Clinical study| Volume 77, P123-127, July 2020

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Is brain perfusion a differentiating feature in the comparison of Progressive Supranuclear Palsy Syndrome (PSPS) and Corticobasal Syndrome (CBS)?


      • PSP and CBS are clinical manifestations of 4R tauopathies.
      • Differentiation of these entities remains a difficult issue.
      • Brain perfusion of the syndromes shows significant overlaps.
      • Boundary of PSP and CBS is questionable.


      The aim of this work is to present whether SPECT 99mTc-HMPAO can be a method of examination to possibly differentiate the syndromes. 21 patients with PSP syndrome and 14 patients with corticobasal syndrome (CBS) were examined using SPECT 99mTc-HMPAO. Perfusion single photon emission computed tomography (SPECT) as a method of examination of progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS) has not been extensively analyzed in contemporary literature. Recent criteria of PSP and CBS do not describe this method of examination as primary or additional. Extended analysis was done in the context of regions of interest affected by significant average hypoperfusion (>2 standard deviations). Differences between the syndromes were subsequently evaluated using the U-Mann-Whitney test. Lack of significant differences (p < 0.05) were observed in 92 out of 94 regions of interest. However, certain asymmetries were observed in a minority of regions in both of the syndromes. Additionally, the authors of the study verified possible differences of asymmetry of perfusion of both of the syndromes. The overlapping of clinical manifestations and locations of hypoperfusion leads to a question of whether the syndromes should be interpreted as separate entities or variants of the same disease.


      ASL (arterial spin labeling), CBD (corticobasal degeneration), CBS (corticobasal syndrome), CT (Computed Tomography), DMFP (desmethoxyfallypride), 18F-FDG-PET (fluorodeoxyglucose positron emission tomography), HMPAO (hexamethylpropyleneamine oxime), 123IBZM (iodobenzamide), LEHR (low energy high resolution), MRI (magnetic resonance imaging), MSA (multiple system atrophy), PET (positron emission tomography), PSP (progressive supranuclear palsy), PSP-P (progressive supranuclear palsy resembling idiopathic Parkinson’s disease), PSP-RS (progressive supranuclear palsy – Richardson’s syndrome), PSPS (progressive supranuclear palsy syndrome), ROI (region of interest), SPECT (single photon emission computed tomography), SD (standard deviation)


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