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Brain, Vol. 125, No. 4, 789-800, March 2002
© 2002 Guarantors of Brain

Frontal atrophy correlates with behavioural changes in progressive supranuclear palsy

N. J. Cordato1,3,4, C. Pantelis3,5, G. M. Halliday4, D. Velakoulis3,5, S. J. Wood3,5, G. W. Stuart3,5, J. Currie3, M. Soo2, G. Olivieri2, G. A. Broe4 and J. G. L. Morris1

1 Departments of Neurology and 2 Radiology, Westmead Hospital, Westmead, NSW 2145, 3 The Mental Health Research Institute (MHRI), Parkville, Vic 3052, 4 Prince of Wales Medical Research Institute, Sydney, NSW 2031, 5 Cognitive Neuropsychiatry Research and Academic Unit (CNRAU), The University of Melbourne and Sunshine Hospital, Vic 3021, Australia

Correspondence to: Dr N. J. Cordato, Prince of Wales Medical Research Institute, Barker Street, Randwick, NSW 2031, Australia E-mail: ncordato{at}mail.usyd.edu.au

Regional brain volumes were measured in 21 patients with progressive supranuclear palsy (PSP), 17 patients with Parkinson’s disease and 23 controls using 3D MRI-based volumetry. Cortical, subcortical and ventricular volume measures were correlated with global indices of motor disability and cognitive disturbance. All MRI measures, including hippocampal volume, were preserved in Parkinson’s disease. Patients with PSP could be distinguished from both Parkinson’s disease and controls by whole brain volume loss, ventricular dilatation and disproportionate atrophy of the frontal cortex. Caudate nucleus volume loss additionally differentiated PSP from controls, but was modest in severity and proportionate to whole brain volume loss. The present study identifies disease-specific differences in the topography of brain atrophy between PSP and Parkinson’s disease, and has potential implications for the in vivo radiological differentiation of these two disorders. In PSP, the variance in frontal grey matter volume related to measures of behavioural disturbance, confirming the use of behavioural tests for ante-mortem case differentiation and suggesting that intrinsic cortical deficits contribute to these clinical disturbances.


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