Non-fluent progressive aphasia, depression, and OCD in a woman with progressive supranuclear palsy: neuroanatomical and neuropathological correlations.
This paper details the case of a 64-year-old woman who presented to the psychiatry service with worsening mood in the context of a diagnosis of obsessive-compulsive disorder (OCD). On further examination she was found to have clinical findings consistent with frontotemporal lobar degeneration of the non-fluent progressive aphasia subtype. At post-mortem she was found to have progressive supranuclear palsy. We argue, in retrospect, that her OCD was likely prodromal to the development of her dementia. This case highlights the fact that frontotemporal lobar degeneration/progressive supranuclear palsy (FTLD/PSP) and other "tauopathies" represent a complex group of neurodegenerative disorders that may masquerade for many years as refractory psychiatric disorders.
Karnik
Niranjan S
NS
Department of Anthropology, History & Social Medicine, University of California School of Medicine, San Francisco, CA, USA. nkarnik@stanford.edu
D'Apuzzo
Massimo
M
Greicius
Michael
M
D000203:Activities of Daily Living; D018888:Aphasia, Primary Progressive / Q000175:diagnosis* / Q000209:etiology; D001284:Atrophy / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D015897:Comorbidity; D003704:Dementia / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000209:etiology; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control; D018450:Disease Progression; D004597:Electroshock; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D002479:Inclusion Bodies / Q000378:metabolism / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009483:Neuropsychological Tests; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000209:etiology; D013494:Supranuclear Palsy, Progressive / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D024801:Tauopathies / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed