Progressive supranuclear palsy with dementia: Cortical pathology

Patients with progressive supranuclear palsy (PSP) often develop dementia, and cortical pathology has been documented in PSP. However, there are no re ports correlating dementia in PSP with cortical pathology. We hypothesized that cases of PSP presenting with cognitive impairment would have more seve re cortical tau pathology than those without. We compared 7 cases of PSP pr esenting with cognitive deficits (group 1) with 4 cases of PSP that did not (group 2). The subcortical tau pathology was almost identical in both grou ps. The cortical tau pathology was strikingly different in group 1, in whic h it was on average moderate, compared with group 2, in which it was minima l. The accumulation of cortical neuronoglial tau in PSP cases with dementia suggests that neurofibrillary pathology is central to the cause of dementi a in PSP.