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Fernández-Ferreira R, García-Santos RA, Rodríguez-Violante M, López-Martínez C, Becerra-Laparra IK, Torres-Pérez ME. Progressive supranuclear palsy as differential diagnosis of Parkinson's disease in the elderly. Rev Esp Geriatr Gerontol 2019; 54:251-256. [PMID: 31324404 DOI: 10.1016/j.regg.2019.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 01/28/2019] [Accepted: 04/24/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Progressive supranuclear palsy (PSP) is a syndrome characterized by progressive parkinsonism with early falls due to postural instability, typically vertical gaze supranuclear ophthalmoplegia, pseudobulbar dysfunction, neck dystonia and upper trunk rigidity as well as mild cognitive dysfunction. Progressive supranuclear palsy must be differentiated from Parkinson's disease taking into account several so-called red flags. MATERIALS AND METHODS We report a case series hallmarked by gait abnormalities, falls and bradykinesia in which Parkinson's disease was the initial diagnosis. RESULTS Due to a torpid clinical course, magnetic resonance imaging (MRI) was performed demonstrating midbrain atrophy, highly suggestive of progressive supranuclear palsy. CONCLUSION The neuroradiological exams (magnetic resonance imaging, single photon emission computer tomography, and positron emission tomography) can be useful for diagnosis of PSP. Treatment with levodopa should be considered, especially in patients with a more parkinsonian phenotype.
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Affiliation(s)
| | - Raúl Anwar García-Santos
- Neurology Department, National Institute of Neurology and Neurosurgery, PC 14269, Mexico City, Mexico
| | - Mayela Rodríguez-Violante
- Clinical Laboratory of Neurodegenerative Diseases, National Institute of Neurology and Neurosurgery, PC 14269, Mexico City, Mexico
| | - Coral López-Martínez
- Geriatrics Department, Médica Sur Clinic & Foundation, PC 14050, Mexico City, Mexico
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Taylor LM, McMillan PJ, Kraemer BC, Liachko NF. Tau tubulin kinases in proteinopathy. FEBS J 2019; 286:2434-2446. [PMID: 31034749 PMCID: PMC6936727 DOI: 10.1111/febs.14866] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/23/2019] [Accepted: 04/25/2019] [Indexed: 12/12/2022]
Abstract
A number of neurodegenerative diseases are characterized by deposition of abnormally phosphorylated tau or TDP-43 in disease-affected neurons. These diseases include Alzheimer's disease, frontotemporal lobar degeneration, and amyotrophic lateral sclerosis. No disease-modifying therapeutics is available to treat these disorders, and we have a limited understanding of the cellular and molecular factors integral to disease initiation or progression. Phosphorylated tau and TDP-43 are important markers of pathology in dementia disorders and directly contribute to tau- and TDP-43-related neurotoxicity and neurodegeneration. Here, we review the scope of tau and TDP-43 phosphorylation in neurodegenerative disease and discuss recent work demonstrating the kinases TTBK1 and TTBK2 phosphorylate both tau and TDP-43, promoting neurodegeneration.
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Affiliation(s)
- Laura M Taylor
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Pamela J McMillan
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Brian C Kraemer
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
- Geriatrics Research Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Nicole F Liachko
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Seattle, WA, USA
- Geriatrics Research Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
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Whitwell JL, Stevens CA, Duffy JR, Clark HM, Machulda MM, Strand EA, Martin PR, Utianski RL, Botha H, Spychalla AJ, Senjem ML, Schwarz CG, Jack CR, Ali F, Hassan A, Josephs KA. An Evaluation of the Progressive Supranuclear Palsy Speech/Language Variant. Mov Disord Clin Pract 2019; 6:452-461. [PMID: 31392246 DOI: 10.1002/mdc3.12796] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 05/12/2019] [Indexed: 12/12/2022] Open
Abstract
Background The Movement Disorder Society clinical criteria for progressive supranuclear palsy (PSP) provide a framework for assessing the presence/severity of clinical symptoms and define a speech/language variant of PSP. Objectives To evaluate the clinical criteria in a cohort of speech/language patients with longitudinal follow-up. Methods A total of 52 patients presenting with progressive apraxia of speech and/or agrammatic aphasia were followed longitudinally for up to 6 visits with clinical assessments and magnetic resonance imaging. We assessed oculomotor, postural instability, and akinesia diagnostic levels and determined whether patients met criteria for possible PSP-speech/language or probable PSP at each visit. Kaplan-Meier curves assessed time-to-event probabilities according to age. Statistical parametric mapping and midbrain volume were assessed according to disease progression. Results Few PSP symptoms were observed early in the disease, with oculomotor abnormalities and falls first observed 2 years after onset. Falls were more common than vertical supranuclear gaze palsy. Bradykinesia and rigidity commonly developed but axial was rarely greater than appendicular rigidity. During follow-up, 54% met criteria for possible PSP-speech/language, 38% for probable PSP-Richardson's syndrome, and 38% for probable PSP-parkinsonism, most commonly 6 to 6.9 years after onset. The probability of developing PSP was greater when onset was at an age older than 70 years. Patients who progressed to probable PSP had more parkinsonism and oculomotor impairment at baseline and greater midbrain atrophy when compared with those who did not develop probable PSP. Conclusions Symptoms typical of PSP commonly develop in patients presenting with a progressive speech/language disorder. Older age appears to be an important prognostic factor in these patients.
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Affiliation(s)
| | - Chase A Stevens
- Department of Neurology Mayo Clinic Rochester Minnesota.,Department of Liberal Arts, Spelman College Atlanta Georgia
| | | | | | - Mary M Machulda
- Department of Psychology and Psychiatry Mayo Clinic Rochester Minnesota
| | | | - Peter R Martin
- Department of Health Science Research Mayo Clinic Rochester Minnesota
| | | | - Hugo Botha
- Department of Neurology Mayo Clinic Rochester Minnesota
| | | | - Matthew L Senjem
- Department of Radiology Mayo Clinic Rochester Minnesota.,Department of Information Technology Mayo Clinic Rochester Minnesota
| | | | | | - Farwa Ali
- Department of Neurology Mayo Clinic Rochester Minnesota
| | - Anhar Hassan
- Department of Neurology Mayo Clinic Rochester Minnesota
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Di Stasio F, Suppa A, Marsili L, Upadhyay N, Asci F, Bologna M, Colosimo C, Fabbrini G, Pantano P, Berardelli A. Corticobasal syndrome: neuroimaging and neurophysiological advances. Eur J Neurol 2019; 26:701-e52. [PMID: 30720235 DOI: 10.1111/ene.13928] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 01/30/2019] [Indexed: 01/14/2023]
Abstract
Corticobasal degeneration (CBD) is a neurodegenerative condition characterized by 4R tau protein deposition in several brain regions that clinically manifests itself as a heterogeneous atypical parkinsonism typically expressed in adulthood. The prototypical clinical phenotype of CBD is corticobasal syndrome (CBS). Important insights into the pathophysiological mechanisms underlying motor and higher cortical symptoms in CBS have been gained by using advanced neuroimaging and neurophysiological techniques. Structural and functional neuroimaging studies often show asymmetric cortical and subcortical abnormalities, mainly involving perirolandic and parietal regions and basal ganglia structures. Neurophysiological investigations including electroencephalography and somatosensory evoked potentials provide useful information on the origin of myoclonus and on cortical sensory loss. Transcranial magnetic stimulation demonstrates heterogeneous and asymmetric changes in the excitability and plasticity of primary motor cortex and abnormal hemispheric connectivity. Neuroimaging and neurophysiological abnormalities in multiple brain areas reflect asymmetric neurodegeneration, leading to asymmetric motor and higher cortical symptoms in CBS.
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Affiliation(s)
- F Di Stasio
- IRCCS Neuromed Institute, 'Sapienza' University of Rome, Pozzilli (Isernia), Italy
| | - A Suppa
- IRCCS Neuromed Institute, 'Sapienza' University of Rome, Pozzilli (Isernia), Italy.,Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - L Marsili
- Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - N Upadhyay
- Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - F Asci
- Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - M Bologna
- IRCCS Neuromed Institute, 'Sapienza' University of Rome, Pozzilli (Isernia), Italy.,Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - C Colosimo
- Department of Neurology, Santa Maria University Hospital, Terni, Italy
| | - G Fabbrini
- IRCCS Neuromed Institute, 'Sapienza' University of Rome, Pozzilli (Isernia), Italy.,Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - P Pantano
- IRCCS Neuromed Institute, 'Sapienza' University of Rome, Pozzilli (Isernia), Italy.,Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
| | - A Berardelli
- IRCCS Neuromed Institute, 'Sapienza' University of Rome, Pozzilli (Isernia), Italy.,Department of Human Neuroscience, 'Sapienza' University of Rome, Rome, Italy
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5
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Alster P, Krzyżanowska E, Koziorowski D, Szlufik S, Różański D, Noskowska J, Mianowicz J, Michno A, Królicki L, Friedman A. Difficulties in the diagnosis of four repeats (4R) tauopathic parkinsonian syndromes. Neurol Neurochir Pol 2018; 52:459-464. [PMID: 30025721 DOI: 10.1016/j.pjnns.2018.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 06/03/2018] [Accepted: 06/19/2018] [Indexed: 11/28/2022]
Abstract
Corticobasal Degeneration Degeneration (CBD) and Progressive Supranuclear Palsy (PSP) are types of four repeats (4R) tauopathies, which are associated to parkinsonian syndromes. The aim of the work is to analyze cases of patients of the Department of Neurology, overlapping of syndromes related to both pathologies and to show that most likely CBS and PSP are not lineary related to their commonly associated syndromes i.e. adequately corticobasal syndromes and progressive supranuclear palsy syndromes. In the context of each patient factors in favor of most likely CBS, PSP or both diseases are discussed and analyzed using contemporary criteria. This work discusses multidimensional aspect of the examination of five patient aged 64 to 83 - 4 females and 1 male with 4R tauopathies and difficulties in distinguishing both diseases. The duration of the disease varied from 1 to 5 years. Each patient after neurological examination was assessed using magnetic resonance imaging (MRI) and psychological test. Examination of all patients was extended using single photon emission computer tomography (SPECT) to reveal the usefulness of this tool in differentiation of diseases was done. The outcome of this examination was verified with prior clinical manifestation of patients and morphological abnormalities in magnetic resonance imaging. Autopsies were not conducted.
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Affiliation(s)
- Piotr Alster
- Department of Neurology, Medical University of Warsaw, Poland.
| | | | | | | | - Dorota Różański
- Department of Neurology, Medical University of Warsaw, Poland
| | | | | | | | - Leszek Królicki
- Department of Nuclear Medicine, Medical University of Warsaw, Poland
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Pan P, Liu Y, Zhang Y, Zhao H, Ye X, Xu Y. Brain gray matter abnormalities in progressive supranuclear palsy revisited. Oncotarget 2017; 8:80941-80955. [PMID: 29113357 PMCID: PMC5655252 DOI: 10.18632/oncotarget.20895] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 08/26/2017] [Indexed: 12/11/2022] Open
Abstract
Whole-brain voxel-based morphometry (VBM) studies of progressive supranuclear palsy (PSP) have demonstrated heterogeneous findings regarding gray matter (GM) abnormalities. Here, we used Seed-based d Mapping, a coordinate-based meta-analytic approach to identify consistent regions of GM anomalies across studies of PSP. Totally, 18 original VBM studies, comprising 284 patients with PSP and 367 healthy controls were included. As compared to healthy controls, patients with PSP demonstrated significant GM reductions in both cortical and subcortical regions, including the frontal motor cortices, medial (including anterior cingulate cortex) and lateral frontal cortices, insula, superior temporal gyrus, striatum (putamen and caudate nucleus), thalamus, midbrain, and anterior cerebellum. Our study further suggests that many confounding factors, such as age, male ratio, motor severity, cognitive impairment severity, and illness duration of PSP patients, and scanner field-strength, could contribute to the heterogeneity of GM alterations in PSP across studies. Our comprehensive meta-analysis demonstrates a specific neuroanatomical pattern of GM atrophy in PSP with the involvement of the cortical-subcortical circuitries that mediate vertical supranuclear gaze palsy, motor disabilities (postural instability with falls and parkinsonism), and cognitive-behavioral disturbances. Confounding factors merit attention in future studies.
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Affiliation(s)
- PingLei Pan
- Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, PR China
- Department of Neurology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China
| | - Yi Liu
- Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, PR China
- The State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, PR China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, PR China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, PR China
- Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, PR China
| | - Yang Zhang
- Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, PR China
- The State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, PR China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, PR China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, PR China
- Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, PR China
| | - Hui Zhao
- Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, PR China
- The State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, PR China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, PR China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, PR China
- Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, PR China
| | - Xing Ye
- Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, PR China
- The State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, PR China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, PR China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, PR China
- Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, PR China
| | - Yun Xu
- Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, PR China
- The State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, PR China
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, PR China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, PR China
- Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, PR China
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Ahmed RM, Devenney EM, Irish M, Ittner A, Naismith S, Ittner LM, Rohrer JD, Halliday GM, Eisen A, Hodges JR, Kiernan MC. Neuronal network disintegration: common pathways linking neurodegenerative diseases. J Neurol Neurosurg Psychiatry 2016; 87:1234-1241. [PMID: 27172939 PMCID: PMC5099318 DOI: 10.1136/jnnp-2014-308350] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 04/18/2016] [Indexed: 12/16/2022]
Abstract
Neurodegeneration refers to a heterogeneous group of brain disorders that progressively evolve. It has been increasingly appreciated that many neurodegenerative conditions overlap at multiple levels and therefore traditional clinicopathological correlation approaches to better classify a disease have met with limited success. Neuronal network disintegration is fundamental to neurodegeneration, and concepts based around such a concept may better explain the overlap between their clinical and pathological phenotypes. In this Review, promoters of overlap in neurodegeneration incorporating behavioural, cognitive, metabolic, motor, and extrapyramidal presentations will be critically appraised. In addition, evidence that may support the existence of large-scale networks that might be contributing to phenotypic differentiation will be considered across a neurodegenerative spectrum. Disintegration of neuronal networks through different pathological processes, such as prion-like spread, may provide a better paradigm of disease and thereby facilitate the identification of novel therapies for neurodegeneration.
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Affiliation(s)
- Rebekah M Ahmed
- Sydney Medical School Brain & Mind Centre, University of Sydney, Sydney, New South Wales, Australia Neuroscience Research Australia, University of NSW, Sydney, New South Wales, Australia
| | - Emma M Devenney
- Sydney Medical School Brain & Mind Centre, University of Sydney, Sydney, New South Wales, Australia Neuroscience Research Australia, University of NSW, Sydney, New South Wales, Australia
| | - Muireann Irish
- Neuroscience Research Australia, University of NSW, Sydney, New South Wales, Australia School of Psychology, the University of New South Wales, Sydney, Australia
| | - Arne Ittner
- Faculty of Medicine, Dementia Research Unit, School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Sharon Naismith
- School of Psychology, Brain & Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Lars M Ittner
- Faculty of Medicine, Dementia Research Unit, School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Jonathan D Rohrer
- Dementia Research Centre, University College London Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Glenda M Halliday
- Neuroscience Research Australia, University of NSW, Sydney, New South Wales, Australia
| | - Andrew Eisen
- University of British Columbia, Vancouver, British Columbia, Canada
| | - John R Hodges
- Neuroscience Research Australia, University of NSW, Sydney, New South Wales, Australia
| | - Matthew C Kiernan
- Sydney Medical School Brain & Mind Centre, University of Sydney, Sydney, New South Wales, Australia
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8
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A review on brain structures segmentation in magnetic resonance imaging. Artif Intell Med 2016; 73:45-69. [DOI: 10.1016/j.artmed.2016.09.001] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 07/27/2016] [Accepted: 09/05/2016] [Indexed: 11/18/2022]
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Robertson EE, Hall DA, McAsey AR, O'Keefe JA. Fragile X-associated tremor/ataxia syndrome: phenotypic comparisons with other movement disorders. Clin Neuropsychol 2016; 30:849-900. [PMID: 27414076 PMCID: PMC7336900 DOI: 10.1080/13854046.2016.1202239] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 06/12/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The purpose of this paper is to review the typical cognitive and motor impairments seen in fragile X-associated tremor/ataxia syndrome (FXTAS), essential tremor (ET), Parkinson disease (PD), spinocerebellar ataxias (SCAs), multiple system atrophy (MSA), and progressive supranuclear palsy (PSP) in order to enhance diagnosis of FXTAS patients. METHODS We compared the cognitive and motor phenotypes of FXTAS with each of these other movement disorders. Relevant neuropathological and neuroimaging findings are also reviewed. Finally, we describe the differences in age of onset, disease severity, progression rates, and average lifespan in FXTAS compared to ET, PD, SCAs, MSA, and PSP. We conclude with a flow chart algorithm to guide the clinician in the differential diagnosis of FXTAS. RESULTS By comparing the cognitive and motor phenotypes of FXTAS with the phenotypes of ET, PD, SCAs, MSA, and PSP we have clarified potential symptom overlap while elucidating factors that make these disorders unique from one another. In summary, the clinician should consider a FXTAS diagnosis and testing for the Fragile X mental retardation 1 (FMR1) gene premutation if a patient over the age of 50 (1) presents with cerebellar ataxia and/or intention tremor with mild parkinsonism, (2) has the middle cerebellar peduncle (MCP) sign, global cerebellar and cerebral atrophy, and/or subcortical white matter lesions on MRI, or (3) has a family history of fragile X related disorders, intellectual disability, autism, premature ovarian failure and has neurological signs consistent with FXTAS. Peripheral neuropathy, executive function deficits, anxiety, or depression are supportive of the diagnosis. CONCLUSIONS Distinct profiles in the cognitive and motor domains between these movement disorders may guide practitioners in the differential diagnosis process and ultimately lead to better medical management of FXTAS patients.
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Affiliation(s)
- Erin E Robertson
- a Department of Anatomy and Cell Biology , Rush University , Chicago , IL , USA
| | - Deborah A Hall
- b Department of Neurological Sciences , Rush University , Chicago , IL , USA
| | - Andrew R McAsey
- a Department of Anatomy and Cell Biology , Rush University , Chicago , IL , USA
| | - Joan A O'Keefe
- a Department of Anatomy and Cell Biology , Rush University , Chicago , IL , USA
- b Department of Neurological Sciences , Rush University , Chicago , IL , USA
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Ogata T, Sakakibara R, Tateno F, Tsuyusaki Y, Tateno H, Aiba Y, Kishi M, Inaoka T, Terada H, Doi H, Suzuki Y. Mild Cognitive Impairment as the Initial Manifestation of Progressive Supranuclear Palsy. J Am Geriatr Soc 2016; 64:683-5. [DOI: 10.1111/jgs.14001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Tsuyoshi Ogata
- Division of Neurology; Department of Internal Medicine; Sakura Medical Center; Toho University; Sakura Japan
| | - Ryuji Sakakibara
- Division of Neurology; Department of Internal Medicine; Sakura Medical Center; Toho University; Sakura Japan
| | - Fuyuki Tateno
- Division of Neurology; Department of Internal Medicine; Sakura Medical Center; Toho University; Sakura Japan
| | - Yohei Tsuyusaki
- Division of Neurology; Department of Internal Medicine; Sakura Medical Center; Toho University; Sakura Japan
| | - Hiromi Tateno
- Division of Neurology; Department of Internal Medicine; Sakura Medical Center; Toho University; Sakura Japan
| | - Yosuke Aiba
- Division of Neurology; Department of Internal Medicine; Sakura Medical Center; Toho University; Sakura Japan
| | - Masahiko Kishi
- Division of Neurology; Department of Internal Medicine; Sakura Medical Center; Toho University; Sakura Japan
| | - Tsutomu Inaoka
- Department of Radiology; Sakura Medical Center; Toho University; Sakura Japan
| | - Hitoshi Terada
- Department of Radiology; Sakura Medical Center; Toho University; Sakura Japan
| | - Hirokazu Doi
- Pharmaceutical Unit; Sakura Medical Center; Toho University; Sakura Japan
| | - Yasuo Suzuki
- Department of Gatroenterology; Sakura Medical Center; Toho University; Sakura Japan
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Koga S, Josephs KA, Ogaki K, Labbé C, Uitti RJ, Graff-Radford N, van Gerpen JA, Cheshire WP, Aoki N, Rademakers R, Wszolek ZK, Ross OA, Dickson DW. Cerebellar ataxia in progressive supranuclear palsy: An autopsy study of PSP-C. Mov Disord 2016; 31:653-62. [PMID: 26841329 DOI: 10.1002/mds.26499] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 11/03/2015] [Accepted: 11/09/2015] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Cerebellar ataxia is an exclusion criterion for the clinical diagnosis of progressive supranuclear palsy, but a variant with predominant cerebellar ataxia has been reported. The aims of this study were to estimate the frequency of progressive supranuclear palsy with predominant cerebellar ataxia in an autopsy series from the United States and to compare clinical, pathologic, and genetic differences between progressive supranuclear palsy with and without predominant cerebellar ataxia. METHOD We selected 100 consecutive patients with pathologically confirmed progressive supranuclear palsy who had been evaluated at the Mayo Clinic (referred to as the Mayo Clinic patient series) from our brain bank database (N = 1085). We next enriched in cases likely to have cerebellar ataxia by searching the remaining 985 cases for (1) an antemortem diagnosis of multiple system atrophy or (2) neuropathologic evidence of prominent degeneration of the cerebellum or cerebellar afferent nuclei. Subsequently, clinical, pathologic, and genetic features were compared between the two groups. RESULTS One patient in the Mayo Clinic patient series (1%) met criteria for progressive supranuclear palsy with predominant cerebellar ataxia and had both cerebellar and mild midbrain atrophy on MRI. Four patients were identified with the targeted search. Four of the five patients were clinically misdiagnosed as multiple system atrophy. The severity of tau-related pathology and cerebellar degeneration were not different between the two groups. No differences were detected in tau genotypes. CONCLUSION Although our data cannot provide definitive information about how to make an accurate clinical diagnosis, they should serve to raise awareness of progressive supranuclear palsy with predominant cerebellar ataxia in the differential diagnosis of multiple system atrophy. © 2016 Movement Disorder Society.
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Affiliation(s)
- Shunsuke Koga
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
| | - Keith A Josephs
- Department of Neurology (Behavioural Neurology & Movement Disorders), Mayo Clinic, Rochester, Minnesota, USA
| | - Kotaro Ogaki
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
| | - Catherine Labbé
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
| | - Ryan J Uitti
- Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA
| | | | - Jay A van Gerpen
- Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA
| | | | - Naoya Aoki
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
| | - Rosa Rademakers
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
| | | | - Owen A Ross
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
| | - Dennis W Dickson
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
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