[Neuroimaging in corticobasal syndrome]

Area of Science:

• Neuroimaging
• Neuropathology
• Clinical Neurology

Context:

• Corticobasal degeneration (CBD) and corticobasal syndrome (CBS) are challenging neurodegenerative conditions.
• Characterizing clinical symptoms and brain atrophy patterns is crucial for diagnosis.
• Previous studies have primarily focused on structural MRI findings.

Purpose:

• To review and synthesize findings from neuroimaging studies in pathology-proven CBD and CBS.
• To highlight the utility of functional imaging techniques in understanding CBS pathophysiology.
• To discuss the role of novel imaging agents in diagnosing underlying pathologies.

Summary:

• Voxel-based morphometry (VBM) MRI shows frontal lobe atrophy in CBD and perirolandic atrophy in CBS.
• CBS due to frontotemporal lobar degeneration (FTLD) involves prefrontal, striatal, and brainstem atrophy.
• CBS due to Alzheimer's disease (AD) shows temporoparietal and precuneus atrophy.
• Functional imaging (PET, SPECT) reveals hypometabolism and hypoperfusion in fronto-parietal regions in CBS.
• Dopaminergic nigrostriatal dysfunction is evident in CBS.
• Decreased cortical acetylcholinesterase (AChE) activity correlates with cognitive decline in CBS.
• Amyloid and tau imaging agents aid in detecting AD pathology and neurofibrillary tangles in CBS.

Impact:

• Provides a comprehensive overview of imaging findings in CBD and CBS.
• Emphasizes the diagnostic value of integrating structural and functional neuroimaging.
• Highlights the potential of advanced imaging techniques for differential diagnosis and understanding disease mechanisms.