A conglomeration of dysfunction in 3 lbs?

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A conglomeration of dysfunction in 3 lbs?

Postby boxcar9 » Sun Sep 14, 2014 12:48 pm

Greetings PSP Family:

Would anyone be able to help me get access to professional journal articles? In my quest to understand what is causing the bizarre, atypical symptoms Mom is experiencing, I continue to read.

The more I read about brain pathology, the more I REALLY understand that doctors are GUESSING (albeit very well educated) at what they should prescribe or do for people with neurodegeneration.

It really confounds me further to find out that PWPSP have MUCH MORE than just PSP or CBD, etc. (see bolded info below)

Anyway, here's some info from the article I want to read.

Concomitant pathologies among a spectrum of parkinsonian disorders
Parkinsonism and Related Disorders Vol. 20, Issue 5, Pages 525-529
published online 17 March 2014
Brittany N. Dugger, Charles H. Adler,Holly A. Shill,John Caviness,Sandra Jacobson,Erika Driver-Dunckley,Thomas G. Beach
The Arizona Parkinson's Disease Consortium


Of the neuropathologically-confirmed PD cases,
38% had a concomitant diagnosis of AD,
9% PSP,
25% Arg,
44% CWMR, and
24% CAA.

For DLB,
89% had AD,
1% PSP,
21% Arg,
51% CWMR, and
50% CAA.

For PSP cases,
36% had AD,
20% PD,
1% DLB,
44% Arg,
52% CWMR and
25% CAA.

Similar heterogeneity was seen for MSA and CBD cases.
Many cases had more than one of the above additional diagnoses.


Data from the Arizona Study of Aging and Neurodegenerative Disorders (AZSAND), an ongoing longitudinal clinical-neuropathological study, was used to analyze concomitant pathologies, including
Alzheimer's disease (AD),
argyrophilic grains (Arg),
cerebral amyloid angiopathy (CAA),
cerebral white matter rarefaction (CWMR) and

overlap of each parkinsonian disorder in clinico-pathologically defined
Parkinson's disease (PD; N = 140),
dementia with Lewy bodies (DLB; N = 90),
progressive supranuclear palsy (PSP; N = 64),
multiple system atrophy (MSA; N = 6),
corticobasal degeneration (CBD; N = 7); and
normal elderly (controls; N = 166).

I've never even heard of cerebral amyloid angiopathy (CAA) or cerebral white matter rarefaction (CWMR)!

It seems like doctors don't relay having more than one type of neurodegeneration at the same time. And I'm a little disgruntled by this.

This is all a great big guessing game and it makes me lose hope for a little while. Mom is still here and she deserves whatever she can get to make her more comfortable. (we're battling rib cage spasms that we didn't know about--detected by the ekg in hospital--in addition to the high BP, high pulse and ridiculous sweating)

Thanks to all and wishing you peaceful moments
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Joined: Tue Sep 04, 2012 5:01 pm
Location: Illinois, USA

Re: A conglomeration of dysfunction in 3 lbs?

Postby eplowman » Sun Sep 14, 2014 5:06 pm


Interesting survey. Thanks for posting.

My late Rose was one of those with PSP who was found also to have AGD.

Just a quick initial note for now. You said, "It seems like doctors don't relay having more than one type of neurodegeneration at the same time. And I'm a little disgruntled by this."

You need/should not be. As of now, some of these "other" conditions can be found ONLY with an analysis of brain tissue -- which in MOST cases means AFTER death occurs! Aging itself appears to be a risk factor. Researchers don't yet know which, if any, symptoms of, say, AGD, are associated with what is seen externally in PSP, for example. Even a diagnosis of PSP itself can be verified only by autopsy of the brain. In making a diagnosis of PSP, even the sharpest, most savvy-about-PSP neurologists are issuing what amounts to a "best guess," based on observed and/or reported symptoms, medical history, etc. Test-tube results for PSP et al may become possible some day in the future. Meanwhile, patience is the order of the day while we focus on and try to fill the caregiving needs of our loved ones as best we can.

ed p.
|My wife of 56 years was Rose b. 1930, dx 1999, symptoms from 1997; d. 06/21/08; PSP-rs autopsy confirmed.
Posts: 3659
Joined: Tue May 10, 2005 10:22 pm
Location: USA (Northern Va.)

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