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NEUROLOGY 2007;68:1274-1283
© 2007 American Academy of Neurology

Cognitive and motor assessment in autopsy-proven corticobasal degeneration

R. Murray, BS, M. Neumann, MD, M. S. Forman, MD, PhD, J. Farmer, MSc, L. Massimo, LPN, A. Rice, BS, B. L. Miller, MD, J. K. Johnson, PhD, C. M. Clark, MD, H. I. Hurtig, MD, M. L. Gorno-Tempini, MD, PhD, V. M.-Y. Lee, MD, PhD, J. Q. Trojanowski, MD, PhD and M. Grossman, MD

From the Departments of Neurology (R.M., L.M., A.R., C.M.C., M.G.) and Pathology (M.S.F., V.M.-Y.L., J.Q.T.) and Center for Neurodegenerative Disease Research (M.N., M.S.F., J.F., V.M.-Y., J.Q.T.), University of Pennsylvania School of Medicine, Philadelphia, PA; and Department of Neurology (B.L.M., J.K.J., H.I.H., M.L.G.T.), University of California at San Francisco, San Francisco, CA.

Address correspondence and reprint requests to Dr. Murray Grossman, Department of Neurology, 2 Gibson, University of Pennsylvania School of Medicine, 3400 Spruce Street, Philadelphia, PA 19104-4283; email: mgrossma{at}mail.med.upenn.edu

Objective: To investigate the clinical features of autopsy-proven corticobasal degeneration (CBD).

Methods: We evaluated symptoms, signs, and neuropsychological deficits longitudinally in 15 patients with autopsy-proven CBD and related these observations directly to the neuroanatomic distribution of disease.

Results: At presentation, a specific pattern of cognitive impairment was evident, whereas an extrapyramidal motor abnormality was present in less than half of the patients. Follow-up examination revealed persistent impairment of apraxia and executive functioning, worsening language performance, and preserved memory. The motor disorder emerged and worsened as the condition progressed. Statistical analysis associated cognitive deficits with tau-immunoreactive pathology that is significantly more prominent in frontal and parietal cortices and the basal ganglia than temporal neocortex and the hippocampus.

Conclusion: The clinical diagnosis of corticobasal degeneration should depend on a specific pattern of impaired cognition as well as an extrapyramidal motor disorder, reflecting the neuroanatomic distribution of disease in frontal and parietal cortices and the basal ganglia.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the April 17 issue to find the title link for this article.

This work was supported in part by National Institutes of Health (NS44266, AG17586, AG15116, AG09215, AG10124, AG19724, and AG23501) and the Dana Foundation.

Disclosure: The authors report no conflicts of interest.

Received June 29, 2006. Accepted in final form December 11, 2006.


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