title: Clinical, cognitive, and behavioural correlates of white matter damage in progressive supranuclear palsy.
abstract: White matter (WM) tract alterations were assessed in patients with progressive supranuclear palsy (PSP) relative to healthy controls and patients with idiopathic Parkinson's disease (PD) to explore the relationship of WM tract damage with clinical disease severity, performance on cognitive tests, and apathy. 37 PSP patients, 41 PD patients, and 34 healthy controls underwent an MRI scan and clinical testing to evaluate physical disability, cognitive impairment, and apathy. In PSP, the contribution of WM tract damage to global disease severity and cognitive and behavioural disturbances was assessed using Random Forest analysis. Relative to controls, PSP patients showed diffusion tensor (DT) MRI abnormalities of the corpus callosum, superior cerebellar peduncle (SCP), cingulum and uncinate fasciculus bilaterally, and right inferior longitudinal fasciculus. Corpus callosum and SCP DT MRI measures distinguished PSP from PD patients with high accuracy (area under the curve ranging from 0.89 to 0.72). In PSP, DT MRI metrics of the corpus callosum and superior cerebellar peduncles were the best predictors of global disease severity scale scores. DT MRI metrics of the corpus callosum, right superior longitudinal and inferior longitudinal fasciculus, and left uncinate were the best predictors of executive dysfunction. In PSP, apathy severity was related to the damage to the corpus callosum, right superior longitudinal, and uncinate fasciculi. In conclusion, WM tract damage contributes to the motor, cognitive, and behavioural deficits in PSP. DT MRI offers markers for PSP diagnosis, assessment, and monitoring.
authors.affiliation: Neuroimaging Research Unit, Division of Neuroscience, Institute of Experimental Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Agosta
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Galantucci
authors.forename: Marina
authors.initials: M
authors.lastname: Svetel
authors.forename: Milica Ječmenica
authors.initials: MJ
authors.lastname: Lukić
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Copetti
authors.forename: Kristina
authors.initials: K
authors.lastname: Davidovic
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Tomić
authors.forename: Edoardo G
authors.initials: EG
authors.lastname: Spinelli
authors.forename: Vladimir S
authors.initials: VS
authors.lastname: Kostić
authors.forename: Massimo
authors.initials: M
authors.lastname: Filippi
mesh_terms: D000368:Aged; D057565:Apathy; D010054:Brief Psychiatric Rating Scale; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology*; D003430:Cross-Sectional Studies; D056324:Diffusion Tensor Imaging / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013494:Supranuclear Palsy, Progressive / Q000175:diagnosis* / Q000523:psychology*; D066127:White Matter / Q000473:pathology*