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Progressive supranuclear palsy: neuropathologic and clinical heterogeneity
M Gearing1, D A Olson, R L Watts
1Veterans Affairs Medical Center, Emory University School of Medicine, Atlanta, GA.
Neurology
|June 1, 1994
Summary
Progressive supranuclear palsy (PSP) shows significant heterogeneity. Many patients exhibit co-occurring Alzheimer's disease (AD) or Parkinson's disease (PD) pathology, suggesting PSP is often underdiagnosed.
Area of Science:
- Neurology
- Neuroscience
- Pathology
Background:
- Progressive supranuclear palsy (PSP) is a neurodegenerative disease.
- Clinical heterogeneity is observed in PSP patients.
- Differential diagnosis of dementing illnesses can be challenging.
Purpose of the Study:
- To investigate the neuropathological heterogeneity of progressive supranuclear palsy (PSP).
- To determine the frequency of co-occurring Alzheimer's disease (AD) and Parkinson's disease (PD) pathology in PSP.
Main Methods:
- Examination of 13 patients with neuropathologically confirmed PSP.
- Review of clinical diagnoses, including PSP and probable AD.
- Analysis of concomitant neuropathologic findings of AD, PD, or both.
Main Results:
- Clinical diagnosis of PSP was confirmed in 8 of 13 patients.
- Five patients initially diagnosed with probable AD also had PSP neuropathology.
- Seven patients (54%) showed co-existing AD and/or PD pathology alongside PSP.
Conclusions:
- Alzheimer's disease and Parkinson's disease pathologies frequently coexist with PSP neuropathology.
- Significant clinical and neuropathologic heterogeneity exists in neurodegenerative disorders.
- PSP may be underdiagnosed and should be considered more in dementia differential diagnoses.