Neuroimaging in Parkinson' s Disease and Related Disorders: Chapter 13: Neuroimaging in progressive supranuclear palsy

Elsevier, Neuroimaging in Parkinson' s Disease and Related Disorders 2023, Pages 355-397
Edoardo Rosariode Natale, Heather Wilson, Marios Politis, and Flavia Niccolini

Progressive supranuclear palsy (PSP) is a neurodegenerative disorder pathologically characterized by accumulation of abnormal tau protein in subcortical nuclei neurons forming the neurofibrillary tangles, and in glial cells as tufted astrocytes and oligodendroglial inclusions. Early diagnosis is still challenging due to the heterogeneity of the disease and overlapping features with other neurodegenerative disorders. Several neuroimaging studies using structural and functional MRI and molecular imaging techniques such as PET and SPECT have improved our understanding of the neurobiology of PSP. Quantitative and qualitative measures of brainstem, cortical and striatal atrophy, diffusion-weighted and diffusion tensor imaging abnormalities, [18F]FDG PET hypometabolism, reductions in striatal dopamine imaging, and, most recently, subcortical deposition of tau proteins have been suggested as potential biomarkers of disease. However, since they have not yielded confirmation as a diagnostic biomarker, more work is needed to find a reliable biomarker aiding in the early diagnosis and in monitoring disease progression.