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Progressive Supranuclear Palsy Diagnosis and Treatment

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Abstract

Purpose of review

This review describes the current approaches to the diagnosis and management of progressive supranuclear palsy (PSP)

Recent findings

PSP is an atypical parkinsonian disorder associated with the accumulation of abnormal 4-repeat tau protein in the brain. Initially, the recognized clinical phenotype included a progressive disorder with vertical supranuclear gaze palsy and prominent postural instability leading to early falls. However, the current PSP diagnostic criteria recognize a broader range of clinical PSP presentations and define eight clinical PSP variants according to the levels of diagnostic certainty. While definite PSP remains a neuropathological diagnosis, imaging modalities including brain magnetic resonance imaging (MRI), dopamine transporter (DAT), and tau positron emission tomography (PET) scans may aid in the diagnosis. In the future, new tau PET ligands and CSF and genetic biomarkers may improve diagnostic accuracy. There is no disease-modifying therapy currently available for PSP. However, there are many pharmacological and non-pharmacological treatment options for symptomatic management. Because PSP is a multisystem disease, optimal management requires a coordinated multidisciplinary team approach.

Summary

PSP is a fatal multisystem disease that can be challenging to diagnose and manage. However, improved clinical diagnostic criteria, emerging biomarkers, and availability of useful therapeutic approaches provide cause for optimism.

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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Department of Neurology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD, 21287, USA

    Lauryn Currens MD & Alexander Pantelyat MD

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  1. Lauryn Currens MD
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L.C. and A.P. wrote the main manuscript text. L.C. prepared Tables 1, 2, 3, and 4. All authors reviewed the manuscript.

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Correspondence to Lauryn Currens MD.

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Dr. Alex Pantelyat is a board member of CurePSP.

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Currens, L., Pantelyat, A. Progressive Supranuclear Palsy Diagnosis and Treatment. Curr Treat Options Neurol 26, 97–114 (2024). https://doi.org/10.1007/s11940-024-00784-9

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