Skip to main content
SpringerLink
Log in

Arterial spin labeling imaging for the detection of cerebral blood flow asymmetry in patients with corticobasal syndrome

  • Functional Neuroradiology
  • Published:
Neuroradiology Aims and scope Submit manuscript

Abstract

Purpose

Corticobasal syndrome (CBS) and Parkinson’s disease (PD) both present with asymmetrical extrapyramidal symptoms, often leading to a diagnostic dilemma. Patients with CBS frequently show cerebral blood flow (CBF) asymmetry alongside asymmetrical cortical atrophy. This study aimed to evaluate the clinical utility of arterial spin labeling (ASL) magnetic resonance imaging (MRI) to detect CBF asymmetry in patients with CBS.

Methods

We retrospectively investigated asymmetries of regional CBF and cortical volume, measured using ASL and T1-weighted MRI, in 13 patients with CBS and 22 age-matched patients with PD. Regional CBF and cortical volume values were derived from nine brain regions on each side. CBF and volume asymmetries were calculated as %difference in each region, respectively.

Results

CBF asymmetry showed significantly greater differences in seven of nine regions, such as the perirolandic area (− 8.7% vs. − 1.4%, p < 0.001) and parietal cortex (− 9.7% vs. − 1.3%, p < 0.001) in patients with CBS compared with patients with PD. In contrast, significant differences in volume asymmetry were observed in three regions included within the seven regions showing CBF asymmetry, which indicated that CBF asymmetry has greater sensitivity than volume asymmetry to detect asymmetricity in CBS.

Conclusion

ASL imaging showed significant CBF asymmetry in a wider range of brain regions in patients with CBS, which suggests that noninvasive MRI with ASL imaging is a promising tool for the diagnosis of CBS, with advantages that include the simultaneous evaluation of asymmetrical hypoperfusion in addition to focal atrophy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig.4

Similar content being viewed by others

Data availability

Data is available on reasonable request.

Code availability

Not applicable.

References

  1. Dickson DW, Bergeron C, Chin SS et al (2002) Office of Rare Diseases neuropathologic criteria for corticobasal degeneration. J Neuropathol Exp Neurol 61:935–946. https://doi.org/10.1093/jnen/61.11.935

    Article  CAS  PubMed  Google Scholar 

  2. Boeve BF, Maraganore DM, Parisi JE et al (1999) Pathologic heterogeneity in clinically diagnosed corticobasal degeneration. Neurology 53:795–800. https://doi.org/10.1212/wnl.53.4.795

    Article  CAS  PubMed  Google Scholar 

  3. Armstrong MJ, Litvan I, Lang AE et al (2013) Criteria for the diagnosis of corticobasal degeneration. Neurology 80:496–503. https://doi.org/10.1212/WNL.0b013e31827f0fd1

    Article  PubMed  PubMed Central  Google Scholar 

  4. Mathew R, Bak TH, Hodges JR (2012) Diagnostic criteria for corticobasal syndrome: a comparative study. J Neurol Neurosurg Psychiatry 83:405–410. https://doi.org/10.1136/jnnp-2011-300875

    Article  PubMed  Google Scholar 

  5. Cubo E, Martín PM, Martin-Gonzalez JA et al (2010) Motor laterality asymmetry and nonmotor symptoms in Parkinson’s disease. Mov Disord 25:70–75. https://doi.org/10.1002/mds.22896

    Article  PubMed  Google Scholar 

  6. Djaldetti R, Ziv I, Melamed E (2006) The mystery of motor asymmetry in Parkinson’s disease. Lancet Neurol 9:796–802. https://doi.org/10.1016/S1474-4422(06)70549-X

    Article  Google Scholar 

  7. Kitagaki H, Hirono N, Ishii K, Mori E (2000) Corticobasal degeneration: evaluation of cortical atrophy by means of hemispheric surface display generated with MR images. Radiology 216:31–38. https://doi.org/10.1148/radiology.216.1.r00ma0531

    Article  CAS  PubMed  Google Scholar 

  8. Soliveri P, Monza D, Paridi D et al (1999) Cognitive and magnetic resonance imaging aspects of corticobasal degeneration and progressive supranuclear palsy. Neurology 53:502–507. https://doi.org/10.1212/wnl.53.3.502

    Article  CAS  PubMed  Google Scholar 

  9. Di Stasio F, Suppa A, Marsili L et al (2019) Corticobasal syndrome: neuroimaging and neurophysiological advances. Eur J Neurol 26:701-e52. https://doi.org/10.1111/ene.13928

    Article  PubMed  Google Scholar 

  10. Takaya S, Sawamoto N, Okada T et al (2018) Differential diagnosis of parkinsonian syndromes using dopamine transporter and perfusion SPECT. Parkinsonism Relat Disord 47:15–21. https://doi.org/10.1016/j.parkreldis.2017.11.333

    Article  PubMed  Google Scholar 

  11. Hossain AK, Murata Y, Zhang L et al (2003) Brain perfusion SPECT in patients with corticobasal degeneration: analysis using statistical parametric mapping. Mov Disord 18:697–703. https://doi.org/10.1002/mds.10415

    Article  PubMed  Google Scholar 

  12. Okuda B, Tachibana H, Kawabata K et al (1999) Cerebral blood flow correlates of higher brain dysfunctions in corticobasal degeneration. J Geriatr Psychiatry Neurol 12:189–193. https://doi.org/10.1177/089198879901200404

    Article  CAS  PubMed  Google Scholar 

  13. Okuda B, Tachibana H, Kawabata K et al (2001) Comparison of brain perfusion in corticobasal degeneration and Alzheimer’s disease. Dement Geriatr Cogn Disord 12:226–231. https://doi.org/10.1159/000051262

    Article  CAS  PubMed  Google Scholar 

  14. Mille E, Levin J, Brendel M et al (2017) Cerebral glucose metabolism and dopaminergic function in patients with corticobasal syndrome. J Neuroimaging 27:255–261. https://doi.org/10.1111/jon.12391

    Article  PubMed  Google Scholar 

  15. Niethammer M, Tang CC, Feigin A et al (2014) A disease-specific metabolic brain network associated with corticobasal degeneration. Brain 137:3036–3046. https://doi.org/10.1093/brain/awu256

    Article  PubMed  PubMed Central  Google Scholar 

  16. Pardini M, Huey ED, Spina S et al (2019) FDG-PET patterns associated with underlying pathology in corticobasal syndrome. Neurology 92:e1121–e1135. https://doi.org/10.1212/WNL.0000000000007038

    Article  PubMed  PubMed Central  Google Scholar 

  17. Markus HS, Lees AJ, Lennox G et al (1995) Patterns of regional cerebral blood flow in corticobasal degeneration studied using HMPAO SPECT; comparison with Parkinson’s disease and normal controls. Mov Disord 10:179–187. https://doi.org/10.1002/mds.870100208

    Article  CAS  PubMed  Google Scholar 

  18. Zhang L, Murata Y, Ishida R et al (2001) Differentiating between progressive supranuclear palsy and corticobasal degeneration by brain perfusion SPET. Nucl Med Commun 22:767–772. https://doi.org/10.1097/00006231-200107000-00007

    Article  CAS  PubMed  Google Scholar 

  19. Kimura H, Kado H, Koshimoto Y et al (2005) Multislice continuous arterial spin-labeled perfusion MRI in patients with chronic occlusive cerebrovascular disease: a correlative study with CO2 PET validation. J Magn Reson Imaging 22:189–198. https://doi.org/10.1002/jmri.20382

    Article  PubMed  Google Scholar 

  20. Detre JA, Rao H, Wang DJ et al (2012) Applications of arterial spin labeled MRI in the brain. J Magn Reson Imaging 35:1026–1037. https://doi.org/10.1002/jmri.23581

    Article  PubMed  PubMed Central  Google Scholar 

  21. Melzer TR, Watts R, MacAskill MR et al (2011) Arterial spin labelling reveals an abnormal cerebral perfusion pattern in Parkinson’s disease. Brain 134:845–855. https://doi.org/10.1093/brain/awq377

    Article  PubMed  PubMed Central  Google Scholar 

  22. Ikawa M, Kimura H, Kitazaki Y et al (2018) Arterial spin labeling MR imaging for the clinical detection of cerebellar hypoperfusion in patients with spinocerebellar degeneration. J Neurol Sci 394:58–62. https://doi.org/10.1016/j.jns.2018.09.007

    Article  PubMed  Google Scholar 

  23. Ikawa M, Yoneda M, Muramatsu T et al (2013) Detection of preclinically latent hyperperfusion due to stroke-like episodes by arterial spin-labeling perfusion MRI in MELAS patients. Mitochondrion 13:676–680. https://doi.org/10.1016/j.mito.2013.09.007

    Article  CAS  PubMed  Google Scholar 

  24. Dashjamts T, Yoshiura T, Hiwatashi A et al (2010) Asymmetrical cerebral perfusion demonstrated by noninvasive arterial spin-labeling perfusion imaging in a patient with corticobasal degeneration. Jpn J Radiol 28:75–78. https://doi.org/10.1007/s11604-009-0382-8

    Article  PubMed  Google Scholar 

  25. Tomlinson CL, Stowe R, Patel S et al (2010) Systematic review of levodopa dose equivalency reporting in Parkinson’s disease. Mov Disord 25:2649–2653. https://doi.org/10.1002/mds.23429

    Article  PubMed  Google Scholar 

  26. Hughes AJ, Daniel SE, Kilford L, Lees AJ (1992) Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 55:181–184. https://doi.org/10.1136/jnnp.55.3.181

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Dai W, Garcia D, de Bazelaire C, Alsop DC (2008) Continuous flow-driven inversion for arterial spin labeling using pulsed radio frequency and gradient fields. Magn Reson Med 60:1488–97. https://doi.org/10.1002/mrm.21790

    Article  PubMed  PubMed Central  Google Scholar 

  28. Hammers A, Allom R, Koepp MJ et al (2003) Three-dimensional maximum probability atlas of the human brain, with particular reference to the temporal lobe. Hum Brain Mapp 19:224–247. https://doi.org/10.1002/hbm.10123

    Article  PubMed  PubMed Central  Google Scholar 

  29. Gousias IS, Rueckert D, Heckemann RA et al (2008) Automatic segmentation of brain MRIs of 2-year-olds into 83 regions of interest. Neuroimage 40:672–684. https://doi.org/10.1016/j.neuroimage.2007.11.034

    Article  PubMed  Google Scholar 

  30. Chen S, Guan M, Lian HJ et al (2014) Crossed cerebellar diaschisis detected by arterial spin-labeled perfusion magnetic resonance imaging in subacute ischemic stroke. J Stroke Cerebrovasc Dis 23:2378–2383. https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.05.009

    Article  PubMed  Google Scholar 

  31. Hauser RA, Murtaugh FR, Akhter K et al (1996) Magnetic resonance imaging of corticobasal degeneration. J Neuroimaging 6:222–226. https://doi.org/10.1111/jon199664222

    Article  CAS  PubMed  Google Scholar 

  32. Upadhyay N, Suppa A, Piattella MC et al (2016) Gray and white matter structural changes in corticobasal syndrome. Neurobiol Aging 37:82–90. https://doi.org/10.1016/j.neurobiolaging.2015.10.011

    Article  PubMed  Google Scholar 

  33. Gröschel K, Hauser TK, Luft A et al (2004) Magnetic resonance imaging-based volumetry differentiates progressive supranuclear palsy from corticobasal degeneration. Neuroimage 21:714–724. https://doi.org/10.1016/j.neuroimage.2003.09.070

    Article  PubMed  Google Scholar 

Download references

Funding

This study was supported in part by Grant-in-Aid for Scientific Research (C) Grant Number 20K07900 from the Japan Society for the Promotion of Science (JSPS KAKENHI) (to M.I.).

Author information

Authors and Affiliations

  1. Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji, Fukui, 910-1193, Japan

    Tomohisa Yamaguchi, Masamichi Ikawa, Souichi Enomoto, Norimichi Shirafuji, Osamu Yamamura, Yasunari Nakamoto & Tadanori Hamano

  2. Biomedical Imaging Research Center, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji, Fukui, 910-1193, Japan

    Masamichi Ikawa, Tetsuya Tsujikawa & Hidehiko Okazawa

  3. Department of Advanced Medicine for Community Healthcare, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji, Fukui, 910-1193, Japan

    Masamichi Ikawa

  4. Department of Radiology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji, Fukui, 910-1193, Japan

    Hirohiko Kimura

  5. Department of Aging and Dementia (DAD), Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji, Fukui, 910-1193, Japan

    Tadanori Hamano

Authors
  1. Tomohisa Yamaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Masamichi Ikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Souichi Enomoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Norimichi Shirafuji
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Osamu Yamamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tetsuya Tsujikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hidehiko Okazawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hirohiko Kimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yasunari Nakamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Tadanori Hamano
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Masamichi Ikawa.

Ethics declarations

Ethics approval

This study was approved by the Research Ethics Committee of the University of Fukui (20170130).

Consent to participate

This retrospective case–control study was approved by the Research Ethics Committee of the University of Fukui (20170130) with a waiver of the requirement for patients’ informed consent.

Consent to publication

Not applicable.

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 30 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yamaguchi, T., Ikawa, M., Enomoto, S. et al. Arterial spin labeling imaging for the detection of cerebral blood flow asymmetry in patients with corticobasal syndrome. Neuroradiology 64, 1829–1837 (2022). https://doi.org/10.1007/s00234-022-02942-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00234-022-02942-9

Keywords

Search

Navigation