Voxel-based distribution of metabolic impairment in corticobasal degeneration

This report emphasizes the precise topographic distribution of cerebral met abolic impairment in corticobasal degeneration (CBD) and the pathophysiolog ical differences between CBD and progressive supranuclear palsy (PSP). Stat istical parametric mapping (SPM96) analysis of (18)FDG positron emission to mography (PET) data was performed in 22 patients with CBD compared with 46 healthy subjects (HS) and 21 patients with PSP who were studied at rest. A statistical threshold of p <0.001 was fixed, further corrected for multiple or independent comparisons (p <0.05). In comparison with HS, the metabolic impairment in CBD was asymmetrically distributed in the putamen, thalamus, precentral (Brodmann's area, BA 4), lateral premotor (BA 6/44) and supplem entary motor areas (SMA, BA 6), dorsolateral prefrontal (8/9/46) cortex, an d the anterior part of the inferior parietal lobe (BA 40) including the int raparietal sulcus (BA 7/40). A similar hypometabolic pattern was observed f or most individual analyses. When PSP was compared with CBD, metabolic impa irment predominated in the midbrain, anterior cingulate (BA 24/32), and orb itofrontal regions (BA 10). The reverse contrast showed more posterior invo lvement in CBD (BA 6 and 5/7/40) including SMA. Our data suggest that multi ple components of neural networks related to both movement execution and pr oduction of skilled movements are functionally disturbed in CBD compared wi th both HS and PSP.