TY - JOUR
T1 - Clinical and neuropathologic features of progressive supranuclear palsy with severe pallido-nigro-luysial degeneration and axonal dystrophy
AU - Ahmed, Zeshan
AU - Josephs, Keith A.
AU - Gonzalez, John
AU - DelleDonne, Anthony
AU - Dickson, Dennis W.
N1 - Funding Information:
Z.A. is a Doctoral Candidate at the MRC Centre for Neurodegeneration Research, King’s College London, Institute of Psychiatry, Department of Neuroscience, De Crespigny Park, London, SE5 8AF, UK. The authors acknowledge the valuable statistical support of Michael G. Heckman and Samuel Younkin; the assistance of Stacey Melquist and Mike L. Hutton in genetic analyses and the histological support of Monica Casey-Castanedes, Virginia Phillips and Linda Rousseau. Hiroshige Fujishiro helped with interpretation of original Japanese articles. The authors would like to thank the Society for Progressive Supranuclear Palsy and the generous brain donations from PSP patients and their families, without which these studies would be impossible. The article is funded by National Institute of Health (P50-NS40256, P01-AG17216 to D.W.D.), Society for Progressive Supranuclear Palsy (CurePSP, Inc.) and Mayo Foundation.
PY - 2008/2
Y1 - 2008/2
N2 - Pallido-nigro-luysial atrophy (PNLA) is a rare disorder that in many cases has histopathological features similar to progressive supranuclear palsy (PSP). In a pathological series of over 400 cases of PSP, eight cases were noted to have features similar to those described in PNLA, including severe atrophy and neuronal loss in the globus pallidus, substantia nigra and subthalamic nucleus, in addition to many axonal spheroids in the globus pallidus and substantia nigra. These eight cases of PSP-PNLA were compared to 11 typical PSP cases with quantitative neuropathologic indices and assessment of demographics, clinical features and the timing of clinical features. PSP-PNLA cases were younger, had longer disease duration and more often were not initially diagnosed with PSP; in the end, they did not differ from PSP with respect to any major clinical feature. The clinical course of PSP-PNLA, however, was different, with earlier gait abnormalities and difficulty with handwriting, but later falls, rigidity and dysphagia than PSP. Pathologically, the same types of lesions were detected in both PSP and PSP-PNLA, but there were differences in the distribution and density of tau-pathology, with less tau-pathology in motor cortex, striatum, pontine nuclei and cerebellum in PSP-PNLA. These clinical and pathological findings suggest that PSP-PNLA should be considered a variant of PSP.
AB - Pallido-nigro-luysial atrophy (PNLA) is a rare disorder that in many cases has histopathological features similar to progressive supranuclear palsy (PSP). In a pathological series of over 400 cases of PSP, eight cases were noted to have features similar to those described in PNLA, including severe atrophy and neuronal loss in the globus pallidus, substantia nigra and subthalamic nucleus, in addition to many axonal spheroids in the globus pallidus and substantia nigra. These eight cases of PSP-PNLA were compared to 11 typical PSP cases with quantitative neuropathologic indices and assessment of demographics, clinical features and the timing of clinical features. PSP-PNLA cases were younger, had longer disease duration and more often were not initially diagnosed with PSP; in the end, they did not differ from PSP with respect to any major clinical feature. The clinical course of PSP-PNLA, however, was different, with earlier gait abnormalities and difficulty with handwriting, but later falls, rigidity and dysphagia than PSP. Pathologically, the same types of lesions were detected in both PSP and PSP-PNLA, but there were differences in the distribution and density of tau-pathology, with less tau-pathology in motor cortex, striatum, pontine nuclei and cerebellum in PSP-PNLA. These clinical and pathological findings suggest that PSP-PNLA should be considered a variant of PSP.
KW - Natural history
KW - Neuropathology
KW - Pallido-nigro-luysial atrophy
KW - Progressive supranuclear palsy
KW - Pure akinesia
KW - Tau
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U2 - 10.1093/brain/awm301
DO - 10.1093/brain/awm301
M3 - Article
C2 - 18158316
AN - SCOPUS:38849097742
SN - 0006-8950
VL - 131
SP - 460
EP - 472
JO - Brain
JF - Brain
IS - 2
ER -