Thank you to all who participated last month in the first of what will hopefully be an annual think-tank on Progressive Supranuclear Palsy (PSP) and atypical parkinsonisms here at UF Center for Movement Disorders & Neurorestoration. We had over 100 registered attendees! Special guests Drs. Irene Litvan (UC Davis) and Dennis Dickson (Mayo Jacksonville) were featured, as well as several of our own, including Drs. Jada Lewis, David Vaillancourt, and Chris Hass.
Discussions ranged from recognition and diagnosis of Parkinsonisms and PSP to pathology and genetics, and then to imaging biomarkers and comprehensive gait evaluation. In neurology and among movement disorders specialists PSP, though relatively rare, is a widely recognized condition but it is clear that the condition can easily be misdiagnosed and may be under-recognized by other physicians. Many of the features, including gait difficulty, falls, slowing, lack of facial expression, and speech difficulty overlap with those seen in Parkinson disease. Furthermore, we are increasingly becoming aware that PSP is a heterogeneous disorder with a sometimes varied presentation. These PSP “variants” were highlighted at the symposium and pathological distinction discussed.
Future efforts clearly will include further characterization and identification of these variants. Current efforts are already underway and involve both genetics (see recent article on genome-wide association study, GWAS, on PSP in Nature Genetics; http://www.nature.com/ng/journal/v43/n7/full/ng.859.html) and biomarkers (molecular markers found in blood or other tissues). Here at UF, we also have ongoing efforts to better understand the pathology and distinguish patients with PSP from classic Parkinson disease with studies that look at brain imaging biomarkers (Vaillancourt lab), utilizing functional MRI and diffusion tensor imaging (DTI), as well as quantitative gait and balance assessments at the UF Applied Neuromechanics Laboratory (Hass lab). A major outcome of this PSP symposium/think-tank was the generation of new ideas and strengthening of collaborative efforts among physicians and researchers.
We again thank all the participants, and in particular the Allen family for their generous support and continued encouragement in the fight against this devastating disorder.