Abstract Details

Title Predicting the Pathology of Corticobasal Syndrome Using Modified Clinical Criteria, MRI and FDG PET

Topic Aging and Dementia

Presentation(s) P06 - (-)

Poster/Presentation
Number 047

Objective

Background BACKGROUND: Group comparisons have revealed that patients with CBS due to AD have greater temporoparietal clinical deficits and neuroimaging patterns than patients with non-AD pathology. The predictive value for individual patients is not known.

Design/Methods DESIGN/METHODS: 22 patients meeting CBS core criteria with PIB-PET had clinical records, neuropsychological testing, MRI and FDG scans reviewed blinded to PIB results. Positive PIB scan was considered a surrogate underlying AD pathology. Patients were designated as temporoparietal variant (tpvCBS) if they had either (1) logopenic aphasia; (2) elements of Gerstmann or Balint syndromes (3) episodic memory or visuospatial greater than executive dysfunction. Frontal-variant CBS (fvCBS) designation included either (1) Agrammatic or motor speech deficits; (2) Apathy, disinhibition, loss of empathy; (3) lower extremity apraxia; (4) executive greater than memory or visuospatial impairment. MRI and FDG-PET were classified as frontal or temporoparietal based on the predominant atrophy/hypometabolism pattern.

Results RESULTS: Of the 10 patients with a final classification of tpvCBS, 6 were PIB+ and 4 were PIB- (sensitivity 67%, specificity 69% for AD). Visual MRI reads had 67% sensitivity and 42% specificity for PIB+ with intra-rater reliability kappa=0.42 (re-review of 10 scans). Visual FDG reads had higher sensitivity (89%) than MRI reads with perfect intra-rater reliability (kappa=1.00), though specificity remained low (50%). PIB results were confirmed in all four patients who have undergone autopsy (2 PIB+ with confirmed AD, 2 PIB- with CBD).

Conclusions CONCLUSIONS: Describing frontal vs. temporoparietal variants of CBS can help predict underlying AD, but criteria require further refinement. Temporoparietal-predominant neuroimaging patterns are sensitive but not specific for AD.

Authors/Disclosures
Sharon Sha, MD (Stanford Univeristy) PRESENTER	Dr. Sha has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Guidepoint Global. Dr. Sha has received personal compensation in the range of $500-$4,999 for serving as a Consultant for ExpertConnect. Dr. Sha has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Sha has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cognition Therapeutics. Dr. Sha has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Forefront Collaborative. Dr. Sha has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for ReachMD. Dr. Sha has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for PeerView. Dr. Sha has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Medscape. Dr. Sha has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for medlearning group. Dr. Sha has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for webmd. The institution of Dr. Sha has received research support from Biogen. The institution of Dr. Sha has received research support from Jannssen. The institution of Dr. Sha has received research support from Eisai. The institution of Dr. Sha has received research support from Eli Lilly. The institution of Dr. Sha has received research support from Aribio. The institution of Dr. Sha has received research support from cognition therapeutics. The institution of Dr. Sha has received research support from EIP pharma. Dr. Sha has received publishing royalties from a publication relating to health care.
	No disclosure on file
Suzee Lee, MD	Dr. Lee has nothing to disclose.
William Jagust, MD (Helen Wills Neuroscience Institute)	No disclosure on file
Harold Moses, MD (Vanderbilt Multiple Sclerosis Center)	No disclosure on file
Katherine P. Rankin, PhD (University of California San Francisco)	The institution of Dr. Rankin has received research support from Marcus Foundation.
Adam L. Boxer, MD, PhD (University of California, San Francisco)	An immediate family member of Dr. Boxer has received personal compensation for serving as an employee of Kaiser Permanente. Dr. Boxer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ono. Dr. Boxer has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Oscotec. Dr. Boxer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Boxer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Arrowhead. Dr. Boxer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neurocrine Biosciences. Dr. Boxer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Switch. Dr. Boxer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Arvinas. Dr. Boxer has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Alector. Dr. Boxer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Boxer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Boxer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Transposon. Dr. Boxer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen . Dr. Boxer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. Dr. Boxer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Boxer has stock in Alector. Dr. Boxer has stock in Arvinas. Dr. Boxer has stock in Neurovanda. The institution of Dr. Boxer has received research support from Biogen. The institution of Dr. Boxer has received research support from Eisai. The institution of Dr. Boxer has received research support from Regeneron. The institution of Dr. Boxer has received research support from NIH. The institution of Dr. Boxer has received research support from Bluefield Project-5. Dr. Boxer has received research support from Rainwater Charitable Foundation. Dr. Boxer has received research support from GHR Foundation. Dr. Boxer has received intellectual property interests from a discovery or technology relating to health care.
Bruce L. Miller, MD, FAAN (University of California, San Francisco)	Dr. Miller has nothing to disclose.
Gil D. Rabinovici, MD, FAAN (UCSF Memory & Aging Center)	Dr. Rabinovici has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eli Lilly. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alector. Dr. Rabinovici has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novo Norodisk. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Consultant for C2N. Dr. Rabinovici has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Johnson & Joihnson. Dr. Rabinovici has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Peerview. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Medscape. Dr. Rabinovici has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Rabinovici has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA. The institution of Dr. Rabinovici has received research support from NIH. The institution of Dr. Rabinovici has received research support from American College of Radiology. The institution of Dr. Rabinovici has received research support from Alzheimer's Association. The institution of Dr. Rabinovici has received research support from Rainwater Charitable Foundation. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Topic Chair, Course Director and teacher with AAN. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Grant reviewer with NIH. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Invited speaker with ANA.

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