[Autonomic Dysfunction in Tauopathies]

Area of Science:

• Neurology
• Neuroscience
• Pathology

Background:

• Progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) are tauopathies presenting as atypical parkinsonism.
• Autonomic dysfunction is well-documented in synucleinopathies like multiple system atrophy, but its prevalence in tauopathies is less understood.
• Recent findings suggest urinary dysfunction and constipation are frequent in PSP and impact prognosis.

Purpose of the Study:

• To clarify the frequency and characteristics of autonomic dysfunction in patients with PSP and CBD.
• To evaluate the diagnostic utility of specific autonomic symptoms in differentiating tauopathies from synucleinopathies.
• To assess the role of urinary dysfunction as a potential diagnostic criterion for PSP in CBD patients.

Main Methods:

• Review of existing literature and clinical data on autonomic dysfunction in PSP and CBD.
• Comparative analysis of autonomic symptom profiles between tauopathies and synucleinopathies.
• Evaluation of the diagnostic value of urinary dysfunction in PSP and CBD cohorts.

Main Results:

• Urinary dysfunction and constipation are common in PSP and influence patient outcomes.
• Neurogenic orthostatic hypotension is infrequent in PSP, distinguishing it from multiple system atrophy and Lewy body disease.
• Urinary dysfunction is also prevalent in CBD, suggesting its potential as a diagnostic marker.

Conclusions:

• Autonomic dysfunction, particularly urinary issues, is a significant feature of PSP and CBD.
• The low incidence of neurogenic orthostatic hypotension in PSP is a key differentiator from other parkinsonian disorders.
• Further validation is needed to confirm urinary dysfunction as a reliable diagnostic criterion for PSP in CBD patients.