Could a structural damage mimic a Parkinson plus syndrome?

• Authors: Athanasia Alexoudi , Ioannis Zalonis , Pantelis Stathis
• Languages of publication: EN

Abstracts

EN

Corticobasal syndrome (CBS) is a progressive disease that includes a heterogeneous neuropathological spectrum. In the majority of cases, corticobasal degeneration (CBD) is the underlying disease. Clinical heterogeneity is reflected in the clinical presentation of the syndrome and consequently misdiagnosis is common. Our case is of interest because the symptoms, the poor response to L-dopa and the I123 Ioflupane CIT SPECT (DAT-SCAN) results were typical for CBD. However, the magnetic resonance imaging appearance suggested the possibility of a disease of vascular etiology. A 63-year-old woman presented in our outpatient clinic with symptoms of progressive clumsiness in the right arm when performing movements demanding fine motor skills, and mild speech difficulties. The brain magnetic resonance imaging (MRI) report described ischemic lesions in the left subcortical parietal areas, in the centrum semiovale, in periventricular white matter, cingulated gyrus bilaterally and moderate ventricle dilatation. A comprehensive neuropsychological study suggested mixed cortical and subcortical involvement. A DAT-SCAN examination showed a diminished dopamine transporter uptake in the left lenticular nucleus, suggesting parkinsonisn. For this patient, CBS-CBD was the most probable diagnosis, whereas vascular CBS was not excluded. This case report illustrates the low diagnostic sensitivity in predicting CBD and the overlap with other related neurodegenerative diseases. Finally, it demonstrates that in CBS, different underlying pathologies can be found at the same individual.

Keywords

EN

Corticibasal degeneration (CBD); Corticobasal syndrome (CBS); Vascular dementia; I123 Ioflupane CIT SPECT (DAT-SCAN)

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2013
• Volume: 8
• Issue: 4
• Pages: 450-454

Dates

published

1 - 8 - 2013

online

12 - 6 - 2013

Contributors

author

Athanasia Alexoudi

• General Hospital of Athens G.N.A, Mesogion 154, 11527, Athens, Greece

author

Ioannis Zalonis

• 1st Department of Neurology, University of Athens, Vass. Sofias Avenue 72-74, 11528, Athens, Greece

author

Pantelis Stathis

• Department of Neurology, 1st Hospital of Social Security Services, Zaimi STR, 15127, Athens, Greece

References

• [1] Ling H., O’Sullivan S.S., Holton J.L., Revesz T., Massey L.A., Williams D.R., et al., Does corticobasal degeneration exist? A clinicopathological reevaluation, Brain, 2010, 133, 2045–2057 [WoS][Crossref]
• [2] Litvan I., Agid Y., Goetz C., Jankovic J., Wenning G.K., Brandel J.P., et al., Accuracy of the clinical diagnosis of corticobasal degeneration: a clinicopathologic study, Neurology, 1997, 48,119–125 http://dx.doi.org/10.1212/WNL.48.1.119[Crossref]
• [3] Engelen M., Westhoff D., de Gans J., Nederkoorn P.J., A 64-year old man presenting with carotid artery occlusion and corticobasal syndrome: a case report, J. Med. Case Rep., 2011, 5, 357 http://dx.doi.org/10.1186/1752-1947-5-357[Crossref]
• [4] Watts R.L., Brewer R.P., Schneider J.A., Mirra S., Corticobasal degeneration, In: Watts R.L., Koller W.C. (Eds.), Movement disorders: neurologic principles and practice, New York, McGraw Hill, 1997
• [5] Watts R.L., Mirra S., Corticobasal ganglionic degeneration, In: Marsden C.D., Fahn S., (Eds.), Movement disorders III, London, Butterworths-Heinemann, Boston, 1994
• [6] Riley D.E., Lang A.E., Lewis A., Resch L., Ashby P., Hornikewicz O., et al., Corticobasal ganglionic degeneration. Neurology 1990, 40, 1203–1212 http://dx.doi.org/10.1212/WNL.40.8.1203[Crossref]
• [7] Lang A.E., Riley D.E., Bergeron C., Corticobasal ganglionic degeneration, In: Calne D.B., (Eds.), Neurodegenerative diseases, Saunders; Philadelphia, 1994
• [8] Lang A.E., Corticobasal degeneration: selected developments. Mov. Disord., 2003, 18,Suppl 6:51–56 http://dx.doi.org/10.1002/mds.10563[Crossref]
• [9] Cummings J.L., Litvan I., Neuropsychiatric aspects of corticobasal degeneration, Adv. Neurol., 2000, 82, 147–152
• [10] Josephs K.A., Duffy J.R., Strand E.A., Whitwell J.L., Layton K.F., Parisi J.E., et al., Clinicopathological and imaging correlates of progressive aphasia and apraxia of speech, Brain, 2006, 129, 1385–1398 http://dx.doi.org/10.1093/brain/awl078[Crossref]
• [11] Geda Y.E., Boeve B.F., Negash S., Graff-Radford N.R., Knopman D.S., Parisi J.E., et al., Neuropsychiatric features in 36 pathologically confirmed cases of corticobasal degeneration, J. Neuropsychiatry Clin. Neurosci., 2007, 19, 77–80 http://dx.doi.org/10.1176/appi.neuropsych.19.1.77[WoS][Crossref]
• [12] Murray R., Neumann M., Forman M.S., Farmer J., Massimo L., Rice A., et al., Cognitive and motor assessment in autopsy-proven corticobasal degeneration, Neurology, 2007, 17,68, 1274–1283 http://dx.doi.org/10.1212/01.wnl.0000259519.78480.c3[Crossref]
• [13] Grimes D.A., Lang A.E., Bergeron C.B., Dementia as the most common presentation of cortical-basal ganglionic degeneration, Neurology, 1999, 10,53, 1969–1974 http://dx.doi.org/10.1212/WNL.53.9.1969[Crossref]
• [14] Boeve B.F., Corticobasal degeneration: the syndrome and the disease, In: Litvan I. (Eds.), Atypical parkinsonian disorders: clinical and research aspects, Totowa, New Jersey, Humana Press, 2005
• [15] Dickson D.W., Bergeron C., Chin S.S., Duyckaerts C., Horoupian D., Ikeda K., et al., Office of Rare Diseases of the National Institutes of Health. Office of Rare Diseases neuropathologic criteria for corticobasal degeneration, J. Neuropathol. Exp. Neurol., 2002, 61, 935–946
• [16] Litvan I., Bhatia K.P., Burn D.J., Goetz C.G., Lang A.E., McKeith I., et al., Movement Disorders Society Scientific Issues Committee. Movement Disorders Society Scientific Issues Committee report: SIC Task Force appraisal of clinical diagnostic criteria for Parkinsonian disorders, Mov. Disord., 2003, 18, 467–486 http://dx.doi.org/10.1002/mds.10459[Crossref]
• [17] O’Keeffe F.M., Murray B., Coen R.F., Dockree P.M., Bellgrove M.A., Garavan H.,et al., Loss of insight in frontotemporal dementia, corticobasal degeneration and progressive supranuclear palsy, Brain, 2007, 130, 753–764 http://dx.doi.org/10.1093/brain/awl367[WoS][Crossref]
• [18] Calderon J., Perry R.J., Erzinclioglu S.W., Berrios G.E., Dening T.R., Hodges J.R., Perception, attention, and working memory are disproportionately impaired in dementia with Lewy bodies compared with Alzheimer’s disease, J. Neurol. Neurosurg. Psychiatry, 2001, 70, 157–164 http://dx.doi.org/10.1136/jnnp.70.2.157[Crossref]
• [19] Bak T.H., Caine D., Hearn V.C., Hodges J.R., Visuospatial functions in atypical parkinsonian syndromes, J. Neurol. Neurosurg. Psychiatry, 2006, 77, 454–456 http://dx.doi.org/10.1136/jnnp.2005.068239[Crossref]
• [20] Cooper S., Greene J.D., The clinical assessment of the patient with early dementia, J. Neurol. Neurosurg. Psychiatry, 2005, 76, 15–24 http://dx.doi.org/10.1136/jnnp.2005.081133[Crossref]
• [21] Baudic S., Barba G.D., Thibaudet M.C., Smagghe A., Remy P., Traykov L., Executive function deficits in early Alzheimer’s disease and their relations with episodic memory, Arch. Clin. Neuropsychol., 2006, 21, 15–21 http://dx.doi.org/10.1016/j.acn.2005.07.002[Crossref]
• [22] Riley D.E., Lang A.E., Lewis A., Resch L., Ashby P., Hornikewicz O., et al., Corticobasal ganglionic degeneration, Neurology, 1990, 40, 1203–1212 http://dx.doi.org/10.1212/WNL.40.8.1203[Crossref]
• [23] Lu C.S., Ikeda A., Terada K., Mima T., Nagamine T., Fukuyama H., et al., Electrophysiological studies of early stage corticobasal degeneration, Mov. Disord., 1998, 13, 140–146 http://dx.doi.org/10.1002/mds.870130126[Crossref]
• [24] Ozsancak C., Auzou P., Hannequin D., La dégéné rescence corticobasale, Revue Neurologique, 1999,155, 1007–1020
• [25] Vion-Dury J., Rochefort N., Michotey P., Planche D., Ceccaldi M., Proton magnetic resonance neurospectroscopy and EEG cartography in corticobasal degeneration: correlations with neuropsychological signs, J. Neurol. Neurosurg. Psychiatry, 2004, 75, 1352–1355 http://dx.doi.org/10.1136/jnnp.2003.018903[Crossref]
• [26] Josephs K.A., Whitwell J.L., Boeve B.F., Knopman D.S., Petersen R.C., Hu W.T., et al., Anatomical differences between CBS-corticobasal degeneration and CBS-Alzheimer’s disease, Mov. Disord., 2010, 25, 1246–1252 http://dx.doi.org/10.1002/mds.23062[Crossref]
• [27] Savoiardo M., Grisoli M., Girotti F., Magnetic resonance imaging in CBD, related atypical parkinsonian disorders, and dementias, Adv. Neurol., 2000, 82, 197–208
• [28] Soliveri P., Monza D., Paridi D., Radice D., Grisoli M., Testa D., et al., Cognitive and magnetic resonance imaging aspects of corticobasal degeneration and progressive supranuclear palsy, Neurology, 1999, 53, 502–507 http://dx.doi.org/10.1212/WNL.53.3.502[Crossref]
• [29] Lee S.E., Rabinovici G.D., Mayo M.C., Wilson S.M., Seeley W.W., DeArmond S.J., Clinicopathological correlations in corticobasal degeneration, Ann. Neurol., 2011, 70, 327–340 http://dx.doi.org/10.1002/ana.22424[Crossref]
• [30] Pagani M., Salmaso D., Ramström C., Jonsson C., Lundqvist R., Thurfjell L., et al., Mapping pathological (99m)Tc-d,l-hexamethylpropylene amine oxime uptake in Alzheimer’s disease and frontal lobe dementia with SPECT, Dement. Geriatr. Cogn. Disord., 2001, 12, 177–184 http://dx.doi.org/10.1159/000051255[Crossref]
• [31] Shim Y.S., Yang D.W., Kim B.S., Shon Y.M., Chung Y.A., Comparison of regional cerebral blood flow in two subsets of subcortical ischemic vascular dementia: statistical parametric mapping analysis of SPECT, J. Neurol. Sci., 2005, 250, 85–91 http://dx.doi.org/10.1016/j.jns.2006.07.008[Crossref]
• [32] Seritan A.L., Mendez M.F., Silverman D.H., Hurley R.A., Taber K.H., Functional Imaging as a Window to Dementia: Corticobasal Degeneration, J. Neuropsychiatry Clin. Neurosci., 2004, 16, 393–399 http://dx.doi.org/10.1176/appi.neuropsych.16.4.393[Crossref]
• [33] Herholz K., Schopphoff H., Schmidt M., Mielke R., Eschner W., Scheidhauer K., et al., Direct comparison of spatially normalized PET and SPECT scans in Alzheimer’s disease, J. Nucl. Med., 2002, 43, 21–26
• [34] Lee J.H., Kim S.H., Kim G.H., Seo S.W., Park H.K., Oh S.J., et al., Identification of pure subcortical vascular dementia using 11C-Pittsburgh compound B, Neurology., 2011, 77, 18–25 http://dx.doi.org/10.1212/WNL.0b013e318221acee[Crossref][WoS]
• [35] Josephs K.A., Tang-Wai D.F., Edland S.D., Knopman D.S., Dickson D.W., Parisi J.E., et al., Correlation between antemortem magnetic resonance imaging findings and pathologically confirmed corticobasal degeneration, Arch. Neurol., 2004, 61, 1881–1884 http://dx.doi.org/10.1001/archneur.61.12.1881[Crossref]

Identifiers

DOI

10.2478/s11536-013-0151-z