National Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan; Department of Neurology, Chiba University Graduate School of Medicine, Chiba, Japan; Department of Neurology, Chibaken Saiseikai Narashino Hospital, Narashino, Japan.
National Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan; Department of Functional Neurology & Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan.
Parkinsonism Relat Disord. 2022 May;98:92-98. doi: 10.1016/j.parkreldis.2022.04.015. Epub 2022 Apr 25.
Corticobasal degeneration (CBD) is the most common neuropathological substrate for clinically diagnosed corticobasal syndrome (CBS), while identifying CBD pathology in living individuals has been challenging. This study aimed to examine the capability of positron emission tomography (PET) to detect CBD-type tau depositions and neuropathological classification of CBS.
Sixteen CBS cases diagnosed by Cambridge's criteria and 12 cognitively healthy controls (HCs) underwent PET scans with C-PiB, C-PBB3, and F-FDG, along with T1-weighted magnetic resonance imaging. Amyloid positivity was assessed by visual inspection of C-PiB retentions. Tau positivity was judged by quantitative comparisons of C-PBB3 binding to HCs.
Sixteen CBS cases consisted of two cases (13%) with amyloid and tau positivities indicative of Alzheimer's disease (AD) pathologies, 11 cases (69%) with amyloid negativity and tau positivity, and three cases (19%) with amyloid and tau negativities. Amyloid(-), tau(+) CBS cases showed increased retentions of C-PBB3 in the frontoparietal areas, basal ganglia, and midbrain, and reduced metabolism in the precentral gyrus and thalamus relative to HCs. The enhanced tau probe retentions in the frontal gray and white matters partially overlapped with metabolic deficits and atrophy and correlated with Clinical Dementia Rating scores.
PET-based classification of CBS was in accordance with previous neuropathological reports on the prevalences of AD, non-AD tauopathies, and others in CBS. The current work suggests that C-PBB3-PET may assist the biological classification of CBS and understanding of links between CBD-type tau depositions and neuronal deteriorations leading to cognitive declines.
皮质基底节变性（CBD）是临床诊断的皮质基底节综合征（CBS）最常见的神经病理学基础，而在活体中识别 CBD 病理学一直具有挑战性。本研究旨在检查正电子发射断层扫描（PET）检测 CBD 型 tau 沉积和 CBS 神经病理学分类的能力。
16 例经剑桥标准诊断为 CBS 的病例和 12 例认知健康对照（HC）接受了 C-PiB、C-PBB3 和 F-FDG 的 PET 扫描以及 T1 加权磁共振成像。通过 C-PiB 保留的视觉检查评估淀粉样蛋白阳性。通过与 HC 进行 C-PBB3 结合的定量比较来判断 tau 阳性。
16 例 CBS 病例包括 2 例（13%）具有阿尔茨海默病（AD）病理学的淀粉样蛋白和 tau 阳性，11 例（69%）淀粉样蛋白阴性和 tau 阳性，3 例（19%）淀粉样蛋白和 tau 阴性。淀粉样蛋白（-）、tau（+）CBS 病例与 HC 相比，额顶叶、基底节和中脑的 C-PBB3 保留增加，中央前回和丘脑的代谢减少。额叶灰质和白质中增强的 tau 探针保留与代谢缺陷和萎缩部分重叠，并与临床痴呆评定量表评分相关。
基于 PET 的 CBS 分类与 CBS 中 AD、非 AD tau 病和其他疾病的先前神经病理学报告一致。目前的工作表明，C-PBB3-PET 可能有助于 CBS 的生物学分类，并有助于理解 CBD 型 tau 沉积与导致认知下降的神经元恶化之间的联系。
