Decoding PSP: A Dive into Its Diverse Subtypes

Decoding PSP: A Dive into Its Diverse Subtypes

Progressive Supranuclear Palsy (PSP) is a neurodegenerative disease, and while it primarily presents with a classic set of symptoms, there are multiple clinical subtypes that have been described based on the predominant symptoms at the onset and during the course of the disease. Here are the main subtypes:

  1. PSP-Richardson's Syndrome (PSP-RS): This is the most common and classic presentation of PSP. Symptoms include early falls, vertical supranuclear gaze palsy (difficulty moving the eyes vertically), and cognitive changes.
  1. PSP-Parkinsonism (PSP-P): This subtype manifests with symptoms that resemble Parkinson's disease, such as tremor, bradykinesia (slowness of movement), and rigidity, but with a poor response to levodopa.
  1. PSP-Pure Akinesia with Gait Freezing (PSP-PAGF): Predominant symptom in this subtype is gait freezing without significant rigidity or tremor.
  1. PSP-Corticobasal Syndrome (PSP-CBS): This presents with asymmetrical limb rigidity, dystonia (abnormal muscle contractions), and apraxia (difficulty performing tasks even when there's no muscle weakness).
  1. PSP-Progressive Non-fluent Aphasia (PSP-PNFA): This subtype involves speech and language disturbances, such as effortful speech, grammatical errors, and word-finding difficulty.
  1. PSP-Frontal (PSP-F): This subtype is characterized by behavioral and cognitive symptoms that resemble frontotemporal dementia, including personality changes, apathy, and executive dysfunction.
  1. PSP-Cerebellar (PSP-C): This less common subtype manifests with cerebellar symptoms like imbalance, unsteady gait, and incoordination.

While these subtypes help guide clinical understanding and treatment of PSP, it's important to note that the disease can be heterogeneous, with patients showing symptoms from more than one subtype. Additionally, as the disease progresses, patients might evolve from one subtype to another.

This list is for information only and not medical advice. Please speak to your doctor and care team. 

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2 comments

Thank you, Tim, for your thoughtful comment. I couldn’t agree more about the need to raise awareness among caregivers and medical professionals about PSP variants. It’s so important that everyone has access to this information. Your support means a lot.

Laura Louizos

Not too many caregivers, or medical professionals are aware of the variants/subtypes of PSP. This is a great read and should go a long way in helping those who are affected by this disease to better understand PSP.

Tim Brown

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