Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Cognitive Impairment in PSP Linked with Tau Burden

Mov Disord; ePub 2017 Oct 30; Koga, Parks, et al

Cognitive impairment in progressive supranuclear palsy (PSP), most notably executive dysfunction, is associated with severity of PSP-related tau pathology, according to a recent study. Researchers retrospectively reviewed medical records to evaluate the pattern and severity of cognitive impairment in 121 autopsy-confirmed PSP patients. A subset of 37 patients underwent neuropsychological evaluation as part of their clinical workup. The burden of PSP-related tau pathology (neurofibrillary tangles/pretangles, coiled bodies, tufted astrocytes, and threads) was semiquantitatively scored in 20 vulnerable brain regions. Concurrent pathologies potentially associated with cognitive impairment, such as Alzheimer-type pathology, were also assessed. They found:

  • 90 patients (74%) had documented cognitive impairment based on neurologic evaluation.
  • In the subgroup with neuropsychological testing, executive functioning was the most severely impaired cognitive domain.
  • A global cognitive impairment index and executive functioning were negatively correlated with total tau burden, but not correlated with the Alzheimer-type pathology.
  • APOE ɛ4 carriers had more severe amyloid pathology, but total tau burden and a global cognitive impairment index did not differ from APOE ɛ4 noncarriers.


Koga S, Parks A, Kasanuki K, et al. Cognitive impairment in progressive supranuclear palsy is associated with tau burden. [Published online ahead of print October 30, 2017]. Mov Disord. doi:10.1002/mds.27198.

This Week's Must Reads

Potential Limitations of Balance Confidence Scales, Int J MS Care; ePub 2018 Jan 24; Wood, Wajda, et al

Cognitive Phenotypes in MS and Targeted Treatments, J Neurology; ePub 2018 Jan 22; Leavitt, Tosto, et al

Demographic Characteristics in Persons with MS, J Int Neuropsychol Soc; 2018 Feb; Costa, et al

Mercy Evaluation of MS Appropriately Valid, Clin Neuropsychol; ePub 2018 Jan 23; Merz, et al

Walking Speed, Endurance Studied in Persons with MS, J Neurophysiol; ePub 2018 Jan 3; Almuklass, et al

Must Reads in Alzheimer's & Cognition

AD, Rest-Activity Rhythm Fragmentation Linked , JAMA Neurology; ePub 2018 Jan 29; Musiek, et al

Setting Plays Role in Evaluating Cognitive Decline, Alzheimers Dement; ePub 2018 Jan 17; Snitz, et al

AD Biomarkers Lead to Earlier Driving Cessation, Alzheimers Dement; ePub 2018 Jan 9; Stout, et al

Better CVH Linked with Reduced Cognition Decline, Alzheimers Dementia; ePub 2017 Dec 18; González, et al

15 Million Americans Predicted to Get AD by 2060, Alzheimers Dement; ePub 2017 Dec 6; Brookmeyer, et al