Document Detail


Imaging correlates of pathology in corticobasal syndrome.
MedLine Citation:
PMID:  21098403     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Corticobasal syndrome (CBS) can be associated with different underlying pathologies that are difficult to predict based on clinical presentation. The aim of this study was to determine whether patterns of atrophy on imaging could be useful to help predict underlying pathology in CBS.
METHODS: This was a case-control study of 24 patients with CBS who had undergone MRI during life and came to autopsy. Pathologic diagnoses included frontotemporal lobar degeneration (FTLD) with TDP-43 immunoreactivity in 5 (CBS-TDP), Alzheimer disease (AD) in 6 (CBS-AD), corticobasal degeneration in 7 (CBS-CBD), and progressive supranuclear palsy in 6 (CBS-PSP). Voxel-based morphometry and atlas-based parcellation were used to assess atrophy across the CBS groups and compared to 24 age- and gender-matched controls.
RESULTS: All CBS pathologic groups showed gray matter loss in premotor cortices, supplemental motor area, and insula on imaging. However, CBS-TDP and CBS-AD showed more widespread patterns of loss, with frontotemporal loss observed in CBS-TDP and temporoparietal loss observed in CBS-AD. CBS-TDP showed significantly greater loss in prefrontal cortex than the other groups, whereas CBS-AD showed significantly greater loss in parietal lobe than the other groups. The focus of loss was similar in CBS-CBD and CBS-PSP, although more severe in CBS-CBD.
CONCLUSIONS: Imaging patterns of atrophy in CBS vary according to pathologic diagnosis. Widespread atrophy points toward a pathologic diagnosis of FTLD-TDP or AD, with frontotemporal loss suggesting FTLD-TDP and temporoparietal loss suggesting AD. On the contrary, more focal atrophy predominantly involving the premotor and supplemental motor area suggests CBD or PSP pathology.
Authors:
J L Whitwell; C R Jack; B F Boeve; J E Parisi; J E Ahlskog; D A Drubach; M L Senjem; D S Knopman; R C Petersen; D W Dickson; K A Josephs
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurology     Volume:  75     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-01-04     Revised Date:  2011-12-21    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1879-87     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA. whitwell.jennifer@mayo.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Alzheimer Disease / complications,  pathology
Atrophy
Basal Ganglia / pathology*
Brain Diseases / complications,  diagnosis*,  metabolism
Cadaver
Case-Control Studies
Cerebral Cortex / pathology*
DNA-Binding Proteins / metabolism
Female
Frontal Lobe / pathology
Humans
Magnetic Resonance Imaging*
Male
Middle Aged
Motor Cortex / pathology
Parietal Lobe / pathology
Periaqueductal Gray / pathology
Prefrontal Cortex / pathology
Supranuclear Palsy, Progressive / complications,  pathology
Syndrome
Temporal Lobe / pathology
Grant Support
ID/Acronym/Agency:
2P50 NS040256-10/NS/NINDS NIH HHS; C06 RR018898/RR/NCRR NIH HHS; ES010751-10/ES/NIEHS NIH HHS; NS32352-13/NS/NINDS NIH HHS; P01-AG03949/AG/NIA NIH HHS; P01-AG17216/AG/NIA NIH HHS; P50 AG16574/AG/NIA NIH HHS; P50 NS 40256-R/NS/NINDS NIH HHS; P50-AG16574/AG/NIA NIH HHS; P50-AG25711/AG/NIA NIH HHS; P50-NS40256/NS/NINDS NIH HHS; R01 AG15866/AG/NIA NIH HHS; R01 HL70825/HL/NHLBI NIH HHS; R01- DC010367/DC/NIDCD NIH HHS; R01-AG023195/AG/NIA NIH HHS; R01-AG037491/AG/NIA NIH HHS; R01-AG11378/AG/NIA NIH HHS; R01-AG15866/AG/NIA NIH HHS; R01-DC010367/DC/NIDCD NIH HHS; U01 AG 06786/AG/NIA NIH HHS; U01 AG024904-01/AG/NIA NIH HHS; U01-24904//PHS HHS; U01-AG06786/AG/NIA NIH HHS; U24 AG026395/AG/NIA NIH HHS
Chemical
Reg. No./Substance:
0/DNA-Binding Proteins; 0/protein TDP-43
Comments/Corrections
Comment In:
J Neurol. 2011 Jan;258(1):173-5   [PMID:  21165636 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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