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Supranuclear palsy, progressive, 2(PSNP2)

MedGen UID:
324446
Concept ID:
C1836148
Disease or Syndrome
Synonym: PSNP2
 
Monarch Initiative: MONDO:0012278
OMIM®: 609454

Clinical features

From HPO
Dysphagia
MedGen UID:
41440
Concept ID:
C0011168
Disease or Syndrome
Difficulty in swallowing.
Dysarthria
MedGen UID:
8510
Concept ID:
C0013362
Mental or Behavioral Dysfunction
Dysarthric speech is a general description referring to a neurological speech disorder characterized by poor articulation. Depending on the involved neurological structures, dysarthria may be further classified as spastic, flaccid, ataxic, hyperkinetic and hypokinetic, or mixed.
Gliosis
MedGen UID:
4899
Concept ID:
C0017639
Pathologic Function
Gliosis is the focal proliferation of glial cells in the central nervous system.
Neurofibrillary tangles
MedGen UID:
39273
Concept ID:
C0085400
Finding
Pathological protein aggregates formed by hyperphosphorylation of a microtubule-associated protein known as tau, causing it to aggregate in an insoluble form.
Akinesia
MedGen UID:
43218
Concept ID:
C0085623
Finding
Inability to initiate changes in activity or movement and to perform ordinary volitional movements rapidly and easily.
Apathy
MedGen UID:
39083
Concept ID:
C0085632
Mental or Behavioral Dysfunction
Apathy is a quantitative reduction of interest, motivation and the initiation and persistence of goal-directed behavior, where often the accompanying emotions, thoughts, and social interactions are also diminished. The individual is typically non-reactive to provocations, positive or negative, and appears to not care. Distinguished from lethargy which involves lack of physical or mental energy.
Photophobia
MedGen UID:
43220
Concept ID:
C0085636
Sign or Symptom
Excessive sensitivity to light with the sensation of discomfort or pain in the eyes due to exposure to bright light.
Falls
MedGen UID:
39084
Concept ID:
C0085639
Finding
A sudden movement downward, usually resulting in injury.
Bradykinesia
MedGen UID:
115925
Concept ID:
C0233565
Sign or Symptom
Bradykinesia literally means slow movement, and is used clinically to denote a slowness in the execution of movement (in contrast to hypokinesia, which is used to refer to slowness in the initiation of movement).
Memory impairment
MedGen UID:
68579
Concept ID:
C0233794
Mental or Behavioral Dysfunction
An impairment of memory as manifested by a reduced ability to remember things such as dates and names, and increased forgetfulness.
Postural tremor
MedGen UID:
66696
Concept ID:
C0234378
Sign or Symptom
A type of tremors that is triggered by holding a limb in a fixed position.
Parkinsonian disorder
MedGen UID:
66079
Concept ID:
C0242422
Disease or Syndrome
Characteristic neurologic anomaly resulting from degeneration of dopamine-generating cells in the substantia nigra, a region of the midbrain, characterized clinically by shaking, rigidity, slowness of movement and difficulty with walking and gait.
Granulovacuolar degeneration
MedGen UID:
87168
Concept ID:
C0333454
Pathologic Function
Electron-dense granules within double membrane-bound cytoplasmic vacuoles.
Frontal release signs
MedGen UID:
318834
Concept ID:
C1833297
Finding
Primitive reflexes traditionally held to be a sign of disorders that affect the frontal lobes.
Axial dystonia
MedGen UID:
373027
Concept ID:
C1836149
Finding
A type of dystonia that affects the midline muscles, i.e., the chest, abdominal, and back muscles.
Gait imbalance
MedGen UID:
373028
Concept ID:
C1836150
Finding
Frontolimbic dementia
MedGen UID:
324447
Concept ID:
C1836151
Finding
Neuronal loss in central nervous system
MedGen UID:
342515
Concept ID:
C1850496
Finding
Irritability
MedGen UID:
397841
Concept ID:
C2700617
Mental Process
A proneness to anger, i.e., a tendency to become easily bothered or annoyed.
Neuronal loss in basal ganglia
MedGen UID:
413431
Concept ID:
C2750913
Finding
A reduction in the number of nerve cells in the basal ganglia.
Retrocollis
MedGen UID:
854508
Concept ID:
C3887667
Disease or Syndrome
A form of torticollis in which the head is drawn back, either due to a permanent contractures of neck extensor muscles, or to a spasmodic contracture.
Rigidity
MedGen UID:
7752
Concept ID:
C0026837
Sign or Symptom
Continuous involuntary sustained muscle contraction. When an affected muscle is passively stretched, the degree of resistance remains constant regardless of the rate at which the muscle is stretched. This feature helps to distinguish rigidity from muscle spasticity.
Eyelid apraxia
MedGen UID:
222979
Concept ID:
C1142448
Finding
Diplopia
MedGen UID:
41600
Concept ID:
C0012569
Disease or Syndrome
Diplopia is a condition in which a single object is perceived as two images, it is also known as double vision.
Blurred vision
MedGen UID:
91020
Concept ID:
C0344232
Finding
Lack of sharpness of vision resulting in the inability to see fine detail.
Supranuclear gaze palsy
MedGen UID:
314030
Concept ID:
C1720037
Disease or Syndrome
A supranuclear gaze palsy is an inability to look in a particular direction as a result of cerebral impairment. There is a loss of the voluntary aspect of eye movements, but, as the brainstem is still intact, all the reflex conjugate eye movements are normal.

Professional guidelines

PubMed

Ferrari R, Ferrara M, Alinani A, Sutton RB, Famà F, Picco A, Rodriguez G, Nobili F, Momeni P
Curr Alzheimer Res 2015;12(8):802-12. doi: 10.2174/1567205012666150710114751. PMID: 26159191
Golan H, Kremer J, Freedman M, Ichise M
J Neuroimaging 1996 Jan;6(1):23-8. doi: 10.1111/jon19966123. PMID: 8555659

Recent clinical studies

Etiology

Kovacs GG, Lukic MJ, Irwin DJ, Arzberger T, Respondek G, Lee EB, Coughlin D, Giese A, Grossman M, Kurz C, McMillan CT, Gelpi E, Compta Y, van Swieten JC, Laat LD, Troakes C, Al-Sarraj S, Robinson JL, Roeber S, Xie SX, Lee VM, Trojanowski JQ, Höglinger GU
Acta Neuropathol 2020 Aug;140(2):99-119. Epub 2020 May 7 doi: 10.1007/s00401-020-02158-2. PMID: 32383020Free PMC Article
Jabbari E, Holland N, Chelban V, Jones PS, Lamb R, Rawlinson C, Guo T, Costantini AA, Tan MMX, Heslegrave AJ, Roncaroli F, Klein JC, Ansorge O, Allinson KSJ, Jaunmuktane Z, Holton JL, Revesz T, Warner TT, Lees AJ, Zetterberg H, Russell LL, Bocchetta M, Rohrer JD, Williams NM, Grosset DG, Burn DJ, Pavese N, Gerhard A, Kobylecki C, Leigh PN, Church A, Hu MTM, Woodside J, Houlden H, Rowe JB, Morris HR
JAMA Neurol 2020 Mar 1;77(3):377-387. doi: 10.1001/jamaneurol.2019.4347. PMID: 31860007Free PMC Article
Höglinger GU, Respondek G, Stamelou M, Kurz C, Josephs KA, Lang AE, Mollenhauer B, Müller U, Nilsson C, Whitwell JL, Arzberger T, Englund E, Gelpi E, Giese A, Irwin DJ, Meissner WG, Pantelyat A, Rajput A, van Swieten JC, Troakes C, Antonini A, Bhatia KP, Bordelon Y, Compta Y, Corvol JC, Colosimo C, Dickson DW, Dodel R, Ferguson L, Grossman M, Kassubek J, Krismer F, Levin J, Lorenzl S, Morris HR, Nestor P, Oertel WH, Poewe W, Rabinovici G, Rowe JB, Schellenberg GD, Seppi K, van Eimeren T, Wenning GK, Boxer AL, Golbe LI, Litvan I; Movement Disorder Society-endorsed PSP Study Group
Mov Disord 2017 Jun;32(6):853-864. Epub 2017 May 3 doi: 10.1002/mds.26987. PMID: 28467028Free PMC Article
Finger EC
Continuum (Minneap Minn) 2016 Apr;22(2 Dementia):464-89. doi: 10.1212/CON.0000000000000300. PMID: 27042904Free PMC Article
Golbe LI
Semin Neurol 2014 Apr;34(2):151-9. Epub 2014 Jun 25 doi: 10.1055/s-0034-1381736. PMID: 24963674

Diagnosis

Kovacs GG, Lukic MJ, Irwin DJ, Arzberger T, Respondek G, Lee EB, Coughlin D, Giese A, Grossman M, Kurz C, McMillan CT, Gelpi E, Compta Y, van Swieten JC, Laat LD, Troakes C, Al-Sarraj S, Robinson JL, Roeber S, Xie SX, Lee VM, Trojanowski JQ, Höglinger GU
Acta Neuropathol 2020 Aug;140(2):99-119. Epub 2020 May 7 doi: 10.1007/s00401-020-02158-2. PMID: 32383020Free PMC Article
Jabbari E, Holland N, Chelban V, Jones PS, Lamb R, Rawlinson C, Guo T, Costantini AA, Tan MMX, Heslegrave AJ, Roncaroli F, Klein JC, Ansorge O, Allinson KSJ, Jaunmuktane Z, Holton JL, Revesz T, Warner TT, Lees AJ, Zetterberg H, Russell LL, Bocchetta M, Rohrer JD, Williams NM, Grosset DG, Burn DJ, Pavese N, Gerhard A, Kobylecki C, Leigh PN, Church A, Hu MTM, Woodside J, Houlden H, Rowe JB, Morris HR
JAMA Neurol 2020 Mar 1;77(3):377-387. doi: 10.1001/jamaneurol.2019.4347. PMID: 31860007Free PMC Article
Höglinger GU, Respondek G, Stamelou M, Kurz C, Josephs KA, Lang AE, Mollenhauer B, Müller U, Nilsson C, Whitwell JL, Arzberger T, Englund E, Gelpi E, Giese A, Irwin DJ, Meissner WG, Pantelyat A, Rajput A, van Swieten JC, Troakes C, Antonini A, Bhatia KP, Bordelon Y, Compta Y, Corvol JC, Colosimo C, Dickson DW, Dodel R, Ferguson L, Grossman M, Kassubek J, Krismer F, Levin J, Lorenzl S, Morris HR, Nestor P, Oertel WH, Poewe W, Rabinovici G, Rowe JB, Schellenberg GD, Seppi K, van Eimeren T, Wenning GK, Boxer AL, Golbe LI, Litvan I; Movement Disorder Society-endorsed PSP Study Group
Mov Disord 2017 Jun;32(6):853-864. Epub 2017 May 3 doi: 10.1002/mds.26987. PMID: 28467028Free PMC Article
Olney NT, Spina S, Miller BL
Neurol Clin 2017 May;35(2):339-374. doi: 10.1016/j.ncl.2017.01.008. PMID: 28410663Free PMC Article
Golbe LI
Semin Neurol 2014 Apr;34(2):151-9. Epub 2014 Jun 25 doi: 10.1055/s-0034-1381736. PMID: 24963674

Therapy

Höglinger GU, Litvan I, Mendonca N, Wang D, Zheng H, Rendenbach-Mueller B, Lon HK, Jin Z, Fisseha N, Budur K, Gold M, Ryman D, Florian H; Arise Investigators
Lancet Neurol 2021 Mar;20(3):182-192. doi: 10.1016/S1474-4422(20)30489-0. PMID: 33609476
Vaswani PA, Olsen AL
Curr Opin Neurol 2020 Aug;33(4):527-533. doi: 10.1097/WCO.0000000000000836. PMID: 32657895Free PMC Article
Bayram E, Marras C, Standaert DG, Kluger BM, Bordelon YM, Shprecher DR, Litvan I; ENGENE-PSP Consortium
Mov Disord 2020 Jul;35(7):1253-1257. Epub 2020 Mar 27 doi: 10.1002/mds.28038. PMID: 32220093Free PMC Article
Giagkou N, Stamelou M
Expert Opin Emerg Drugs 2019 Jun;24(2):83-92. Epub 2019 May 20 doi: 10.1080/14728214.2019.1609450. PMID: 31007097
Pîrşcoveanu DFV, Pirici I, Tudorică V, Bălşeanu TA, Albu VC, Bondari S, Bumbea AM, Pîrşcoveanu M
Rom J Morphol Embryol 2017;58(4):1141-1150. PMID: 29556602

Prognosis

Thijssen EH, La Joie R, Strom A, Fonseca C, Iaccarino L, Wolf A, Spina S, Allen IE, Cobigo Y, Heuer H, VandeVrede L, Proctor NK, Lago AL, Baker S, Sivasankaran R, Kieloch A, Kinhikar A, Yu L, Valentin MA, Jeromin A, Zetterberg H, Hansson O, Mattsson-Carlgren N, Graham D, Blennow K, Kramer JH, Grinberg LT, Seeley WW, Rosen H, Boeve BF, Miller BL, Teunissen CE, Rabinovici GD, Rojas JC, Dage JL, Boxer AL; Advancing Research and Treatment for Frontotemporal Lobar Degeneration investigators
Lancet Neurol 2021 Sep;20(9):739-752. doi: 10.1016/S1474-4422(21)00214-3. PMID: 34418401Free PMC Article
Karikari TK, Pascoal TA, Ashton NJ, Janelidze S, Benedet AL, Rodriguez JL, Chamoun M, Savard M, Kang MS, Therriault J, Schöll M, Massarweh G, Soucy JP, Höglund K, Brinkmalm G, Mattsson N, Palmqvist S, Gauthier S, Stomrud E, Zetterberg H, Hansson O, Rosa-Neto P, Blennow K
Lancet Neurol 2020 May;19(5):422-433. doi: 10.1016/S1474-4422(20)30071-5. PMID: 32333900
Höglinger GU, Respondek G, Stamelou M, Kurz C, Josephs KA, Lang AE, Mollenhauer B, Müller U, Nilsson C, Whitwell JL, Arzberger T, Englund E, Gelpi E, Giese A, Irwin DJ, Meissner WG, Pantelyat A, Rajput A, van Swieten JC, Troakes C, Antonini A, Bhatia KP, Bordelon Y, Compta Y, Corvol JC, Colosimo C, Dickson DW, Dodel R, Ferguson L, Grossman M, Kassubek J, Krismer F, Levin J, Lorenzl S, Morris HR, Nestor P, Oertel WH, Poewe W, Rabinovici G, Rowe JB, Schellenberg GD, Seppi K, van Eimeren T, Wenning GK, Boxer AL, Golbe LI, Litvan I; Movement Disorder Society-endorsed PSP Study Group
Mov Disord 2017 Jun;32(6):853-864. Epub 2017 May 3 doi: 10.1002/mds.26987. PMID: 28467028Free PMC Article
Finger EC
Continuum (Minneap Minn) 2016 Apr;22(2 Dementia):464-89. doi: 10.1212/CON.0000000000000300. PMID: 27042904Free PMC Article
Hynd GW, Pirozzolo FJ, Maletta GJ
Int J Neurosci 1982 Mar;16(2):87-98. doi: 10.3109/00207458209147609. PMID: 6762362

Clinical prediction guides

Shi Y, Zhang W, Yang Y, Murzin AG, Falcon B, Kotecha A, van Beers M, Tarutani A, Kametani F, Garringer HJ, Vidal R, Hallinan GI, Lashley T, Saito Y, Murayama S, Yoshida M, Tanaka H, Kakita A, Ikeuchi T, Robinson AC, Mann DMA, Kovacs GG, Revesz T, Ghetti B, Hasegawa M, Goedert M, Scheres SHW
Nature 2021 Oct;598(7880):359-363. Epub 2021 Sep 29 doi: 10.1038/s41586-021-03911-7. PMID: 34588692Free PMC Article
Vergouw LJM, Melhem S, Donker Kaat L, Chiu WZ, Kuipers DJS, Breedveld G, Boon AJW, Wang LS, Naj AC, Mlynarksi E, Cantwell L, Quadri M, Ross OA, Dickson DW, Schellenberg GD, van Swieten JC, Bonifati V, de Jong FJ
Neurobiol Aging 2020 Oct;94:311.e5-311.e10. Epub 2020 Apr 30 doi: 10.1016/j.neurobiolaging.2020.04.016. PMID: 32527607Free PMC Article
Höglinger GU, Respondek G, Stamelou M, Kurz C, Josephs KA, Lang AE, Mollenhauer B, Müller U, Nilsson C, Whitwell JL, Arzberger T, Englund E, Gelpi E, Giese A, Irwin DJ, Meissner WG, Pantelyat A, Rajput A, van Swieten JC, Troakes C, Antonini A, Bhatia KP, Bordelon Y, Compta Y, Corvol JC, Colosimo C, Dickson DW, Dodel R, Ferguson L, Grossman M, Kassubek J, Krismer F, Levin J, Lorenzl S, Morris HR, Nestor P, Oertel WH, Poewe W, Rabinovici G, Rowe JB, Schellenberg GD, Seppi K, van Eimeren T, Wenning GK, Boxer AL, Golbe LI, Litvan I; Movement Disorder Society-endorsed PSP Study Group
Mov Disord 2017 Jun;32(6):853-864. Epub 2017 May 3 doi: 10.1002/mds.26987. PMID: 28467028Free PMC Article
Finger EC
Continuum (Minneap Minn) 2016 Apr;22(2 Dementia):464-89. doi: 10.1212/CON.0000000000000300. PMID: 27042904Free PMC Article
Duvoisin RC, Golbe LI, Lepore FE
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Recent systematic reviews

Jin J, Su D, Zhang J, Li X, Feng T
J Neurol 2023 May;270(5):2451-2467. Epub 2023 Jan 12 doi: 10.1007/s00415-022-11556-3. PMID: 36633672
Chan LML, Yan OY, Lee JJJ, Lam WWT, Lin CC, Auyeung M, Bloem BR, Kwok JYY
J Am Med Dir Assoc 2023 Feb;24(2):171-184. Epub 2022 Dec 5 doi: 10.1016/j.jamda.2022.11.001. PMID: 36481217
Parthimos TP, Schulpis KH
Clin Gerontol 2020 Mar-Apr;43(2):155-180. Epub 2019 Nov 22 doi: 10.1080/07317115.2019.1694115. PMID: 31752626
Glasmacher SA, Leigh PN, Saha RA
J Neurol Neurosurg Psychiatry 2017 May;88(5):402-411. Epub 2017 Mar 1 doi: 10.1136/jnnp-2016-314956. PMID: 28250027
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Neurobiol Dis 2005 Nov;20(2):179-86. doi: 10.1016/j.nbd.2005.03.013. PMID: 16242626

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