FDG‐PET Patterns Predict Amyloid Deposition and Clinical Profile in Corticobasal Syndrome

• Published in: Movement disorders Vol. 36; no. 3; pp. 651 - 661
• Main Authors: Parmera, Jacy Bezerra, Coutinho, Artur Martins, Aranha, Mateus Rozalem, Studart‐Neto, Adalberto, Godoi Carneiro, Camila, Almeida, Isabel Junqueira, Fontoura Solla, Davi J., Ono, Carla Rachel, Barbosa, Egberto Reis, Nitrini, Ricardo, Buchpiguel, Carlos Alberto, Brucki, Sonia Maria Dozzi
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01-03-2021; Wiley Subscription Services, Inc
• Subjects: Alzheimer Disease - diagnostic imaging; Alzheimer's disease; Amyloid - metabolism; Aniline Compounds; Basal ganglia; Brain - diagnostic imaging; Brain - metabolism; Brain diseases; Brain stem; Central nervous system diseases; Cognitive ability; corticobasal syndrome; corticobasal degeneration; positron emission tomography; [18F]fluorodeoxyglucose; amyloid PET; Dystonia; Fluorodeoxyglucose F18; Hallucinations; Humans; Magnetic resonance imaging; Metabolism; Movement disorders; Myoclonus; Neurodegeneration; Neurodegenerative diseases; Neuroimaging; Parkinson's disease; Positron emission tomography; Radiopharmaceuticals; Spatial memory; Thalamus; corticobasal syndrome; corticobasal degeneration; positron emission tomography; [18F]fluorodeoxyglucose; amyloid PET
• ISSN: 0885-3185; 1531-8257
• DOI: 10.1002/mds.28373

ABSTRACT
Background
Corticobasal syndrome (CBS) is an atypical parkinsonian syndrome related to multiple underlying pathologies.
Objective
To investigate if individual brain [18F]fluorodeoxyglucose‐positron emission tomography (FDG‐PET) patterns could distinguish CBS due to Alzheimer's disease (AD) from other pathologies based on [11C]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. © 2020 International Parkinson and Movement Disorder Society