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Progressive Supranuclear Palsy: an Update.

Melissa J Armstrong1,2

  • 1Department of Neurology, University of Florida College of Medicine, Gainesville, FL, USA. melissa.armstrong@neurology.ufl.edu.

Current Neurology and Neuroscience Reports
|February 19, 2018
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Summary
This summary is machine-generated.

New criteria improve diagnosis of progressive supranuclear palsy (PSP), a 4R tau disorder. Current treatments are symptomatic, but new tau-based therapies are in clinical trials for PSP.

Keywords:
Clinical diagnostic criteriaDiagnostic imagingProgressive supranuclear palsyProgressive supranuclear palsy/therapy

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Area of Science:

  • Neuropathology
  • Neurodegenerative Diseases

Background:

  • Progressive supranuclear palsy (PSP) is defined by 4R tau pathology.
  • Historically, PSP diagnosis relied on vertical gaze palsy and early falls.
  • Clinicopathologic studies reveal diverse PSP presentations beyond the classic phenotype.

Purpose of the Study:

  • Review updated diagnostic criteria for PSP.
  • Discuss current diagnostic approaches and treatment strategies.
  • Highlight implications of new criteria for diagnosis and research.

Main Methods:

  • The 2017 International Parkinson and Movement Disorder Society (MDS) PSP criteria were analyzed.
  • Clinical features and diagnostic clues for eight PSP phenotypes were examined.
  • Evidence for imaging in PSP diagnosis was reviewed.
  • Outcomes of recent therapeutic trials were considered.

Main Results:

  • The 2017 MDS criteria integrate 14 core features and 4 clues for diagnosing eight PSP phenotypes.
  • Imaging supports diagnosis in the classic PSP-Richardson syndrome.
  • Recent disease-modifying trials for PSP showed no benefit.
  • New criteria broaden diagnostic scope, impacting clinical practice and research.

Conclusions:

  • Updated PSP criteria encompass a wider range of clinical presentations.
  • Diagnostic evaluations need further refinement to assess phenotype and progression.
  • Symptomatic treatments remain the current standard for PSP.
  • Tau-based therapeutics are under investigation in ongoing clinical trials.