Comparison of regional brain atrophy and cognitive impairment between pure akinesia with gait freezing and Richardson's syndrome.
Pure akinesia with gait freezing (PAGF) is considered a clinical phenotype of progressive supranuclear palsy. The brain atrophy and cognitive deficits in PAGF are expected to be less prominent than in classical Richardson's syndrome (RS), but this hypothesis has not been explored yet. We reviewed the medical records of 28 patients with probable RS, 19 with PAGF, and 29 healthy controls, and compared cortical thickness, subcortical gray matter volume, and neuropsychological performance among the three groups. Patients with PAGF had thinner cortices in frontal, inferior parietal, and temporal areas compared with controls; however, areas of cortical thinning in PAGF patients were less extensive than those in RS patients. In PAGF patients, hippocampal, and thalamic volumes were also smaller than controls, whereas subcortical gray matter volumes in PAGF and RS patients were comparable. In a comparison of neuropsychological tests, PAGF patients had better cognitive performance in executive function, visual memory, and visuospatial function than RS patients had. These results demonstrate that cognitive impairment, cortical thinning, and subcortical gray matter atrophy in PAGF patients resemble to those in RS patients, though the severity of cortical thinning and cognitive dysfunction is milder. Our results suggest that, PAGF and RS may share same pathology but that it appears to affect a smaller proportion of the cortex in PAGF.
Department of Neurology, Yonsei University Wonju College of Medicine Wonju, South Korea.
Jin Yong
JY
Hong
Department of Biomedical Engineering, Hanyang University Seoul, South Korea.
Hyuk Jin
HJ
Yun
Department of Neurology, Bundang Jesaeng General Hospital Seongnam, South Korea.
Mun Kyung
MK
Sunwoo
Department of Neurology and Brain Research Institute, Yonsei University College of Medicine Seoul, South Korea.
Jee Hyun
JH
Ham
Department of Biomedical Engineering, Hanyang University Seoul, South Korea.
Jong-Min
JM
Lee
Department of Neurology and Brain Research Institute, Yonsei University College of Medicine Seoul, South Korea.
Young H
YH
Sohn
Department of Neurology and Brain Research Institute, Yonsei University College of Medicine Seoul, South Korea ; Severance Biomedical Science Institute, Yonsei University College of Medicine Seoul, South Korea.
Phil Hyu
PH
Lee
cognition; cortical thickness; freezing of gait; progressive supranuclear palsy; pure akinesia with gait freezing; subcortical volume