Progression of brain atrophy in PSP and CBS over 6 months and 1 year

Shubir Dutt, Richard J. Binney, Hilary W. Heuer, Phi Luong, Suneth Attygalle, Priyanka Bhatt, Gabe A. Marx, Jonathan Elofson, Maria C. Tartaglia, Irene Litvan, Scott M. McGinnis, Bradford C. Dickerson, John Kornak, Dana Waltzman, Lisa Voltarelli, Norbert Schuff, Gil D. Rabinovici, Joel H. Kramer, Clifford R. Jack, Bruce L. MillerHoward J. Rosen, Adam L. Boxer

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Objective: To examine the utility and reliability of volumetric MRI in measuring disease progression in the 4 repeat tauopathies, progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS), to support clinical development of new tau-directed therapeutic agents. Methods: Six-and 12-month changes in regional MRI volumes and PSP Rating Scale scores were examined in 55 patients with PSP and 33 patients with CBS (78% amyloid PET negative) compared to 30 normal controls from a multicenter natural history study. Longitudinal voxel-based morphometric analyses identified patterns of volume loss, and region-of-interest analyses examined rates of volume loss in brainstem (midbrain, pons, superior cerebellar peduncle), cortical, and subcortical regions based on previously validated atlases. Results were compared to those in a replication cohort of 226 patients with PSP with MRI data from the AL-108-231 clinical trial. Results: Patients with CBS exhibited greater baseline atrophy and greater longitudinal atrophy rates in cortical and basal ganglia regions than patients with PSP; however, midbrain and pontine atrophy rates were similar. Voxel-wise analyses showed distinct patterns of regional longitudinal atrophy in each group as compared to normal controls. The midbrain/pons volumetric ratio differed between diagnoses but remained stable over time. In both patient groups, brainstem atrophy rates were correlated with disease progression measured using the PSP Rating Scale. Conclusions: Volume loss is quantifiable over a period of 6 months in CBS and PSP. Future clinical trials may be able to combine CBS and PSP to measure therapeutic effects.

Original languageEnglish (US)
Pages (from-to)2016-2025
Number of pages10
JournalNeurology
Volume87
Issue number19
DOIs
StatePublished - Nov 8 2016

ASJC Scopus subject areas

  • Clinical Neurology

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    Dutt, S., Binney, R. J., Heuer, H. W., Luong, P., Attygalle, S., Bhatt, P., Marx, G. A., Elofson, J., Tartaglia, M. C., Litvan, I., McGinnis, S. M., Dickerson, B. C., Kornak, J., Waltzman, D., Voltarelli, L., Schuff, N., Rabinovici, G. D., Kramer, J. H., Jack, C. R., ... Boxer, A. L. (2016). Progression of brain atrophy in PSP and CBS over 6 months and 1 year. Neurology, 87(19), 2016-2025. https://doi.org/10.1212/WNL.0000000000003305