1st Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, Athens, Greece.
Nuclear Medicine Division, 1st Radiology Department, National and Kapodistrian University of Athens, Aretaieion Hospital, Athens, Greece.
Acta Neurol Scand. 2022 Jun;145(6):762-769. doi: 10.1111/ane.13614. Epub 2022 Mar 20.
Multiple pathologies may underlie corticobasal syndrome (CBS), including Alzheimer's disease (AD). Dopamine transporter density imaging with Ioflupane I SPECT (DaTscan) may be normal in CBS. No studies to date have examined the relationship between DaTscan status and underlying pathology in CBS.
The main objective of the study was to test whether a normal DaTscan in CBS patients is indicative of an underlying AD pathology, as determined by cerebrospinal fluid (CSF) biomarkers.
Eighteen CBS patients were included. They were divided into patients with an AD and a non-AD disease pathology, based on their cerebrospinal fluid biochemical profile. A typical AD CSF profile was defined as an increase in total and phosphorylated at threonine 181 tau protein in addition to a decrease in amyloid-beta with 42 amino acids. DaTscan data were compared in these two groups.
Eight of the 18 CBS patients (44%) had a normal DaTscan. Seven of the 18 CBS patients (39%) had an AD cerebrospinal fluid biochemical profile. Two of seven CBS patients with AD biomarker profile had abnormal DaTscans. Three of 11 CBS patients with a non-AD biomarker profile had normal DaTscans. A normal DaTscan was indicative of AD pathology with suboptimal (~70%) sensitivity and specificity. Semi-quantitative DaTscan analysis did not differentiate between AD from non-AD CSF biomarker profile in CBS.
A normal DaTscan is indicative of AD in CBS, but the sensitivity and specificity of DaTscan as an in vivo marker of AD pathology is suboptimal.
皮质基底节综合征（CBS）可能存在多种病理学改变，包括阿尔茨海默病（AD）。使用碘氟苯 1 SPECT（DaTscan）进行多巴胺转运蛋白密度成像可能在 CBS 中正常。迄今为止，尚无研究检查 DaTscan 状态与 CBS 中潜在病理学之间的关系。
本研究的主要目的是测试 DaTscan 在 CBS 患者中是否正常，是否提示存在 AD 病理学，这是通过脑脊液（CSF）生物标志物来确定的。
纳入 18 例 CBS 患者。根据他们的脑脊液生化特征，将他们分为 AD 和非 AD 疾病病理学患者。典型的 AD CSF 图谱定义为总 tau 蛋白和磷酸化丝氨酸 181 增加，以及 42 个氨基酸的淀粉样蛋白-β减少。比较这两组患者的 DaTscan 数据。
18 例 CBS 患者中有 8 例（44%）DaTscan 正常。18 例 CBS 患者中有 7 例（39%）有 AD 脑脊液生化特征。7 例具有 AD 生物标志物特征的 CBS 患者中有 2 例 DaTscan 异常。11 例具有非 AD 生物标志物特征的 CBS 患者中有 3 例 DaTscan 正常。DaTscan 正常提示 AD 病理学，但敏感性和特异性欠佳（~70%）。DaTscan 半定量分析不能区分 CBS 中 AD 与非 AD CSF 生物标志物特征。
DaTscan 正常提示 CBS 中的 AD，但 DaTscan 作为 AD 病理学的体内标志物的敏感性和特异性欠佳。
