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Progressive supranuclear palsy combined with Alzheimer's disease: A clinicopathological study of two autopsy cases
Author(s) -
Sakamoto Rieko,
Tsuchiya Kuniaki,
Yoshida Ryoichi,
Itoh Yoshinori,
Furuta Nobuo,
Kosuga Asako,
Sugai Yuichi,
Mimura Masaru
Publication year - 2009
Publication title -
neuropathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.701
H-Index - 61
eISSN - 1440-1789
pISSN - 0919-6544
DOI - 10.1111/j.1440-1789.2008.00968.x
Subject(s) - progressive supranuclear palsy , pseudobulbar palsy , tauopathy , autopsy , medicine , stage (stratigraphy) , pathology , pathological , executive dysfunction , dementia , disease , psychology , psychiatry , cognition , neurodegeneration , neuropsychology , paleontology , biology
We present here the clinicopathological characteristics of two autopsy‐confirmed cases comorbid of progressive supranuclear palsy (PSP) and Alzheimer's disease (AD). Histopathologically, the amount and distribution of neurofibrillary tangles (NFTs) in the basal ganglia and brainstem fulfilled the pathological criteria of PSP proposed by the National Institute of Neurological Disorders and Stroke – The Society for PSP (NINDS‐SPSP). The Braak stages of senile plaques and NFTs were stage C and stage V in Case 1, and stage C and stage IV in Case 2. These neuropathological findings confirmed that the two patients had combined PSP with AD. Our patients presented clinically with executive dysfunction prior to memory disturbance as an early symptom. Not only neurological symptoms such as gait disturbance, supranuclear ophthalmoplegia and pseudobulbar palsy, but emotional and personality changes and delirium were prominent. Therefore, symptoms of subcortical dementia of PSP were more predominant than AD‐related symptoms in the present two patients. Comorbid PSP and AD further complicates the clinical picture and makes clinical diagnosis even more difficult.