Corticobasal degeneration and Parkinson's disease assessed by HmPaO SPECT: The utility of factorial discriminant analysis

Abstract

The diagnosis of corticobasal degeneration (CBD) is difficult despite the existence of some typical clinical features. Single photon emission computerized tomography (SPECT) in CBD presents an original pattern (with asymmetric hypoperfusion in pre- and retrorolandic regions) that could facilitate the differential diagnosis of CBD relative to the other degenerative parkinsonian syndromes. The objective of our study was to compare the regional cerebral blood flow measurements studied by SPECT in both CBD and Parkinson's disease (PD) using a multivariate procedure. Twenty-one patients with probable CBD and 20 patients with probable PD underwent brain (99m)Tc HmPaO SPECT. We used factorial discriminant analysis (FDA) to study the relative fixation of 26 regions of interest (ROIs) drawn on two transverse slices, together with the asymmetry indexes of 13 pairs of ROIs. FDA performed using the full set of parameters classified all the patients correctly. In order to classify the patients more easily, a predictive score using a selection of parameters was established. The most discriminating ROIs were the temporoinsular, temporoparietal, and frontal medial regions. We believe that this semiautomatic classification may be a precious tool for reinforcing the current clinical differential diagnosis of CBD and PD.

Corticobasal degeneration and corticobasal syndrome: A review

“…CBD patients had more extensive and asymmetric rCBF reductions than in PSP, with the two diseases sharing medial frontal involvement [ 68 ]. Likewise, by use of 99m Tc HmPaO SPECT, CBD patients could be discriminated from PD patients, since CBD patients exhibited decreased perfusion in the temporoinsular, temporoparietal, and frontal medial regions [ 69 ].…”

Apport de la scintigraphie de perfusion cérébrale dans l’exploration du syndrome cortico-basal

“…En TEMP de perfusion cérébrale, différentes études mettent en évidence une perfusion asymétrique [41][42][43][44][45][46][47][48] avec des hypoperfusions régionales d'étendue variable, concernant le cortex fronto-pariétal [41][42][43]46,49,50], en particulier péri-rolandique [50], parfois le cortex temporal [41,44,46,47,49], les ganglions de la base et le thalamus [41,42,44,46,[49][50][51].…”