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

Abstract

ContextThe cortico-basal syndrome (CBS), a complex clinical neurodegenerative disorder, may have multiple aetiologies including corticobasal degeneration (CBD) and Alzheimer's disease (AD). The aim of this study was to explore the brain perfusion profile in CBS patients according to the biological profile of CFS biomarkers (BM). Materials and methodsFifteen patients fulfilling clinical criteria of CBS underwent a brain perfusion scintigraphy with 99mTc-ECD and a lumbar punction to determine the biochemical profile of CSF biomarkers (BM). Several groups were compared with SPM8 software: 1) 5 patients with SCB and with an AD CSF profile (CBS-AD); 2) 10 patients with CBS and not having an AD CSF profile (SCB-nonAD); 3) 24 healthy controls (Wit-N); 4) 24 typical amnestic (AD). ResultsCompared to the group Wit-N, the entire SCB group (non-AD and AD) showed an asymmetric cortical hypoperfusion with the left parietal-frontal cortex predominance, the SCB-AD group a symmetrical hypoperfusion in the association posterior cortex and the SCB-nonAD group a more asymmetrical hypoperfusion with a peri-rolandic, prefrontal and left perisylvian involvement. The comparisons with the typical amnestic AD found no significant difference for the SCB-AD group and, for the SCB-nonAD group, an asymmetric bilateral peri-rolandic hypoperfusion. ConclusionFor the SCB related to AD, the hypoperfusion is symmetrical and mainly in the association posterior cortex, whereas for the SCB non-related to AD pathology, the hypoperfusion is more asymmetrical and anterior with a peri-rolandic involvement.