Discrepancy between clinical and pathological diagnoses of CBD and PSP

Toshiki Mizuno, Kensuke Shiga, Yuriko Nakata, Junko Nagura, Taizen Nakase, Yoshihiro Ueda, Yoshiaki Takanashi, Kohji Urasaki, Yumiko Oyamada, Shinji Fushiki, Junji Nishikawa, Masahiro Yasuhara, Kenji Nakajima, Masanori Nakagawa

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)

Abstract

Progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) are often clinically confused with each other. Moreover, the discrepancy between clinical and pathological diagnoses of CBD and PSP are still controversial. We report here two atypical cases of PSP and CBD. A 73-yearold woman was admitted with right hand rigidity, limb kinetic apraxia and cortical sensory loss. Brain atrophy, hypoperfusion and hypometabolism predominantly in the left frontoparietal lobes indicated CBD clinically. Pathological studies revealed neuronal loss and spongy change without ballooned neurons (BN) in the cerebral cortex. Modified Gallyas-Braak (G-B) staining revealed neurofibrillary tangles (NFTs) and tufted astrocytes, indicating pathological diagnosis of PSP. A 75-year-old man admitted with vertical gaze palsy, neck dystonia, parkinsonism and dementia. Atrophy of the frontal lobes and tegmentum of the midbrain and symmetrical frontal hypoperfusion in SPECT indicated PSP. However, neuronal loss and BN in the frontal lobes and clusters of astrocytic plaques indicated CBD pathologically. The G-B staining was useful for differentiating between CBD and PSP, but our atypical cases bring up a new issue about differential diagnosis of CBD and PSP.

Original languageEnglish
Pages (from-to)687-697
Number of pages11
JournalJournal of neurology
Volume252
Issue number6
DOIs
Publication statusPublished - 2005 Jun
Externally publishedYes

Keywords

  • Atypical case
  • Ballooned neuron
  • CBD
  • Neurofibrillary tangle
  • PSP

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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