Natural clinical course of progressive supranuclear palsy in Chinese patients in Hong Kong

Shea, Yat‐Fung; Shum, Chun Keung; Sc, Lee; Chiu, PW; Ks, Leung; Kwan, YK; Mok, Francis Ck; Chan, Felix Hon Wai

doi:10.12809/hkmj198101

Cited by 8 publications

(13 citation statements)

References 28 publications

(72 reference statements)

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“…1. The T1-weighted sagittal images were performed with echo time (TE) 9.09 ms, repetition time (TR) 2510.96 ms and voxel size 0.47*0.47*6mm 3 . The brainstem was divided into 3 sub-regions (midbrain, pons and medulla oblongata) on T1 midsagittal sections by drawing 2 cutting planes: the first line is between the superior pontine notch and inferior edge of the quadrigeminal plate (line1) and the second line is parallel to the first through the inferior pontine notch (line 2) ( Fig.…”

Section: Mri Acquisition and Measurementmentioning

confidence: 99%

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Midbrain/pons area ratio and clinical features predict the prognosis of progressive Supranuclear palsy

Cui

Ling

et al. 2020

BMC Neurol

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Background: Progressive supranuclear palsy (PSP) is a rare movement disorder with poor prognosis. This retrospective study aimed to characterize the natural history of PSP and to find predictors of shorter survival and faster decline of activity of daily living. Method: All patients recruited fulfilled the movement disorder society (MDS) clinical diagnostic criteria for PSP (MDS-PSP criteria) for probable and possible PSP with median 12 years. Data were obtained including age, sex, date of onset, age at onset (AAO), symptoms reported at first visit and follow-up, date of death and date of institutionalization. Magnetic resonance imaging was collected at the first visit. Endpoints were death and institutionalization. Kaplan-Meier method and Cox proportional hazard model were used to explore factors associated with early death and institutionalization. Results: Fifty-nine patients fulfilling MDS-PSP criteria were enrolled in our study. Nineteen patients (32.2%) had died and 31 patients (52.5%) were institutionalized by the end of the follow-up. Predictors associated with poorer survival were late-onset PSP and decreased M/P area ratio. Predictors associated with earlier institutionalization were older AAO and decreased M/P area ratio. Conclusion: Older AAO and decreased M/P area ratio were predictors for earlier dearth and institutionalization in PSP. The neuroimaging biomarker M/P area ratio was a predictor for prognosis in PSP.

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Section: Mri Acquisition and Measurementmentioning

confidence: 99%

“…The prognosis of PSP is poor with increased risks of falls, dysphagia, aspiration pneumonia and pressure ulcer, leading to institutionalization and short survival time [3]. The mean survival is only 3 to 4 years after the diagnosis and 5.3 to 13.0 years at the onset of the disease [1].…”

Section: Introductionmentioning

confidence: 99%

Midbrain/pons area ratio and clinical features predict the prognosis of progressive Supranuclear palsy

Cui

Ling

et al. 2020

BMC Neurol

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“…Multiple studies have reported that pneumonia is more likely to occur together with dementia and other neurodegenerative diseases [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42]. Attems et al [26], in an autopsy study of 308 hospitalized patients, found bronchopneumonia to be the cause of death in 45% and 28% of those with and without dementia, a significant difference, but neuropathologically-defined dementia subsets, including AD, VaD, DLB and PSP, were not statistically different in their pneumonia rates.…”

Section: Discussionmentioning

confidence: 99%

“…In many studies, predisposing factors to both bacterial pneumonia and pandemic viral lower respiratory infections are wintertime occurrence, older age, male sex, obesity, pre-existing cardiopulmonary conditions, and diabetes . Also implicated are age-related neurodegenerative diseases that cause parkinsonism and dementia [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42]. Pneumonia-associated deaths have been estimated to be twice as high in subjects with dementia [43], and the apolipoprotein E4 allele, a genetic risk factor for Alzheimer's disease (AD), has been reported to be more common in subjects dying with severe Covid-19 disease [44][45][46][47][48].…”

Section: Introductionmentioning

confidence: 99%

Increased Risk of Autopsy-Proven Pneumonia with Sex, Season and Neurodegenerative Disease

Beach¹,

Russell²,

Sue³

et al. 2021

Preprint

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There has been a markedly renewed interest in factors associated with pneumonia, a leading cause of death worldwide, due to its frequent concurrence with pandemics of influenza and Covid-19 disease. Reported predisposing factors to both bacterial pneumonia and pandemic viral lower respiratory infections are wintertime occurrence, older age, obesity, pre-existing cardiopulmonary conditions and diabetes. Also implicated are age-related neurodegenerative diseases that cause parkinsonism and dementia. We investigated the prevalence of autopsy-proven pneumonia in the Arizona Study of Aging and Neurodegenerative Disorders (AZSAND), a longitudinal clinicopathological study, between the years 2006 and 2019 and before the beginning of the Covid-19 pandemic. Of 691 subjects dying at advanced ages (mean 83.4), pneumonia was diagnosed postmortem in 343 (49.6%). There were 185 subjects without dementia or parkinsonism while clinicopathological diagnoses for the other subjects included 319 with Alzheimer’s disease dementia, 127 with idiopathic Parkinson’s disease, 72 with dementia with Lewy bodies, 49 with progressive supranuclear palsy and 78 with vascular dementia. Subjects with one or more of these neurodegenerative diseases all had higher pneumonia rates, ranging between 50 and 61%, as compared to those without dementia or parkinsonism (40%). In multivariable logistic regression models, male sex and a non-summer death both had independent contributions (ORs of 1.67 and 1.53) towards the presence of pneumonia at autopsy while the absence of parkinsonism or dementia was a significant negative predictor of pneumonia (OR 0.54). Male sex, dementia and parkinsonism may also be risk factors for Covid-19 pneumonia. The apolipoprotein E4 allele, as well as obesity, chronic obstructive pulmonary disease, diabetes, hypertension, congestive heart failure, cardiomegaly and cigarette smoking history, were not significantly associated with pneumonia, in contradistinction to what has been reported for Covid-19 disease.

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“…Predisposing factors to both acute non-Covid-19 pneumonia and epidemic Covid-19 disease include wintertime occurrence, older age, and male sex, while obesity, pre-existing cardiopulmonary conditions, and diabetes are particularly associated with Covid-19 disease . Also implicated as risk factors for both are age-related neurodegenerative diseases that cause parkinsonism and dementia [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] .…”

Section: Introductionmentioning

confidence: 99%

Acute Brain Ischemia, Infarction and Hemorrhage in Subjects Dying with or Without Autopsy-Proven Acute Pneumonia

Beach

Sue

Intorcia

et al. 2021

Preprint

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Stroke is one of the most serious complications of Covid-19 disease but it is still unclear whether stroke is more common with Covid-19 pneumonia as compared to non-Covid-19 pneumonia. We investigated the concurrence rate of autopsy-confirmed acute brain ischemia, acute brain infarction and acute brain hemorrhage with autopsy-proven acute non-Covid pneumonia in consecutive autopsies in the Arizona Study of Aging and Neurodegenerative Disorders (AZSAND), a longitudinal clinicopathological study of normal aging and neurodegenerative diseases. Of 691 subjects with a mean age of 83.4 years, acute pneumonia was histopathologically diagnosed in 343 (49.6%); the concurrence rates for histopathologically-confirmed acute ischemia, acute infarction or subacute infarction was 14% and did not differ between pneumonia and non-pneumonia groups while the rates of acute brain hemorrhage were 1.4% and 2.0% of those with or without acute pneumonia, respectively. In comparison, in reviews of Covid-19 publications, reported clinically-determined rates of acute brain infarction range from 0.5% to 20% while rates of acute brain hemorrhage range from 0.13% to 2%. In reviews of Covid-19 autopsy studies, concurrence rates for both acute brain infarction and acute brain hemorrhage average about 10%. Covid-19 pneumonia and non-Covid-19 pneumonia may have similar risks tor concurrent acute brain infarction and acute brain hemorrhage when pneumonia is severe enough to cause death. Additionally, acute brain ischemia, infarction or hemorrhage may not be more common in subjects dying of acute pneumonia than in subjects dying without acute pneumonia.

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Natural clinical course of progressive supranuclear palsy in Chinese patients in Hong Kong

Cited by 8 publications

References 28 publications

Midbrain/pons area ratio and clinical features predict the prognosis of progressive Supranuclear palsy

Midbrain/pons area ratio and clinical features predict the prognosis of progressive Supranuclear palsy

Increased Risk of Autopsy-Proven Pneumonia with Sex, Season and Neurodegenerative Disease

Acute Brain Ischemia, Infarction and Hemorrhage in Subjects Dying with or Without Autopsy-Proven Acute Pneumonia

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