Keith A. Josephs, MD, MST, MSc Mayo Clinic Proceedings

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Presentation transcript:

Current Understanding of Neurodegenerative Diseases Associated With the Protein Tau Keith A. Josephs, MD, MST, MSc Mayo Clinic Proceedings Volume 92, Issue 8, Pages 1291-1303 (August 2017) DOI: 10.1016/j.mayocp.2017.04.016 Copyright © 2017 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 1 T1-weighted magnetic resonance imaging features suggestive of an underlying primary tauopathy include the hummingbird sign resulting from atrophy of the dorsal midbrain and preserved pons (A, bottom image), suggestive of progressive supranuclear palsy; asymmetric parietal atrophy (right greater than left), suggestive of corticobasal degeneration (B, bottom image); and striking atrophy of the prefrontal cortex and anterior temporal lobe with secondary ventricular enlargement (worse on the left), suggestive of Pick disease (C, bottom image). Top images are normal magnetic resonance imaging scans for comparison. Mayo Clinic Proceedings 2017 92, 1291-1303DOI: (10.1016/j.mayocp.2017.04.016) Copyright © 2017 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 2 [18F]Fluorodeoxyglucose positron emission tomography scan using the CortexID Suite software (GE Healthcare) reveals mild hypometabolism of the left posterior frontal cortex, bilateral supplemental motor cortices, midbrain, superior cerebellar peduncle, and right cerebellum in a patient with Richardson syndrome (top row) and mild hypometabolism in bilateral posterior frontal cortices and right supplemental motor cortex in a patient with primary progressive apraxia of speech (bottom row), suggestive of an underlying primary tauopathy. Mayo Clinic Proceedings 2017 92, 1291-1303DOI: (10.1016/j.mayocp.2017.04.016) Copyright © 2017 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 3 [18F]AV-1451 tau positron emission tomography shows minimal uptake in a normal (control) patient (top row); mild-moderate uptake in the dentate nucleus of the cerebellum, midbrain, and basal ganglia in a patient with progressive supranuclear palsy (PSP); a primary 4R tauopathy (middle row); and striking uptake in the cortex in a patient with typical Alzheimer disease (AD), a 3R+4R tauopathy, for comparison (bottom row). Mayo Clinic Proceedings 2017 92, 1291-1303DOI: (10.1016/j.mayocp.2017.04.016) Copyright © 2017 Mayo Foundation for Medical Education and Research Terms and Conditions