Progression of white matter damage in progressive supranuclear palsy with predominant parkinsonism

Area of Science:

• Neuroimaging
• Neurology
• Neurodegeneration

Background:

• Progressive supranuclear palsy with predominant parkinsonism (PSP-P) is a subtype of PSP, accounting for 14-35% of cases.
• Cross-sectional MRI studies indicate significant white matter (WM) damage in PSP-P patients.
• The longitudinal progression of brain structural damage in PSP-P remains largely unknown.

Purpose of the Study:

• To investigate the progression of white matter (WM) damage in patients with progressive supranuclear palsy with predominant parkinsonism (PSP-P) over time.
• To assess the utility of longitudinal diffusion tensor (DT) MRI as a potential in vivo marker for disease progression in PSP-P.

Main Methods:

• Longitudinal data collection including clinical, cognitive, and diffusion tensor (DT) MRI over a mean follow-up of 1.6 years in 10 PSP-P patients.
• Comparison of PSP-P patients at baseline with 36 healthy controls.
• Voxelwise statistical analysis of white matter DT MRI metrics (mean, axial, radial diffusivity, fractional anisotropy) using tract-based spatial statistics.

Main Results:

• PSP-P patients demonstrated significant declines in motor, cognitive, and mood disturbances during the follow-up period.
• Baseline DT MRI analysis revealed widespread white matter (WM) alterations in PSP-P patients.
• Longitudinal analysis showed progression of WM damage in supratentorial tracts over time, with no changes observed in cerebellar WM.

Conclusions:

• White matter (WM) damage significantly progresses over time in patients with progressive supranuclear palsy with predominant parkinsonism (PSP-P).
• Longitudinal diffusion tensor (DT) MRI measures show potential as in vivo biomarkers for monitoring disease progression in PSP-P.