Clinical correlations of microstructural changes in progressive supranuclear palsy.
In patients with progressive supranuclear palsy (PSP), previous reports have shown a severe white matter (WM) damage involving supra and infratentorial regions including cerebellum. In the present study, we investigated potential correlations between WM integrity loss and clinical-cognitive features of patients with PSP. By using magnetic resonance imaging and diffusion tensor imaging with tract based spatial statistic analysis, we analyzed WM volume in 18 patients with PSP and 18 healthy controls (HCs). All patients and HCs underwent a detailed clinical and neuropsychological evaluation. Relative to HCs, patients with PSP showed WM changes encompassing supra and infratentorial areas such as corpus callosum, fornix, midbrain, inferior fronto-occipital fasciculus, anterior thalamic radiation, superior cerebellar peduncle, superior longitudinal fasciculus, uncinate fasciculus, cingulate gyrus, and cortico-spinal tract bilaterally. Among different correlations between motor-cognitive features and WM structural abnormalities, we detected a significant association between fronto-cerebellar WM loss and executive cognitive impairment in patients with PSP. Our findings, therefore, corroborate the hypothesis that cognitive impairment in PSP may result from both "intrinsic" and "extrinsic" frontal lobe dysfunction, likely related to cerebellar disconnection.
Department of Neurology, Second University of Naples, Naples, Italy. Electronic address: alessandro.tessitore@unina2.it.
Alessandro
A
Tessitore
Department of Neurology, Second University of Naples, Naples, Italy; IDC Hermitage Capodimonte, Naples, Italy.
Alfonso
A
Giordano
MRI Research Center SUN-FISM, Second University of Naples, Naples, Italy.
Giuseppina
G
Caiazzo
MRI Research Center SUN-FISM, Second University of Naples, Naples, Italy.
Daniele
D
Corbo
Department of Neurology, Second University of Naples, Naples, Italy.
Rosa
R
De Micco
Department of Neurology, Second University of Naples, Naples, Italy; IDC Hermitage Capodimonte, Naples, Italy.
Antonio
A
Russo
Department of Neurology, Second University of Naples, Naples, Italy.
Sara
S
Liguori
Neuroradiology Service, Second University of Naples, Naples, Italy.
Mario
M
Cirillo
Department of Medicine and Surgery, University of Salerno, Baronissi, Italy; Department of Cognitive Neuroscience, Maastricht University, Maastricht, the Netherlands.
Fabrizio
F
Esposito
Department of Neurology, Second University of Naples, Naples, Italy.
Gioacchino
G
Tedeschi
D000368:Aged; D002531:Cerebellum / Q000473:pathology*; D003071:Cognition; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D005625:Frontal Lobe / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009929:Organ Size; D011597:Psychomotor Performance; D013494:Supranuclear Palsy, Progressive / Q000473:pathology* / Q000523:psychology*; D066127:White Matter / Q000473:pathology*
Abnormal diffusivity; Cerebellar cognitive syndrome; Diffusion tensor imaging; Magnetic resonance imaging; Progressive supranuclear palsy; Tract based spatial statistics