What is the pathophysiology of supranuclear palsy (PSP)?

Updated: Sep 24, 2018
  • Author: Stephen M Bloomfield, MD; Chief Editor: Selim R Benbadis, MD  more...
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Answer

Answer

PSP is associated with neuronal loss, gliosis, and neurofibrillary tangles in the pretectal area, substantia nigra, subthalamic nucleus, globus pallidus, superior colliculus, and substantia innominata. Degeneration of multiple neurotransmitter systems leads to a more diffuse disorder than idiopathic PD. The cholinergic and adrenergic systems are involved in addition to the dopaminergic system. Tau-positive glial inclusions are a consistent pathologic finding (see the images below). Coiled bodies, which are small round cells of oligodendrocytic origin found in white matter, are also seen in a widespread distribution. [17, 18, 19, 20]

Subcortical white matter showing tau-positive peri Subcortical white matter showing tau-positive perinuclear glial inclusions.
Subcortical white matter showing tau-positive peri Subcortical white matter showing tau-positive perinuclear glial inclusions.

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