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The Rate of Decrease in Brain Perfusion in Progressive Supranuclear Palsy and Corticobasal Syndrome May Be Impacted
Piotr Alster1, Anna Dunalska2, Bartosz Migda3
1Department of Neurology, Medical University of Warsaw, Warsaw, Poland.
Frontiers in Neurology
|November 25, 2021
Summary
Glycemic variability may worsen brain perfusion in patients with progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS). This hypoperfusion, particularly in the hippocampus, could accelerate cognitive decline in these neurodegenerative diseases.
Area of Science:
- Neuroscience
- Endocrinology
- Neurology
Background:
- Progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS) are debilitating tauopathic parkinsonian syndromes.
- Current treatments for PSP and CBS lack disease-modifying capabilities, focusing on symptomatic relief.
- While hypertension and diabetes are known risk factors, the impact of prediabetes and glycemic variability on PSP/CBS progression is less understood.
Purpose of the Study:
- To investigate the association between glycemic variability and brain perfusion in patients diagnosed with PSP and CBS.
- To determine if increased glycemic variability correlates with reduced cerebral blood flow in specific brain regions.
Main Methods:
- The study included 26 patients with clinical diagnoses of PSP and CBS.
- Glycated hemoglobin (HbA1c) levels were measured to assess glycemic control and variability.
- Perfusion single-photon emission tomography (SPECT) was used to evaluate regional brain perfusion.
- Patient perfusion data was compared against a database of healthy volunteers.
Main Results:
- Patients with higher glycemic variability (HbA1c > 5.7%) exhibited decreased perfusion in several brain regions.
- A more significant reduction in perfusion was noted in the hippocampus, pons, left thalamus, and right insula among patients with greater glycemic variability.
- These findings suggest a correlation between pronounced glycemic variability and more severe hypoperfusion in specific brain areas in PSP/CBS patients.
Conclusions:
- Increased glycemic variability is associated with more pronounced hypoperfusion in key brain regions in patients with PSP and CBS.
- Reduced hippocampal perfusion, linked to glycemic variability, may exacerbate cognitive impairment in these conditions.
- Further research is warranted to explore therapeutic strategies targeting glycemic control to potentially mitigate disease progression in PSP and CBS.
