Cited by 434Dementia and Cognitive Impairment ResearchAlzheimer's disease research and treatmentsAmyotrophic Lateral Sclerosis Research

Clinicopathological correlations in corticobasal degeneration

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Lee, Suzee E., Rabinovici, Gil D., Mayo, Mary Catherine, Wilson, Stephen M., Seeley, William W., DeArmond, Stephen J., Huang, Eric J., Trojanowski, John Q. +11 more·2011·Annals of Neurology

Abstract

OBJECTIVE: To characterize cognitive and behavioral features, physical findings, and brain atrophy patterns in pathology-proven corticobasal degeneration (CBD) and corticobasal syndrome (CBS) with known histopathology. METHODS: We reviewed clinical and magnetic resonance imaging data in all patients evaluated at our center with either an autopsy diagnosis of CBD (n = 18) or clinical CBS at first presentation with known histopathology (n = 40). Atrophy patterns were compared using voxel-based morphometry. RESULTS: CBD was associated with 4 clinical syndromes: progressive nonfluent aphasia (n = 5), behavioral variant frontotemporal dementia (n = 5), executive-motor (n = 7), and posterior cortical atrophy (n = 1). Behavioral or cognitive problems were the initial symptoms in 15 of 18 patients; less than half exhibited early motor findings. Compared to controls, CBD patients showed atrophy in dorsal prefrontal and perirolandic cortex, striatum, and brainstem (p < 0.001 uncorrected). The most common pathologic substrates for clinical CBS were CBD (35%), Alzheimer disease (AD, 23%), progressive supranuclear palsy (13%), and frontotemporal lobar degeneration (FTLD) with TDP inclusions (13%). CBS was associated with perirolandic atrophy irrespective of underlying pathology. In CBS due to FTLD (tau or TDP), atrophy extended into prefrontal cortex, striatum, and brainstem, whereas in CBS due to AD, atrophy extended into temporoparietal cortex and precuneus (p < 0.001 uncorrected). INTERPRETATION: Frontal lobe involvement is characteristic of CBD, and in many patients frontal, not parietal or basal ganglia, symptoms dominate early stage disease. CBS is driven by medial perirolandic dysfunction, but this anatomy is not specific to a single underlying histopathology. Antemortem prediction of CBD will remain challenging until clinical features of CBD are redefined, and sensitive, specific biomarkers are identified.

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  • A corticobasal syndrome is more often due to AD pathology than corticobasal degeneration or other disorders.

    “On the other hand, a corticobasal syndrome (asymmetric parkinsonism with limb dystonia, apraxia, and cortical sensory loss) is more often due to AD pathology than corticobasal degeneration or other disorders [31].”

    From Diagnosing the frontal variant of Alzheimer’s disease: a clinician’s yellow brick road (2017) · cites this paper as [31]

    The Abstract (Results) reports that CBD was the most common pathological cause of clinical corticobasal syndrome (35%), followed by AD (23%). The Results (Subjects: Histopathology) likewise lists 14 CBD cases versus 9 AD cases, contrary to the claim that AD was more common. (LLM, conf=0.94)

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  • In behavioural or dysexecutive variants, corticobasal syndrome, and semantic or non-fluent variants of primary progressive aphasia, positive Alzheimer's disease biomarkers are particularly ambiguous and can be considered either as Alzheimer's disease copathology or atypical forms of Alzheimer's disease.

    “This biomarker positivity is particularly ambiguous in the case of behavioural or dysexecutive variants, corticobasal syndrome, and semantic or non-fluent variants of primary progressive aphasia, in which the presence of positive Alzheimer’s disease biomarkers can be considered either as Alzheimer’s disease copathology or atypical forms of Alzheimer’s disease94,96,98,99 (appendix p 2).”

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Authors
Lee, S. E., Rabinovici, G. D., Mayo, M. C., Wilson, S. M., Seeley, W. W., DeArmond, S. J., Huang, E. J., Trojanowski, J. Q., Growdon, M. E., Jang, J. Y., Sidhu, M., See, T. M., Karydas, A. M., Gorno‐Tempini, M., Boxer, A. L., Weiner, M. W., Geschwind, M. D., Rankin, K. P., & Miller, B. L.
Affiliations
  • University of California, San Francisco (US)
  • University of Arizona (US)
  • University of Pennsylvania (US)
Corresponding author
Lee, Suzee E.
Venue
Annals of Neurology
Publisher
Wiley
Published
2011-08
Volume
70
Issue
2
Pages
327-340
ISSN
  • 0364-5134 (ISSN-L)
  • 1531-8249
OpenAlex
W1996314668
Cited by
434
References
52
Citations by year
2026: 16 · 2025: 27 · 2024: 23 · 2023: 22 · 2022: 30 · 2021: 34 · 2020: 35 · 2019: 39 · 2018: 29 · 2017: 34 · 2016: 34 · 2015: 29 · 2014: 32 · 2013: 23 · 2012: 21
FWCI
17.73
Type
journal article
Language
en
Open access
Locations
  • Annals of Neurology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Institutional Research Information System (Università degli Studi di Trento) (submittedVersion)
Funders
  • National Institutes of Health (K26OD010927)
  • National Institute on Aging (K23AG021989, AG-19724, P30AG010124, P01AG017586, AG17586, AG-10124, AG023501, R01AG031189, R01AG031278, K23AG031861, R01AG038791, P01AG019724, T32AG023481, P50AG023501)
  • National Institute on Deafness and Other Communication Disorders (R03DC010878)
  • National Institute of Neurological Disorders and Stroke (R01NS050915)
  • National Center for Research Resources (UL1RR024131, K26RR024858, P41RR023953)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
  • Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
Keywords
corticobasal degeneration, corticobasal syndrome, clinicopathological correlation, brain atrophy patterns, frontal lobe involvement, progressive nonfluent aphasia, behavioral variant frontotemporal dementia, posterior cortical atrophy, Alzheimer's disease, progressive supranuclear palsy, frontotemporal lobar degeneration, voxel-based morphometry, differential diagnosis
MeSH terms
Aged, Aged, 80 and over, Autopsy, Basal Ganglia, Cerebral Cortex, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Neuropsychological Tests, Syndrome, Neurodegenerative Diseases

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