, patients with CBS-PSP disclosed a more anterior hypometabolic pattern, including the medial frontal regions and the anterior cingulate. A conjunction analysis revealed that the primary motor cortex was the only common area of hypometabolism in all groups, irrespective of pathologic diagnosis. DISCUSSION AND CONCLUSIONS: In patients with CBS, different underling pathologies are associated with different patterns of hypometabolism. Our data suggest that FDG-PET scans could help in the etiologic diagnosis of CBS.

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Pardini M, Huey ED, Spina S, Kreisl WC, Morbelli S, Wassermann EM et al. FDG-PET patterns associated with underlying pathology in corticobasal syndrome. Neurology. 2019 Mar 5;92(10):e1121-e1135. https://doi.org/10.1212/WNL.0000000000007038