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.
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