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Int J Clin Exp Pathol 2(4),399-406;2009

Original Article
Cortical Alzheimer Type Pathology Does Not Influence tau Pathology in Progressive
Supranuclear Palsy

Kenichi Oshima and Dennis W. Dickson

Department of Neuroscience, Mayo Clinic, Jacksonville, Florida

Received 11 December 2008; Accepted and available online 20 December 2008

Abstract: Alzheimer disease (AD) is characterized by numerous senile plaques (SP) in addition to widespread neocortical neurofibrillary
tangles (NFT). Some elderly have pathologic aging (PA), which is characterized by numerous SP composed of diffuse amyloid deposits with
few or no NFT confined to the limbic lobe. Both AD and PA represent a range of Alzheimer type pathology (ATP). Some cases of progressive
supranuclear palsy (PSP) have concurrent ATP, but the relationship between ATP and PSP has not been addressed. In this study, a
consecutive series of PSP cases were divided into three groups according to the degree of concurrent ATP – pure PSP, PSP/PA and PSP/AD.
Braak NFT stage was significantly greater in PSP/AD compared with both PSP/PA and PSP. Among the pathologic variables studied in middle
frontal, superior temporal and motor cortices, there were no differences between PSP and PSP/PA except for SP. In PSP/AD, there was greater
neuronal tau pathology (pretangles, NFT and neuropil threads) in middle frontal and superior temporal cortices, probably a reflection of ATP
since there was no comparable increase in PSP-related glial tau pathology in these regions. The APOEε4 allele frequency was significantly
higher in PSP/PA and PSP/AD than in PSP. These results strongly argue that ATP in PSP represents independent disease processes even
when present in the same brain. (IJCEP812003).

Key Words: Alzheimer’s disease, progressive supranuclear palsy, senile plaque, tau, apolipoprotein E

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Address all correspondence to: Dennis W. Dickson, MD, Neuropathology Laboratory, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL
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