Cerebral glucose metabolism, clinical, neuropsychological, and radiological profile in patients with corticobasal syndrome

Abstract

Background: Corticobasal syndrome (CBS) is characterized by progressive asymmetric rigidity and localized cortical disorders namely apraxia, cortical, sensory loss, focal dystonia, and refractory to levodopa treatment.

Aim: To study the cerebral glucose-metabolism, cognitive, and magnetic resonance imaging (MRI) features in patients with CBS.

Materials and methods: Seventeen consecutive patients with CBS who fulfilled the criteria proposed by Lang et al., were studied. A detailed neurological including higher cortical functions and Unified Parkinson's Disease Rating Scale (UPDRS) on and off motor scores and neuropsychological assessment were done. All patients except one had undergone MRI brain and 18-Flouro 5-Deoxy Glucose Positron Emission Tomography (FDG PET CT) brain scan for assessing cortical atrophy and cerebral glucose metabolism, respectively.

Results: Most of the 17 patients had Parkinsonian features with focal cortical signs of dystonia, apraxia, and cortical sensory loss and the hypokinesia was predominantly on left side. Neuropsychological assessment had shown impairment of frontal executive function, visuospatial function, and language. MRI brain showed asymmetrical cortical atrophy in left temparoparietal areas and basal ganglia. The MRI findings correlated with FDG PET brain scan findings, asymmetric focal hypometabolism in basal ganglia and inferior parietal and temporal, frontal lobes.

Conclusion: 18 FDG PET brain is more sensitive than MRI brain in the early diagnosis of CBS and also correlates well with neuropsychological assessment.