This research by Mayo Rochester (including CBD expert Dr. Brad Boeve) was published a couple of days ago. In this study, 16 patients had a clinical diagnosis of CBS (corticobasal syndrome). After death, 11 were pathologically diagnosed with CBD (corticobasal degeneration) and 5 with Alzheimer’s Disease (AD). Here are the key differences in the two patient groups, after correlating the clinical record with the pathological results:
* “Patients with AD pathology had an earlier age of onset than patients with CBD pathology (58 vs. 68 years).”
* “Tremors were only present in CBD cases (73%)…”
* Interestingly, “myoclonus was more common in AD than CBD (80 vs. 18%).”
* “SPECT imaging demonstrated parietal hypoperfusion in AD patients and frontotemporal hypoperfusion in CBD patients.”
The authors conclude that: “Functional brain imaging may have greater utility than the clinical and neuropsychological features in differentiating AD presenting as CBS from CBD.”
We need more articles like this, with bigger patient numbers!
Robin
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Movement Disorders. 2009 May 7. [Epub ahead of print]
Alzheimer’s disease and corticobasal degeneration presenting as corticobasal syndrome.
Hu WT, Rippon GW, Boeve BF, Knopman DS, Petersen RC, Parisi JE, Josephs KA.
Department of Neurology, Mayo Clinic, Rochester, Minnesota.
The aim of this article is to compare patients with Alzheimer’s disease (AD) pathology and corticobasal degeneration pathology (CBD) presenting as corticobasal syndrome (CBS).
Clinicopathologic series was used. Five patients with AD and 11 patients with CBD were clinically diagnosed with CBS. Patients with AD pathology had an earlier age of onset than patients with CBD pathology (58 vs. 68 years, P = 0.004), but the two groups had similar disease duration and core features of CBS. Tremors were only present in CBD cases (73%, P = 0.026), but myoclonus was more common in AD than CBD (80 vs. 18%, P = 0.036). Neuropsychological testing showed similar degrees of memory impairment and attentional deficits. (99m)Tc-HMPAO SPECT imaging demonstrated parietal hypoperfusion in AD patients and frontotemporal hypoperfusion in CBD patients. AD patients with clinical CBS have similar characteristics to CBD patients. Functional brain imaging may have greater utility than the clinical and neuropsychological features in differentiating AD presenting as CBS from CBD.
PubMed ID#: 19425061 (see pubmed.gov for this abstract only; you can also link to the full article for which the publisher probably charges $30)