Progressive supranuclear palsy combined with Alzheimer's disease: A clinicopathological study of two autopsy cases

Rieko Sakamoto, Kuniaki Tsuchiya, Ryoichi Yoshida, Yoshinori Itoh, Nobuo Furuta, Asako Kosuga, Yuichi Sugai, Masaru Mimura

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)


We present here the clinicopathological characteristics of two autopsy-confirmed cases comorbid of progressive supranuclear palsy (PSP) and Alzheimer's disease (AD). Histopathologically, the amount and distribution of neurofibrillary tangles (NFTs) in the basal ganglia and brainstem fulfilled the pathological criteria of PSP proposed by the National Institute of Neurological Disorders and Stroke - The Society for PSP (NINDS-SPSP). The Braak stages of senile plaques and NFTs were stage C and stage V in Case 1, and stage C and stage IV in Case 2. These neuropathological findings confirmed that the two patients had combined PSP with AD. Our patients presented clinically with executive dysfunction prior to memory disturbance as an early symptom. Not only neurological symptoms such as gait disturbance, supranuclear ophthalmoplegia and pseudobulbar palsy, but emotional and personality changes and delirium were prominent. Therefore, symptoms of subcortical dementia of PSP were more predominant than AD-related symptoms in the present two patients. Comorbid PSP and AD further complicates the clinical picture and makes clinical diagnosis even more difficult.

Original languageEnglish
Pages (from-to)219-229
Number of pages11
Issue number3
Publication statusPublished - 2009 Jun
Externally publishedYes


  • Alzheimer's disease
  • Braak stage
  • Neurofibrillary tangle
  • Progressive supranuclear palsy
  • Subcortical dementia

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Clinical Neurology


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