Abstract Details

Title Incidental Progressive Supranuclear Palsy Neuropathology on Autopsy

Topic Aging and Dementia

Presentation(s) P04 - (-)

Poster/Presentation
Number 215

Objective

Background BACKGROUND: PSP is marked by movement and dementia components. Motor signs include parkinsonism, postural instability, falls, axial rigidity, supranuclear gaze paresis, dysarthria, and dysphagia. Cognitive changes include frontal-type and dysexecutive features which may precede motor symptoms. Unlike Parkinson's disease (PD), PSP only first described [sim]50 years ago, is still frequently missed clinically. Most persons with PSP are first diagnosed with PD, but also receive diagnoses of corticobasal degeneration, frontotemporal dementia, Lewy Body Dementia, or Alzheimer's disease (AD). While some recent autopsy studies have shown unsuspected "incidental" PSP, its characteristics and significance are unknown.

Design/Methods DESIGN/METHODS: The Columbia University Alzheimer's Disease Center Brain Bank database, which has IRB approval, was examined for all cases with characteristic PSP pathology including typical phosphotau-containing globose tangles, tufted astrocytes, and coiled bodies. Cases with and without PSP, and cases of incidental vs symptomatic PSP, were statistically compared using SPSS version19.0.

Results RESULTS: A total of 31 brains showed PSP pathology (3.5% of 886 total brains). These cases included 13 (42%) without noted significant movement disorders, unsuspected during life of having parkinsonism/PSP. There was no significant difference in sex distribution among PSP and non-PSP, nor among incidental and symptomatic PSP cases. Those with PSP were significantly older at death, and incidental PSP patients showed a trend for being still older. Copathology, including AD and Lewy Body findings were frequent, but not statistically increased in the PSP brains, or in cases of incidental PSP.

Conclusions CONCLUSIONS: PSP pathology is common in the elderly. About half of cases were entirely unsuspected during life. The glial tau pathology of PSP may increase with age, in the same manner in which there is an increase of neurofibrillary (neuronal) tau pathology.

Authors/Disclosures
Lawrence S. Honig, MD, PhD, FAAN (Columbia University Vagelos College of Physicians & Surgeons) PRESENTER	Dr. Honig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Honig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Honig has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medscape. Dr. Honig has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Prevail. Dr. Honig has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cortexyme. Dr. Honig has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Legal Firms . The institution of Dr. Honig has received research support from Roche. The institution of Dr. Honig has received research support from Eisau. Dr. Honig has received research support from Alector. The institution of Dr. Honig has received research support from Transposon.
	No disclosure on file
	No disclosure on file
	No disclosure on file

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