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FDG‐PET Patterns Predict Amyloid Deposition and Clinical Profile in Corticobasal Syndrome
Author(s) -
Parmera Jacy Bezerra,
Coutinho Artur Martins,
Aranha Mateus Rozalem,
StudartNeto 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
Publication year - 2021
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.28373
Subject(s) - pittsburgh compound b , positron emission tomography , corticobasal degeneration , nuclear medicine , psychology , magnetic resonance imaging , medicine , standardized uptake value , progressive supranuclear palsy , dementia , pathology , radiology , disease
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. © 2020 International Parkinson and Movement Disorder Society