Progressive supranuclear palsy: what do we know about it?
Progressive supranuclear palsy (PSP) is a progressive tauopathy characterized by supranuclear ophthalmoplegia, pseudobulbar palsy, dysarthria, axial rigidity, frontal lobe dysfunction, and dementia. The typical pathology includes neuronal loss, gliosis and microtubule-associated protein tau (MAPT)-positive inclusions in neurons and glial cells, primarily in basal ganglia, brainstem and cerebellum. The pathogenesis of PSP is not yet completely understood; however, there are several hypotheses. This article reviews the present knowledge about PSP, and the concepts underlying mitochondrial dysfunction, lipoperoxidation, and gene mutations. The clinical features of PSP are also discussed; these include vertical gaze palsy, pseudobulbar palsy, aphasia, dysarthria, axial rigidity, and neuropsychiatric symptoms, such as amnesia, irritability, loss of interest, and dementia. In terms of diagnosis, there is considerable interest in neuroimaging for detecting PSP; therefore, neuroimaging techniques such as magnetic resonance imaging (MRI) and [18F]- fluorodeoxyglucose positron-emission tomography (FDG-PET) are reviewed. A definitive diagnosis of PSP depends on pathology, and the introduction of new clinical subtypes challenges presents the widely adopted diagnosis criteria. PSP treatments such as serotonin antagonists, α2 receptor antagonists, and coenzyme Q10 are also discussed. There is no curative therapy for PSP; all of the available treatments are palliative.
Ling
L
Long
Xiao-Dong
XD
Cai
Xiao-Bo
XB
Wei
Jin-Chi
JC
Liao
Yun-Qi
YQ
Xu
Hui-Min
HM
Gao
Xiao-Hong
XH
Chen
Third Affiliated Hospital of Sun Yat-Sen University, Tianhe Road 600#, Guangzhou, Guangdong 510630, P.R. China. denniswq@yahoo.com.
Qing
Q
Wang
D006801:Humans; D013494:Supranuclear Palsy, Progressive / Q000175:diagnosis / Q000235:genetics / Q000378:metabolism