Alzheimer Type Pathology in the PSP Brain (Mayo Jax)

It is common upon brain autopsy to find that PSP patients also have Alzheimer type pathology (ATP) in the brain. This Mayo Jax study below that looked into what relationship there is between Alzheimer type pathology and PSP. The conclusion: “These results strongly argue that ATP in PSP represents independent disease processes even when present in the same brain.”

Robin

International Journal of Clinical & Experimental Pathology. 2009;2(4):399-406. Epub 2008 Dec 20.

Cortical Alzheimer Type Pathology Does Not Influence tau Pathology in Progressive Supranuclear Palsy.

Oshima K, Dickson DW.
Department of Neuroscience, Mayo Clinic Jacksonville, Florida.

Alzheimer disease (AD) is characterized by numerous senile plaques (SP) in addition to widespread neocortical neurofibrillary tangles (NFT). Some elderly have pathologic aging (PA), which is characterized by numerous SP composed of diffuse amyloid deposits with few or no NFT confined to the limbic lobe. Both AD and PA represent a range of Alzheimer type pathology (ATP).

Some cases of progressive supranuclear palsy (PSP) have concurrent ATP, but the relationship between ATP and PSP has not been addressed.

In this study, a consecutive series of PSP cases were divided into three groups according to the degree of concurrent ATP – pure PSP, PSP/PA and PSP/AD.

Braak NFT stage was significantly greater in PSP/AD compared with both PSP/PA and PSP.

Among the pathologic variables studied in middle frontal, superior temporal and motor cortices, there were no differences between PSP and PSP/PA except for SP. In PSP/AD, there was greater neuronal tau pathology (pretangles, NFT and neuropil threads) in middle frontal and superior temporal cortices, probably a reflection of ATP since there was no comparable increase in PSP-related glial tau pathology in these regions.

The APOEvarepsilon4 allele frequency was significantly higher in PSP/PA and PSP/AD than in PSP. These results strongly argue that ATP in PSP represents independent disease processes even when present in the same brain.

PubMed ID: 19158937