TY - JOUR
T1 - Progressive supranuclear palsy combined with Alzheimer's disease
T2 - A clinicopathological study of two autopsy cases
AU - Sakamoto, Rieko
AU - Tsuchiya, Kuniaki
AU - Yoshida, Ryoichi
AU - Itoh, Yoshinori
AU - Furuta, Nobuo
AU - Kosuga, Asako
AU - Sugai, Yuichi
AU - Mimura, Masaru
PY - 2009/6/1
Y1 - 2009/6/1
N2 - 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.
AB - 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.
KW - Alzheimer's disease
KW - Braak stage
KW - Neurofibrillary tangle
KW - Progressive supranuclear palsy
KW - Subcortical dementia
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U2 - 10.1111/j.1440-1789.2008.00968.x
DO - 10.1111/j.1440-1789.2008.00968.x
M3 - Article
C2 - 18992014
AN - SCOPUS:65649088676
SN - 0919-6544
VL - 29
SP - 219
EP - 229
JO - Neuropathology
JF - Neuropathology
IS - 3
ER -