Günter U Höglinger1,2, Gesine Respondek1,2, Maria Stamelou3, Carolin Kurz4, Keith A Josephs5, Anthony E Lang6, Brit Mollenhauer7, Ulrich Müller8, Christer Nilsson9, Jennifer L Whitwell10, Thomas Arzberger2,4,11, Elisabet Englund12, Ellen Gelpi13, Armin Giese11, David J Irwin14, Wassilios G Meissner15,16,17, Alexander Pantelyat18, Alex Rajput19, John C van Swieten20, Claire Troakes21, Angelo Antonini22, Kailash P Bhatia23, Yvette Bordelon24, Yaroslau Compta25, Jean-Christophe Corvol26, Carlo Colosimo27, Dennis W Dickson28, Richard Dodel29, Leslie Ferguson19, Murray Grossman14, Jan Kassubek30, Florian Krismer31, Johannes Levin2,32, Stefan Lorenzl33,34,35, Huw R Morris36, Peter Nestor37, Wolfgang H Oertel38, Werner Poewe31, Gil Rabinovici39, James B Rowe40, Gerard D Schellenberg41, Klaus Seppi31, Thilo van Eimeren42, Gregor K Wenning31, Adam L Boxer39, Lawrence I Golbe43, Irene Litvan44. 1. Department of Neurology, Technische Universität München, Munich, Germany. 2. German Center for Neurodegenerative Diseases (DZNE), Munich, Germany. 3. Second Department of Neurology, Attikon University Hospital, University of Athens, Athens, Greece. 4. Department of Psychiatry, Ludwig-Maximilians-Universität, Munich, Germany. 5. Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA. 6. Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Canada. 7. Paracelsus-Elena Klinik, Kassel, Germany, and University Medical Center Göttingen, Institute of Neuropathology, Göttingen, Germany. 8. Institute of Human Genetics, Giessen, Germany. 9. Department of Clinical Sciences, Division of Neurology, Lund University, Lund, Sweden. 10. Department of Radiology, Mayo Clinic, Rochester, Minnesoya, USA. 11. Center for Neuropathology and Prion Research, Ludwig-Maximilians-Universität, Munich, Germany. 12. Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Lund, Sweden. 13. Neurological Tissue Bank of the Biobank - Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, Barcelona, Spain. 14. Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA. 15. Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France. 16. CNRS, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France. 17. Service de Neurologie, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France. 18. Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA. 19. Division of Neurology, Royal University Hospital, University of Saskatchewan, Saskatoon, SK, Canada. 20. Department of Neurology, Erasmus Medical Centre, Rotterdam, The Netherlands. 21. London Neurodegenerative Diseases Brain Bank, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom. 22. Parkinson and Movement Disorders Unit, IRCCS Hospital San Camillo, Venice, and Department of Neurosciences, Padova University, Padova, Italy. 23. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London, United Kingdom. 24. Department of Neurology, University of California, Los Angeles, California, USA. 25. Parkinson's Disease & Movement Disorders Unit, Neurology Service, Hospital Clinic/IDIBAPS/University of Barcelona, Barcelona, Catalonia, Spain. 26. Sorbonne Universités, UPMC Univ Paris 06; and INSERM UMRS_1127, CIC_1422; and CNRS UMR_7225; and AP-HP; and ICM, Hôpital Pitié-Salpêtrière, Département des maladies du système nerveux, Paris, France. 27. Department of Neurology, Santa Maria University Hospital of Terni, Terni, Italy. 28. Mayo Clinic, Jacksonville, Florida, USA. 29. Department of Geriatric Medicine, University Hospital Essen, Essen, Germany. 30. Department of Neurology, University of Ulm, Ulm, Germany. 31. Department of Neurology, Medical University Innsbruck, Innsbruck, Austria. 32. Department of Neurology, Ludwig-Maximilians-Universität, Munich, Germany. 33. Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria. 34. Department of Neurology, Hospital Agatharied, Agatharied, Germany. 35. Department of Palliative Medicine, Munich University Hospital, LMU Munich, Munich, Germany. 36. Department of Clinical Neuroscience, UCL Institute of Neurology, London, United Kingdom. 37. German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany. 38. Department of Neurology, Philipps Universität, Marburg, Germany. 39. Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA. 40. Department of Clinical Neurosciences, Cambridge University, Cambridge, United Kingdom. 41. Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. 42. Departments of Nuclear Medicine and Neurology, University of Cologne, Cologne, Germany. 43. Department of Neurology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA. 44. Department of Neurology, University of California, San Diego, California, USA.
Abstract
BACKGROUND: PSP is a neuropathologically defined disease entity. Clinical diagnostic criteria, published in 1996 by the National Institute of Neurological Disorders and Stroke/Society for PSP, have excellent specificity, but their sensitivity is limited for variant PSP syndromes with presentations other than Richardson's syndrome. OBJECTIVE: We aimed to provide an evidence- and consensus-based revision of the clinical diagnostic criteria for PSP. METHODS: We searched the PubMed, Cochrane, Medline, and PSYCInfo databases for articles published in English since 1996, using postmortem diagnosis or highly specific clinical criteria as the diagnostic standard. Second, we generated retrospective standardized clinical data from patients with autopsy-confirmed PSP and control diseases. On this basis, diagnostic criteria were drafted, optimized in two modified Delphi evaluations, submitted to structured discussions with consensus procedures during a 2-day meeting, and refined in three further Delphi rounds. RESULTS: Defined clinical, imaging, laboratory, and genetic findings serve as mandatory basic features, mandatory exclusion criteria, or context-dependent exclusion criteria. We identified four functional domains (ocular motor dysfunction, postural instability, akinesia, and cognitive dysfunction) as clinical predictors of PSP. Within each of these domains, we propose three clinical features that contribute different levels of diagnostic certainty. Specific combinations of these features define the diagnostic criteria, stratified by three degrees of diagnostic certainty (probable PSP, possible PSP, and suggestive of PSP). Clinical clues and imaging findings represent supportive features. CONCLUSIONS: Here, we present new criteria aimed to optimize early, sensitive, and specific clinical diagnosis of PSP on the basis of currently available evidence.
BACKGROUND: PSP is a neuropathologically defined disease entity. Clinical diagnostic criteria, published in 1996 by the National Institute of Neurological Disorders and Stroke/Society for PSP, have excellent specificity, but their sensitivity is limited for variant PSP syndromes with presentations other than Richardson's syndrome. OBJECTIVE: We aimed to provide an evidence- and consensus-based revision of the clinical diagnostic criteria for PSP. METHODS: We searched the PubMed, Cochrane, Medline, and PSYCInfo databases for articles published in English since 1996, using postmortem diagnosis or highly specific clinical criteria as the diagnostic standard. Second, we generated retrospective standardized clinical data from patients with autopsy-confirmed PSP and control diseases. On this basis, diagnostic criteria were drafted, optimized in two modified Delphi evaluations, submitted to structured discussions with consensus procedures during a 2-day meeting, and refined in three further Delphi rounds. RESULTS: Defined clinical, imaging, laboratory, and genetic findings serve as mandatory basic features, mandatory exclusion criteria, or context-dependent exclusion criteria. We identified four functional domains (ocular motor dysfunction, postural instability, akinesia, and cognitive dysfunction) as clinical predictors of PSP. Within each of these domains, we propose three clinical features that contribute different levels of diagnostic certainty. Specific combinations of these features define the diagnostic criteria, stratified by three degrees of diagnostic certainty (probable PSP, possible PSP, and suggestive of PSP). Clinical clues and imaging findings represent supportive features. CONCLUSIONS: Here, we present new criteria aimed to optimize early, sensitive, and specific clinical diagnosis of PSP on the basis of currently available evidence.
Authors: Gesine Respondek; Sigrun Roeber; Hans Kretzschmar; Claire Troakes; Safa Al-Sarraj; Ellen Gelpi; Carles Gaig; Wang Zheng Chiu; John C van Swieten; Wolfgang H Oertel; Günter U Höglinger Journal: Mov Disord Date: 2013-02-21 Impact factor: 10.338
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Authors: I Litvan; C A Mangone; A McKee; M Verny; A Parsa; K Jellinger; L D'Olhaberriague; K R Chaudhuri; R K Pearce Journal: J Neurol Neurosurg Psychiatry Date: 1996-06 Impact factor: 10.154
Authors: I Litvan; J J Hauw; J J Bartko; P L Lantos; S E Daniel; D S Horoupian; A McKee; D Dickson; C Bancher; M Tabaton; K Jellinger; D W Anderson Journal: J Neuropathol Exp Neurol Date: 1996-01 Impact factor: 3.685
Authors: Jennifer L Whitwell; Günter U Höglinger; Angelo Antonini; Yvette Bordelon; Adam L Boxer; Carlo Colosimo; Thilo van Eimeren; Lawrence I Golbe; Jan Kassubek; Carolin Kurz; Irene Litvan; Alexander Pantelyat; Gil Rabinovici; Gesine Respondek; Axel Rominger; James B Rowe; Maria Stamelou; Keith A Josephs Journal: Mov Disord Date: 2017-05-13 Impact factor: 10.338
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Authors: Han Soo Yoo; Seok Jong Chung; Soo-Jong Kim; Jung Su Oh; Jae Seung Kim; Byoung Seok Ye; Young Ho Sohn; Phil Hyu Lee Journal: Eur J Nucl Med Mol Imaging Date: 2018-05-04 Impact factor: 9.236
Authors: Alberto Lleó; David J Irwin; Ignacio Illán-Gala; Corey T McMillan; David A Wolk; Edward B Lee; Vivianna M Van Deerlin; Leslie M Shaw; John Q Trojanowski; Murray Grossman Journal: JAMA Neurol Date: 2018-06-01 Impact factor: 18.302
Authors: Günter U Höglinger; Jakob Schöpe; Maria Stamelou; Jan Kassubek; Teodoro Del Ser; Adam L Boxer; Stefan Wagenpfeil; Hans-Jürgen Huppertz Journal: Mov Disord Date: 2017-04-24 Impact factor: 10.338
Authors: Rene L Utianski; Joseph R Duffy; Heather M Clark; Edythe A Strand; Sarah M Boland; Mary M Machulda; Jennifer L Whitwell; Keith A Josephs Journal: Am J Speech Lang Pathol Date: 2018-11-21 Impact factor: 2.408
Authors: Andy J Liu; Jessica E Chang; Georges Naasan; Adam L Boxer; Bruce L Miller; Salvatore Spina Journal: Neurocase Date: 2020-02-23 Impact factor: 0.881
Authors: Salvatore Nigro; Angelo Antonini; David E Vaillancourt; Klaus Seppi; Roberto Ceravolo; Antonio P Strafella; Antonio Augimeri; Andrea Quattrone; Maurizio Morelli; Luca Weis; Eleonora Fiorenzato; Roberta Biundo; Roxana G Burciu; Florian Krismer; Nikolaus R McFarland; Christoph Mueller; Elke R Gizewski; Mirco Cosottini; Eleonora Del Prete; Sonia Mazzucchi; Aldo Quattrone Journal: Mov Disord Date: 2020-02-24 Impact factor: 10.338