Lecture 7 (PSP)

What are the primary structures impacted in PSP?

• Basal Ganglia

• Brainstem

• Cortex

What is the average age on onset for PSP?

• 60 - 65

What gender is more affected with PSP?

• Male > Female

What is average survival prognosis of PSP?

• 7 Years

What neurological condition may pair with PSP?

• What is the reason for this?

• Tau Protein Build Up:

  • Alzheimer’s / Dementia

What are hallmark s / sx of PSP?

• Vertical Gaze Palsy

• Falling Backwards

• Speech Difficulties

• Swallowing Difficulties

• Personality / Mood Changes

What is the classic imaging sign seen for PSP?

• The Penguin Sign

What s/sx does PD have, that PD doesn’t (5)?

• PD Responds To Levodopa, PSP Doesn’t

• PD Always Has Tremors, PSP Doesn’t

• PD Falls Forwards, Not Backwards

• PD Unlikely Vision Deficits

• PD Unlikely Dysphagia

What is the most common causes of death for PSP patients?

1. Pneumonia

2. Choking

3. Falls

What is the gold standard for PSP grading?

• What is the best virtual version?

• Gold Standard: PSPRS

  • Virtual Version: mPSRPS-21

What are the PSPRS categories?

• How many points are for each?

• History (24 pts)

• Mentation (16 pts)

• Bulbar (8 pts)

• Ocular (16 pts)

• Limb (16 pts)

• Gait (20 pts)

What are the grades for PSP Staging?

• 1 - Normal Gait

• 2 - Abnormal, But Stable Gait

• 3 - Cane / Intermittent AD Use

• 4 - Walker / Continuous AD Use

• 5 - Mostly WC Bound

What outcome measure is often used for PSP function (not PSPRS)?

• SEADL

What does research indicate regarding PSP gaze shifts and ambulation?

• Gaze Shift & Foot Asymmetry Are Paired

• Gaze Shift Ability Can Be Enhanced:

  • Best Evidence: Auditory Feedback

  • Also Decent: VOR Suppression