FTLD-TDP and progressive supranuclear palsy in comorbidity-a report of two cases with different clinical presentations

Neurocase. 2017 Feb;23(1):5-11. doi: 10.1080/13554794.2016.1264058. Epub 2016 Dec 3.

Abstract

Frontotemporal lobar degeneration with transactive response DNA-binding protein 43 (FTLD-TDP) and progressive supranuclear palsy (PSP) are distinct neurodegenerations with different clinical presentations. We report two cases with FTLD-TDP and PSP in comorbidity: a patient with amnestic dementia developing frontal lobe dementia, Parkinsonism and supranuclear gaze palsy and a patient with cerebellar ataxia and nystagmus developing akinesia, rigidity, and subcortical dementia. Neuropathological examination revealed neuronal and glial tau pathology together with ubiquitin, and phospho-TDP-43-immunoreactivities in the hippocampus, striatum, mesencephalon, and frontal and temporal cortices. Clinical and neuropathological correlations in atypical neurodegenerations are crucial to describe new entities of overlapping syndromes.

Keywords: Progressive supranuclear palsy; TDP-43 inclusions; dementia; frontotemporal lobar degeneration; tauopathy.

Publication types

  • Case Reports

MeSH terms

  • Brain / diagnostic imaging
  • Brain / metabolism
  • DNA-Binding Proteins / metabolism*
  • Frontotemporal Dementia / complications*
  • Frontotemporal Dementia / pathology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Supranuclear Palsy, Progressive / complications*
  • Supranuclear Palsy, Progressive / diagnostic imaging
  • Supranuclear Palsy, Progressive / pathology
  • Ubiquitin / metabolism

Substances

  • DNA-Binding Proteins
  • TARDBP protein, human
  • Ubiquitin