Progressive supranuclear palsy: a review of co-existing neurodegeneration

Can J Neurol Sci. 2008 Nov;35(5):602-8. doi: 10.1017/s0317167100009392.

Abstract

Objectives: The neuropathological findings of 32 progressive supranuclear palsy (PSP) cases over a period of 17 years were reviewed.

Results: Of the 26 cases with adequate clinical data, 20 patients either presented with cognitive dysfunction or developed a cognitive impairment subsequently during the course of the disease. Co-existing changes of argyrophilic grains and corticobasal degeneration (CBD) were found in 28% and 32% of the cases respectively. Alzheimer-related pathology was found in 69% of cases but only 18.75% of cases fulfilled the consortium to establish a registry for Alzheimer's disease (CERAD) criteria for either definite or probable Alzheimer's disease. Lewy bodies were noted in four cases (12.5%), all in the subcortical regions. Only seven cases of PSP showed no pathological evidence of other co-existing neurodegenerative diseases. The severity of the cerebrovascular pathology in this cohort was insufficient to explain any clinical symptomatology.

Conclusions: As in previous studies, this study has demonstrated the frequent co-existence of pathological changes usually noted in other neurodegenerative diseases in PSP. Whether these co-existing pathological changes contribute to the cognitive impairment in PSP remains uncertain.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / complications
  • Alzheimer Disease / pathology
  • Alzheimer Disease / physiopathology
  • Axons / pathology
  • Brain / pathology*
  • Brain / physiopathology
  • Cerebrovascular Disorders / complications
  • Cerebrovascular Disorders / pathology
  • Cerebrovascular Disorders / physiopathology
  • Cohort Studies
  • Comorbidity
  • Female
  • Humans
  • Lewy Bodies / pathology
  • Male
  • Middle Aged
  • Neurodegenerative Diseases / complications*
  • Neurodegenerative Diseases / pathology*
  • Neurodegenerative Diseases / physiopathology
  • Neurons / pathology
  • Ontario
  • Retrospective Studies
  • Silver Staining
  • Supranuclear Palsy, Progressive / complications*
  • Supranuclear Palsy, Progressive / pathology*
  • Supranuclear Palsy, Progressive / physiopathology