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@ARTICLE{Palleis:285043,
author = {Palleis, Carla and Bernhardt, Alexander Maximilian and
Weidinger, Endy and Fietzek, Urban M and Jäck, Alexander
and Katzdobler, Sabrina and Gnoerich, Johannes and Bauer,
Theresa and Franzmeier, Nicolai and Perneczky, Robert and
Brendel, Matthias and Levin, Johannes and Höglinger,
Günter U},
collaboration = {Tauopathies, German Imaging Initiative for},
title = {{A} {B}iomarker-{B}ased {C}lassification of {C}orticobasal
{S}yndrome.},
journal = {Movement disorders},
volume = {41},
number = {1},
issn = {0885-3185},
address = {New York, NY},
publisher = {Wiley},
reportid = {DZNE-2026-00167},
pages = {129 - 142},
year = {2026},
abstract = {Corticobasal syndrome (CBS) is a clinically defined
syndrome with progressive movement and cortical dysfunction,
caused by various underlying pathologies, most commonly
tau-predominant pathologies such as progressive supranuclear
palsy and corticobasal degeneration, or Alzheimer's disease
(AD). Lewy-type α-synucleinopathies (LTS), TDP-43
proteinopathies, and mixed pathologies may also underlie
CBS. The clinical impact of these pathologies remains poorly
understood.To subclassify CBS patients in vivo using
biomarkers for amyloid-β (Aβ), Tau, and α-synuclein
(αSyn), and assess the clinical relevance of this
stratification.We conducted a prospective cohort study of 50
CBS patients at LMU University Hospital Munich. Biomarker
analysis included cerebrospinal fluid (CSF) Aβ42 and
Aβ42/40, [18F]flutemetamol Aβ-PET, [18F]PI-2620 tau-PET,
and αSyn seed amplification assays in CSF. CSF
neurofilament light chain (NfL) served as a marker of
neurodegeneration. Patients were stratified into six groups
based on biomarker positivity.Tau positivity was found in
$90\%$ of CBS cases, Aβ in $28\%,$ and αSyn in $24\%.$
Stratification identified: $52\%$ consistent with
tau-predominant pathology, $18\%$ with AD, $10\%$ with
AD+LTS, $10\%$ with tau-predominant+LTS, $4\%$ with isolated
LTS, and $6\%$ unclassified. αSyn positivity was more
frequent in AD-CBS $(36\%)$ than in tau-predominant-CBS
$(16\%).$ Aβ-positive cases showed greater cognitive
impairment; Tau positivity correlated with worse motor
symptoms; αSyn-positive patients had milder motor symptoms,
slower progression, and lower NfL levels.CBS is molecularly
heterogeneous. Biomarker-based classification may enhance
diagnostic precision and support personalized therapeutic
strategies. © 2025 The Author(s). Movement Disorders
published by Wiley Periodicals LLC on behalf of
International Parkinson and Movement Disorder Society.},
keywords = {Humans / Male / Female / Aged / Biomarkers: cerebrospinal
fluid / Amyloid beta-Peptides: cerebrospinal fluid / Middle
Aged / tau Proteins: cerebrospinal fluid / Positron-Emission
Tomography / alpha-Synuclein: cerebrospinal fluid /
alpha-Synuclein: metabolism / Prospective Studies /
Corticobasal Degeneration: classification / Corticobasal
Degeneration: cerebrospinal fluid / Corticobasal
Degeneration: diagnostic imaging / Peptide Fragments:
cerebrospinal fluid / Aged, 80 and over / proteinopathies
(Other) / tau‐PET (Other) / α‐synuclein seed
amplification assay (Other) / β‐amyloid (Other) /
Biomarkers (NLM Chemicals) / Amyloid beta-Peptides (NLM
Chemicals) / tau Proteins (NLM Chemicals) / alpha-Synuclein
(NLM Chemicals) / Peptide Fragments (NLM Chemicals) /
amyloid beta-protein (1-42) (NLM Chemicals)},
cin = {Clinical Research (Munich) / AG Levin / AG Haass / AG
Dichgans},
ddc = {610},
cid = {I:(DE-2719)1111015 / I:(DE-2719)1111016 /
I:(DE-2719)1110007 / I:(DE-2719)5000022},
pnm = {353 - Clinical and Health Care Research (POF4-353) / 352 -
Disease Mechanisms (POF4-352)},
pid = {G:(DE-HGF)POF4-353 / G:(DE-HGF)POF4-352},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:41048081},
pmc = {pmc:PMC12882055},
doi = {10.1002/mds.70070},
url = {https://pub.dzne.de/record/285043},
}