Clinical, neuropsychological and imaging characteristics of Alzheimer's disease patients presenting as corticobasal syndrome

• Published in: Journal of the neurological sciences 2019-03, Vol.398, p.142-147
• Main Authors: Constantinides, Vasilios C., Paraskevas, George P., Efthymiopoulou, Efthymia, Stefanis, Leonidas, Kapaki, Elisabeth
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Alzheimer Disease - cerebrospinal fluid; Alzheimer Disease - diagnostic imaging; Alzheimer Disease - psychology; Alzheimer's disease; Basal Ganglia - diagnostic imaging; Basal Ganglia Diseases - cerebrospinal fluid; Basal Ganglia Diseases - diagnostic imaging; Basal Ganglia Diseases - psychology; Biomarkers; Biomarkers - cerebrospinal fluid; Cerebral Cortex - diagnostic imaging; Cerebrospinal fluid; Corticobasal syndrome; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Neuropsychological Tests; Prospective Studies; Syndrome
• ISSN: 0022-510X; 1878-5883
• DOI: 10.1016/j.jns.2019.01.046

Corticobasal syndrome (CBS) can harbor diverse pathologies, such as corticobasal degeneration (CBD) and Alzheimer's disease (AD). CSF biochemical analysis in CBS patients can confidently distinguish between an AD (CBS-AD) and a non-AD (CBS-nAD) pathology. We utilized classical CSF biomarkers to make a distinction between the two groups and examine their clinical, neuropsychological, neuropsychiatric and imaging differences. Seventeen patients with a CBS phenotype were included. Detailed clinical history, and neurological examination data were recorded. A thorough neuropsychological and neuropsychiatric test battery was performed, including Goldenberg apraxia test. Simple linear MRI measurements and planimetry data were utilized. CSF biomarkers for AD were ascertained. Five of seventeen CBS patients had a CSF AD profile. Patients with a CSF AD profile (CBS-AD; n = 5) were older and had a greater age at disease onset compared to CBS-nAD. CBS-AD patients had more frequently alien hand phenomena at examination and greater hippocampi surface asymmetry at MRI. CBS-nAD patients (n = 12) had lower superior colliculi width values. Clinical, neuropsychological and imaging data cannot confidently differentiate CBS-AD from CBS-nAD patients. •CSF analysis can differentiate CBS-AD from CBS non-AD patients.•30% of CBS patients have an underlying AD pathology.•Alien hand phenomena are more common in CBS-AD patients.•Clinical and imaging features cannot safely differentiate CBS-AD from CBS-nAD.