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. 2024 Oct;271(10):6866-6875.
doi: 10.1007/s00415-024-12662-0. Epub 2024 Sep 2.

The contribution of white matter changes to clinical phenotype in progressive supranuclear palsy

Maria Francesca Tepedino  1 , Francesco Diana  2   3 , Filomena Abate  1 , Anna Rosa Avallone  1 , Miriam Caterino  1 , Roberto Erro  1 , Maria Teresa Pellecchia  1 , Renzo Manara  4 , Paolo Barone  1 , Marina Picillo  5
Affiliations

The contribution of white matter changes to clinical phenotype in progressive supranuclear palsy

Maria Francesca Tepedino et al. J Neurol. 2024 Oct.

Abstract

White matter hyperintensities (WMH) are considered magnetic brain imaging (MRI) biomarkers of cerebral small vessel disease but their clinical role in neurodegenerative-related disorders is poorly understood. This study describes the distribution of WMH on brain MRI in Progressive Supranuclear Palsy (PSP) in comparison with Parkinson's disease (PD) and explores their possible impact on disease's features. Sixty PSP and 33 PD patients were included. Motor symptoms, cardiovascular risk factors and the age-related white matter changes (ARWMC) score was computed to rate WMH for both groups. Pearson's correlation and linear or logistic regression analysis were used to check for relationships between ARWMC and PSP clinical scores. The mean (standard deviation) ARWMC total score in the PSP cohort was 4.66 (3.25). Any degree of WMH was present in 68% of PSP (ARWMC +). Compared to ARWMC-, ARWMC + did not have greater disease severity or more cardiovascular risk factors. WMH were frequently localized in fronto-parietal lobes and were mild in severity. Linear regression analysis showed that ARWMC total score was related to the PSP-rating scale, irrespective of age, disease duration and the Charlson modified comorbidity index. Logistic regression analysis confirmed that ARWMC total score was related to the use of wheelchair, irrespective of above-mentioned covariates. Vascular risk factors as well as severity and distribution of WMH did not have an impact on the PSP phenotype. No differences were found with PD patients. Our results suggest that WMH in PSP might be markers of neurodegenerative-related pathology rather than being simple expression of atherosclerotic cerebrovascular changes.

Keywords: MRI; Phenotype; Progressive supranuclear palsy; Vascular.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Enrollment flowchart. Legend: ARWMC age-related white matter changes; CBD corticobasal disease; MRI magnetic resonance imaging; PSP Progressive Supranuclear Palsy
Fig. 2
Fig. 2
Spatial distribution of white matter hyperintensities on brain MRI
Fig. 3
Fig. 3
Linear regression analysis between ARWMC total score and PSP-rs. Legend: PSP-rs Progressive Supranuclear Palsy- rating scale
See this image and copyright information in PMC

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