皮质基底节综合征—阿尔茨海默病1例报道

A case of Alzheimer’s disease presenting as corticobasal syndrome

目的:探索以皮质基底节综合征(Corticobasal Syndrome,CBS)-阿尔茨海默病(Alzheimer's Disease,AD)的临床特点及影像学特征。方法:报道1例CBS-AD,并进行文献复习。结果:患者老年女性,主要临床表现为言语障碍,肢体失用、认知障碍等皮层症状伴有非对称性帕金森综合征,左旋多巴治疗效果不佳,头磁共振示左侧额颞顶萎缩,^(18)F-氟脱氧葡萄糖正电子发射断层扫描示不对称性额颞顶皮层、基底节代谢减低,11C-匹兹堡化合物B正电子发射断层显像示皮层β淀粉样蛋白(amyloidβ-protein,Aβ)沉积,诊断为CBS-AD。结论:神经分子影像有助于诊断及鉴别诊断。

Objective:To explore the clinical and imaging features of Alzheimer's Disease(AD)-corticobasal syndrome(CBS)clinical manifestation.Methods:A CBS-AD patient was reported and the literature on CBS-AD was reviewed.Results:The patient,an elderly female,was characterized as speech disorder,limb apraxia,cognitive impairment and asymmetric Parkinson's syndrome with poor effect of levodopa.The MRI features showed atrophy of left frontotemporal parietal cortex,^(18)F-fluorodeoxyglucose-positron emission tomography(FDG-PET)showed asymmetric metabolism decrease in frontotemporal parietal cortex and basal ganglia,and 11C-Pittsburgh Compound B(PIB)-PET showed deposition of amyloidβ-protein(Aβ)in cortex,which was diagnosed as CBS-AD.Conclusion:The clinical manifestation of AD-CBS is complex,and neuromolecular imaging is helpful for diagnosis and differential diagnosis.