Pathologic correlates of supranuclear gaze palsy with parkinsonism

Authors

W R. Martin, Neurology, University of Alberta, Edmonton, AB, Canada. Electronic address: wayne.martin@ualberta.ca.
J Hartlein, Neurology, Washington University in St. Louis, St. Louis, MO, USA.
B A. Racette, Neurology, Washington University in St. Louis, St. Louis, MO, USA; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa.
N Cairns, Neurology, Washington University in St. Louis, St. Louis, MO, USA; Pathology, Washington University in St. Louis, St. Louis, MO, USA.
J S. Perlmutter, Neurology, Washington University in St. Louis, St. Louis, MO, USA; Radiology, Neuroscience, Physical Therapy and Occupational Therapy, Washington University in St. Louis, St. Louis, MO, USA.

Document Type

Article

Abstract

INTRODUCTION: Supranuclear gaze palsy (SGP) is a classic clinical feature of progressive supranuclear palsy (PSP) but is not specific for this diagnosis and has been reported to occur in several other neurodegenerative parkinsonian conditions. Our objective was to evaluate the association between SGP and autopsy-proven diagnoses in a large population of patients with parkinsonism referred to a tertiary movement disorders clinic. METHODS: We reviewed clinical and autopsy data maintained in an electronic medical record from all patients seen in the Movement Disorders Clinic at Washington University, St. Louis between 1996 and 2015. All patients with parkinsonism from this population who had subsequent autopsy confirmation of diagnosis underwent further analysis. RESULTS: 221 unique parkinsonian patients had autopsy-proven diagnoses, 27 of whom had SGP documented at some point during their illness. Major diagnoses associated with SGP were: PSP (9 patients), Parkinson disease (PD) (10 patients), multiple system atrophy (2 patients), corticobasal degeneration (2 patients), Creutzfeld-Jakob disease (1 patient) and Huntington disease (1 patient). In none of the diagnostic groups was the age of onset or disease duration significantly different between cases with SGP and those without SGP. In the PD patients, the UPDRS motor score differed significantly between groups (p = 0.01) with the PD/SGP patients having greater motor deficit than those without SGP. CONCLUSION: Although a common feature of PSP, SGP is not diagnostic for this condition and can be associated with other neurodegenerative causes of parkinsonism including PD.

Medical Subject Headings

Age of Onset; Aged; Aged, 80 and over; Autopsy; Databases, Factual (statistics & numerical data); Female; Humans; Male; Middle Aged; Parkinson Disease (complications); Retrospective Studies; Supranuclear Palsy, Progressive (etiology, pathology)

Publication Date

5-1-2017

Publication Title

Parkinsonism & related disorders

E-ISSN

1873-5126

Volume

38

First Page

68

Last Page

71

PubMed ID

28256434

Digital Object Identifier (DOI)

10.1016/j.parkreldis.2017.02.027

Recommended Citation

Martin, W R.; Hartlein, J; Racette, B A.; Cairns, N; and Perlmutter, J S., "Pathologic correlates of supranuclear gaze palsy with parkinsonism" (2017). Neurology. 1160.
https://scholar.barrowneuro.org/neurology/1160