Vascular progressive supranuclear palsy.

Abstract

BACKGROUND: Progressive supranuclear palsy (PSP) is a neurologic syndrome of unknown cause. This idiopathic type of PSP is usually associated with characteristic clinical and pathological features. OBJECTIVE: To assess evidence of cerebrovascular disease in a population of patients with clinically defined PSP, and to compare clinical and neuroimaging features in vascular versus idiopathic PSP. DESIGN AND METHODS: Using predetermined criteria, the records of 128 patients diagnosed with PSP were reviewed for evidence of vascular disease. RESULTS: Thirty patients (23.3%) satisfied criteria for vascular PSP. The vascular group differed from the idiopathic group by asymmetric and predominantly lower body involvement (p < 0.05). Corticospinal signs, pseudobulbar signs, gait difficulties, dementia, and incontinence of bowels and bladder were also more common in the vascular group, but these differences did not reach statistical significance. CONCLUSION: PSP is a syndrome which can be caused by cerebro-vascular disease. In addition to an increased frequency of stroke risk factors and neuroimaging evidence of vascular disease, vascular PSP can be differentiated from idiopathic PSP by a higher degree of asymmetry, lower body involvement, and evidence of corticospinal and pseudobulbar signs.