Current Treatment Options in Neurology

, Volume 8, Issue 3, pp 211–223 | Cite as

Current and future treatments in progressive supranuclear palsy

  • Irene van Balken
  • Irene Litvan

Opinion statement

Progressive supranuclear palsy (PSP) is an atypical parkinsonian disorder that, in spite of its growing recognition, is still underdiagnosed. For management, prognosis, and research, an accurate and early diagnosis is essential. PSP is a relentlessly progressive neurodegenerative disorder, clinically characterized by parkinsonism with prominent axial involvement and postural instability, bulbar symptoms, supranuclear ophthalmoplegia, and executive dysfunction. Abnormal neuronal and glial four-repeat tau aggregations affecting the basal ganglia and selective brainstem structures result in dysfunction of the five frontosubcortical circuits and brainstem functions. Primary therapeutic approaches are based on neurotransmitter replacement and palliative strategies. This article reviews the experience and challenges with neurotransmitter replacement and palliative strategies through an extensive literature search of studies published between 1965 and 2005. The role of and limited experience with alternative therapies, such as deep brain stimulation and pallidotomy, are also discussed. Advances in the development of biological therapies for PSP and a better understanding of its etiopathogenesis will likely result from epidemiologic studies and developed four-repeat tau-transgenic animal models. The management of patients with this disorder poses a considerable challenge and includes symptomatic and palliative strategies, as well as education and support, to improve the quality of life for patients and their caregivers.


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References and Recommended Reading

  1. 1.
    Hauw JJ, Daniel SE, Dickson D, et al.: Preliminary NINDS neuropathologic criteria for Steele-Richardson-Olszewski syndrome (progressive supranuclear palsy). Neurology 1994, 44: 2015–2019.PubMedGoogle Scholar
  2. 2.
    Litvan I, Agid Y, Calne D, et al.: Clinical research criteria for the diagnosis of progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome): report of the NINDS-SPSP international workshop. Neurology 1996, 47: 1–9.PubMedGoogle Scholar
  3. 3.
    Steele JC, Richardson JC, Olszewski J: Progressive supranuclear palsy. A heterogeneous degeneration involving the brain stem, basal ganglia and cerebellum with vertical gaze and pseudobulbar palsy, nuchal dystonia and dementia. Arch Neurol 1964, 10: 333–359.PubMedGoogle Scholar
  4. 4.
    Nath U, Burn DJ: The epidemiology of progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome). Parkinsonism Relat Disord 2000, 6: 145–153.CrossRefPubMedGoogle Scholar
  5. 5.
    Schrag A, Ben-Shlomo Y, Quinn NP: Prevalence of progressive supranuclear palsy and multiple system atrophy: a cross-sectional study. Lancet 1999, 354: 1771–1775.PubMedCrossRefGoogle Scholar
  6. 6.
    Litvan I: Diagnosis and management of progressive supranuclear palsy. Semin Neurol 2001, 21: 41–48. A systematic and complete review, discussing diagnostic difficulties and research diagnostic criteria.PubMedCrossRefGoogle Scholar
  7. 7.
    Rajput A, Rajput AH: Progressive supranuclear palsy: clinical features, pathophysiology and management. Drugs Aging 2001, 18: 913–925.PubMedCrossRefGoogle Scholar
  8. 8.
    Burn DJ, Warren NM: Toward future therapies in progressive supranuclear palsy. Mov Disord 2005, 20(Suppl 12):S92-S98.PubMedCrossRefGoogle Scholar
  9. 9.
    Barclay CL, Lang AE: Dystonia in progressive supranuclear palsy. J Neurol Neurosurg Psychiatry 1997, 62: 352–356.PubMedGoogle Scholar
  10. 10.
    Rivaud-Pechoux S, Vidailhet M, Gallouedec G, et al.: Longitudinal ocular motor study in corticobasal degeneration and progressive supranuclear palsy. Neurology 2000, 54: 1029–1032.PubMedGoogle Scholar
  11. 11.
    Esteban A, Traba A, Prieto J: Eyelid movements in health and disease. The supranuclear impairment of the palpebral motility. Neurophysiol Clin 2004, 34: 3–15.PubMedCrossRefGoogle Scholar
  12. 12.
    Litvan I, Mega MS, Cummings JL, Fairbanks L: Neuropsychiatric aspects of progressive supranuclear palsy. Neurology 1996, 47: 1184–1189.PubMedGoogle Scholar
  13. 13.
    Bak TH, Rogers TT, Crawford LM, et al.: Cognitive bedside assessment in atypical parkinsonian syndromes. J Neurol Neurosurg Psychiatry 2005, 76: 420–422.PubMedCrossRefGoogle Scholar
  14. 14.
    Litvan I: Cognitive disturbances in progressive supranuclear palsy. J Neural Transm Suppl 1994, 42: 69–78.PubMedGoogle Scholar
  15. 15.
    Choi-Kwon S, Han SW, Kwon SU, et al.: Fluoxetine treatment in poststroke depression, emotional incontinence, and anger proneness: a double-blind, placebo-controlled study. Stroke 2006, 37: 156–161.PubMedCrossRefGoogle Scholar
  16. 16.
    Iannaccone S, Ferini-Strambi L: Pharmacologic treatment of emotional lability. Clin Neuropharmacol 1996, 19: 532–535.PubMedGoogle Scholar
  17. 17.
    GoetzCG, Leurgans S, Lang AE, Litvan I: Progression of gait, speech and swallowing deficits in progressive supranuclear palsy. Neurology 2003, 60: 917–922. First study to identify outcome measures that could be used in neuroprotective trials.PubMedGoogle Scholar
  18. 18.
    Litvan I, Sastry N, Sonies BC: Characterizing swallowing abnormalities in progressive supranuclear palsy. Neurology 1997, 48: 1654–1662.PubMedGoogle Scholar
  19. 19.
    Agid Y, Javoy-Agid F, Ruberg M, et al.: Progressive supranuclear palsy: anatomoclinical and biochemical considerations. Adv Neurol 1987, 45: 191–206.PubMedGoogle Scholar
  20. 20.
    Birdi S, Rajput AH, Fenton M, et al.: Progressive supranuclear palsy diagnosis and confounding features: report on 16 autopsied cases. Mov Disord 2002, 17: 1255–1264.PubMedCrossRefGoogle Scholar
  21. 21.
    Carrilho PE, Barbosa ER: Progressive supranuclear palsy in a sample of Brazilian population: clinical features of 16 patients. Arq Neuropsiquiatr 2002, 60: 917–922.PubMedGoogle Scholar
  22. 22.
    Collins SJ, Ahlskog JE, Parisi JE, Maraganore DM: Progressive supranuclear palsy: neuropathologically based diagnostic clinical criteria. J Neurol Neurosurg Psychiatry 1995, 58: 167–173.PubMedGoogle Scholar
  23. 23.
    Defazio G, De Mari M, De Salvia R, et al.: “Apraxia of eyelid opening” induced by levodopa therapy and apomorphine in atypical parkinsonism (possible progressive supranuclear palsy): a case report. Clin Neuropharmacol 1999, 22: 292–294.PubMedGoogle Scholar
  24. 24.
    Diroma C, Dell’Aquila C, Fraddosio A, et al.: Natural history and clinical features of progressive supranuclear palsy: a clinical study. Neurol Sci 2003, 24: 176–177.PubMedCrossRefGoogle Scholar
  25. 25.
    Esmonde T, Giles E, Xuereb J, Hodges J: Progressive supranuclear palsy presenting with dynamic aphasia. J Neurol Neurosurg Psychiatry 1996, 60: 403–410.PubMedGoogle Scholar
  26. 26.
    Iijima M, Terashi H, Iwata M: A case of progressive supranuclear palsy improved with tandospirone citrate. Rinsho Shinkeigaku 2001, 41: 150–153.PubMedGoogle Scholar
  27. 27.
    Kompoliti K, Goetz CG, Litvan I, et al.: Pharmacological therapy in progressive supranuclear palsy. Arch Neurol 1998, 55: 1099–1102.PubMedCrossRefGoogle Scholar
  28. 28.
    Litvan I, Mangone CA, McKee A, et al.: Natural history of progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome) and clinical predictors of survival: a clinicopathological study. J Neurol Neurosurg Psychiatry 1996, 60: 615–620.PubMedGoogle Scholar
  29. 29.
    Marra M, Toni V, Trianni G, Coppola G: Progressive supranuclear palsy: analysis of six cases. Neurol Sci 2003, 24: 186–187.PubMedCrossRefGoogle Scholar
  30. 30.
    Nath U, Ben-Shlomo Y, Thomson RG, et al.: Clinical features and natural history of progressive supranuclear palsy: a clinical cohort study. Neurology 2003, 60: 910–916.PubMedGoogle Scholar
  31. 31.
    Nieforth KA, Golbe LI: Retrospective study of drug response in 87 patients with progressive supranuclear palsy. Clin Neuropharmacol 1993, 16: 338–346.PubMedCrossRefGoogle Scholar
  32. 32.
    Papapetropoulos S, Gonzalez J, Mash DC: Natural history of progressive supranuclear palsy: a clinicopathologic study from a population of brain donors. Eur Neurol 2005, 54: 1–9.PubMedCrossRefGoogle Scholar
  33. 33.
    Tetrud JW, Golbe LI, Forno LS, Farmer PM: Autopsyproven progressive supranuclear palsy in two siblings. Neurology 1996, 46: 931–934.PubMedGoogle Scholar
  34. 34.
    Yokoji I, Nakamura S, Ikeda T: A case of progressive supranuclear palsy associated with bilateral vocal cord abductor paralysis. Rinsho Shinkeigaku 1997, 37: 523–525.PubMedGoogle Scholar
  35. 35.
    Yoshikawa H, Oda Y, Sakajiri K, et al.: Pure akinesia manifested neuroleptic malignant syndrome: a clinical variant of progressive supranuclear palsy. Acta Neuropathol (Berl) 1997, 93: 306–309.CrossRefGoogle Scholar
  36. 36.
    Litvan I, Chase T: Traditional and Experimental Therapeutic Approaches. New York: Oxford University Press; 1992.Google Scholar
  37. 37.
    Lang AE: Treatment of progressive supranuclear palsy and corticobasal degeneration. Mov Disord 2005, 20(Suppl 12):S83-S91.PubMedCrossRefGoogle Scholar
  38. 38.
    Frattali CM, Sonies BC, Chi-Fishman G, Litvan I: Effects of physostigmine on swallowing and oral motor functions in patients with progressive supranuclear palsy: a pilot study. Dysphagia 1999, 14: 165–168.PubMedCrossRefGoogle Scholar
  39. 39.
    Kertzman C, Robinson DL, Litvan I: Effects of physostigmine on spatial attention in patients with progressive supranuclear palsy. Arch Neurol 1990, 47: 1346–1350.PubMedGoogle Scholar
  40. 40.
    Litvan I, Blesa R, Clark K, et al.: Pharmacological evaluation of the cholinergic system in progressive supranuclear palsy. Ann Neurol 1994, 36: 55–61.PubMedCrossRefGoogle Scholar
  41. 41.
    Litvan I, Gomez C, Atack JR, et al.: Physostigmine treatment of progressive supranuclear palsy. Ann Neurol 1989, 26: 404–407.PubMedCrossRefGoogle Scholar
  42. 42.
    Litvan I, Phipps M, Pharr VL, et al.: Randomized placebo-controlled trial of donepezil in patients with progressive supranuclear palsy. Neurology 2001, 57: 467–473.PubMedGoogle Scholar
  43. 43.
    Haldeman S, Goldman JW, Hyde J, Pribram HF: Progressive supranuclear palsy, computed tomography, and response to antiparkinsonian drugs. Neurology 1981, 31: 442–445.PubMedGoogle Scholar
  44. 44.
    Newman GC: Treatment of progressive supranuclear palsy with tricyclic antidepressants. Neurology 1985, 35: 1189–1193.PubMedGoogle Scholar
  45. 45.
    Asanuma M, Hirata H, Kondo Y, Ogawa N: A case of progressive supranuclear palsy showing marked improvements of frontal hypoperfusion, as well as parkinsonism with amitriptyline. Rinsho Shinkeigaku 1993, 33: 317–321.PubMedGoogle Scholar
  46. 46.
    Chiu HF, Li SW: Progressive supranuclear palsy presenting with psychiatric features. Br J Clin Pract 1996, 50: 60–61.PubMedGoogle Scholar
  47. 47.
    Engel PA: Treatment of progressive supranuclear palsy with amitriptyline: therapeutic and toxic effects. J Am Geriatr Soc 1996, 44: 1072–1074.PubMedGoogle Scholar
  48. 48.
    Fujino Y, Nakajima M, Tsuboi Y, et al.: Clinical effectiveness of tandospirone citrate (5-HT1A agonist) on patients with progressive supranuclear palsy. Rinsho Shinkeigaku 2002, 42: 42–44.PubMedGoogle Scholar
  49. 49.
    Haria M, Fitton A, McTavish D: Trazodone. A review of its pharmacology, therapeutic use in depression and therapeutic potential in other disorders. Drugs Aging 1994, 4: 331–355.PubMedGoogle Scholar
  50. 50.
    Kato E, Takahashi S, Abe T, et al.: A case of progressive supranuclear palsy showing improvement of rigidity, nuchal dystonia and autonomic failure with trazodone. Rinsho Shinkeigaku 1994, 34: 1013–1017.PubMedGoogle Scholar
  51. 51.
    Schneider LS, Gleason RP, Chui HC: Progressive supranuclear palsy with agitation: response to trazodone but not to thiothixine or carbamazepine. J Geriatr Psychiatry Neurol 1989, 2: 109–112.PubMedCrossRefGoogle Scholar
  52. 52.
    Tamai S, Almeida OP: Nortriptyline for the treatment of depression in progressive supranuclear palsy. J Am Geriatr Soc 1997, 45: 1033–1034.PubMedGoogle Scholar
  53. 53.
    Duncombe AS, Lees AJ: Methysergide in progressive supranuclear palsy. Neurology 1985, 35: 936–937.PubMedGoogle Scholar
  54. 54.
    Rafal RD, Grimm RJ: Progressive supranuclear palsy: functional analysis of the response to methysergide and antiparkinsonian agents. Neurology 1981, 31: 1507–1518.PubMedGoogle Scholar
  55. 55.
    Rascol O, Sieradzan K, Peyro-Saint-Paul H, et al.: Efaroxan, an alpha-2 antagonist, in the treatment of progressive supranuclear palsy. Mov Disord 1998, 13: 673–676.PubMedCrossRefGoogle Scholar
  56. 56.
    Ghika J, Tennis M, Hoffman E, et al.: Idazoxan treatment in progressive supranuclear palsy. Neurology 1991, 41: 986–991.PubMedGoogle Scholar
  57. 57.
    Ota S, Tsuchiya K: Pure akinesia presenting with antecollis. No To Shinkei 2005, 57: 893–898.PubMedGoogle Scholar
  58. 58.
    Yamamoto M, Fujii S, Hatanaka Y: Result of long-term administration of L-threo-3,4-dihydroxyphenylserine in patients with pure akinesia as an early symptom of progressive supranuclear palsy. Clin Neuropharmacol 1997, 20: 371–373.PubMedCrossRefGoogle Scholar
  59. 59.
    Levy R, Ruberg M, Herrero MT, et al.: Alterations of GABAergic neurons in the basal ganglia of patients with progressive supranuclear palsy: an in situ hybridization study of GAD67 messenger RNA. Neurology 1995, 45: 127–134.PubMedGoogle Scholar
  60. 60.
    Daniele A, Moro E, Bentivoglio AR: Zolpidem in progressive supranuclear palsy. N Engl J Med 1999, 341: 543–544.PubMedCrossRefGoogle Scholar
  61. 61.
    Hardman CD, Halliday GM: The internal globus pallidus is affected in progressive supranuclear palsy and Parkinson’s disease. Exp Neurol 1999, 158: 135–142.PubMedCrossRefGoogle Scholar
  62. 62.
    Hardman CD, Halliday GM: The external globus pallidus in patients with Parkinson’s disease and progressive supranuclear palsy. Mov Disord 1999, 14: 626–633.PubMedCrossRefGoogle Scholar
  63. 63.
    Kuhn AA, Grosse P, Holtz K, et al.: Patterns of abnormal motor cortex excitability in atypical parkinsonian syndromes. Clin Neurophysiol 2004, 115: 1786–1795.PubMedCrossRefGoogle Scholar
  64. 64.
    Okun MS, Tagliati M, Pourfar M, et al.: Management of referred deep brain stimulation failures: a retrospective analysis from 2 movement disorders centers. Arch Neurol 2005, 62: 1250–1255.PubMedCrossRefGoogle Scholar
  65. 65.
    Plaha P, Gill SS: Bilateral deep brain stimulation of the pedunculopontine nucleus for Parkinson’s disease. Neuroreport 2005, 16: 1883–1887.PubMedCrossRefGoogle Scholar
  66. 66.
    Goetz CG, Olanow CW, Koller WC, et al.: Multicenter study of autologous adrenal medullary transplantation to the corpus striatum in patients with advanced Parkinson’s disease. N Engl J Med 1989, 320: 337–341.PubMedCrossRefGoogle Scholar
  67. 67.
    Koller WC, Morantz R, Vetere-Overfield B, Waxman M: Autologous adrenal medullary transplant in progressive supranuclear palsy. Neurology 1989, 39: 1066–1068.PubMedGoogle Scholar
  68. 68.
    Ward-Smith PA, Berry P: Autologous transplantation as a treatment for progressive supranuclear palsy. J Neurosci Nurs 1990, 22: 100–103.PubMedGoogle Scholar
  69. 69.
    Cordivari C, Misra VP, Catania S, Lees AJ: New therapeutic indications for botulinum toxins. Mov Disord 2004, 19(Suppl 8):S157-S161.PubMedCrossRefGoogle Scholar
  70. 70.
    Ondo WG, Hunter C, Moore W: A double-blind placebo-controlled trial of botulinum toxin B for sialorrhea in Parkinson’s disease. Neurology 2004, 62: 37–40.PubMedGoogle Scholar
  71. 71.
    Muller J, Wenning GK, Wissel J, et al.: Botulinum toxin treatment in atypical parkinsonian disorders associated with disabling focal dystonia. J Neurol 2002, 249: 300–304.PubMedCrossRefGoogle Scholar
  72. 72.
    Skogseid IM, Kerty E: The course of cervical dystonia and patient satisfaction with long-term botulinum toxin A treatment. Eur J Neurol 2005, 12: 163–170.PubMedCrossRefGoogle Scholar
  73. 73.
    Cordivari C, Misra VP, Catania S, Lees AJ: Treatment of dystonic clenched fist with botulinum toxin. Mov Disord 2001, 16: 907–913.PubMedCrossRefGoogle Scholar
  74. 74.
    Jankovic J: Pretarsal injection of botulinum toxin for blepharospasm and apraxia of eyelid opening. J Neurol Neurosurg Psychiatry 1996, 60: 704.PubMedCrossRefGoogle Scholar
  75. 75.
    Silveira-Moriyama L, Goncalves LR, Chien HF, Barbosa ER: Botulinum toxin A in the treatment of blepharospasm: a 10-year experience. Arq Neuropsiquiatr 2005, 63: 221–224.PubMedGoogle Scholar
  76. 76.
    Cakmur R, Ozturk V, Uzunel F, et al.: Comparison of preseptal and pretarsal injections of botulinum toxin in the treatment of blepharospasm and hemifacial spasm. J Neurol 2002, 249: 64–68.PubMedCrossRefGoogle Scholar
  77. 77.
    Uttl B, Santacruz P, Litvan I, Grafman J: Caregiving in progressive supranuclear palsy. Neurology 1998, 51: 1303–1309.PubMedGoogle Scholar
  78. 78.
    Losada Baltar A, Izal Fernandez de Troconiz M, Montorio Cerrato I, et al.: Differential efficacy of two psychoeducational interventions for dementia family caregivers. Rev Neurol 2004, 38: 701–708.Google Scholar
  79. 79.
    Baker M, Litvan I, Houlden H, et al.: Association of an extended haplotype in the tau gene with progressive supranuclear palsy. Hum Mol Genet 1999, 8: 711–715.PubMedCrossRefGoogle Scholar
  80. 80.
    Pastor P, Ezquerra M, Tolosa E, et al.: Further extension of the H1 haplotype associated with progressive supranuclear palsy. Mov Disord 2002, 17: 550–556.PubMedCrossRefGoogle Scholar
  81. 81.
    Buee L, Bussiere T, Buee-Scherrer V, et al.: Tau protein isoforms, phosphorylation and role in neurodegenerative disorders. Brain Res Brain Res Rev 2000, 33: 95–130.PubMedCrossRefGoogle Scholar
  82. 82.
    Jope RS, Johnson GV: The glamour and gloom of glycogen synthase kinase-3. Trends Biochem Sci 2004, 29: 95–102.PubMedCrossRefGoogle Scholar
  83. 83.
    Nakashima H, Ishihara T, Suguimoto P, et al.: Chronic lithium treatment decreases tau lesions by promoting ubiquitination in a mouse model of tauopathies. Acta Neuropathol (Berl) 2005, 110: 547–556.CrossRefGoogle Scholar
  84. 84.
    NobleW, Planel E, Zehr C, et al.: Inhibition of glycogen synthase kinase-3 by lithium correlates with reduced tauopathy and degeneration in vivo. Proc Natl Acad Sci U S A 2005, 102: 6990–6995. Illustration of the benefits of using of a tau animal model to test emerging therapeutic approaches for PSP.PubMedCrossRefGoogle Scholar
  85. 85.
    Chauhan NB, Siegel GJ, Feinstein DL: Propentofylline attenuates tau hyperphosphorylation in Alzheimer’s Swedish mutant model Tg2576. Neuropharmacology 2005, 48: 93–104.PubMedCrossRefGoogle Scholar
  86. 86.
    Frampton M, Harvey RJ, Kirchner V: Propentofylline for dementia. Cochrane Database Syst Rev 2003, CD002853.Google Scholar
  87. 87.
    Albers DS, Augood SJ, Martin DM, et al.: Evidence for oxidative stress in the subthalamic nucleus in progressive supranuclear palsy. J Neurochem 1999, 73: 881–884.PubMedCrossRefGoogle Scholar
  88. 88.
    Albers DS, Augood SJ, Park LC, et al.: Frontal lobe dysfunction in progressive supranuclear palsy: evidence for oxidative stress and mitochondrial impairment. J Neurochem 2000, 74: 878–881.PubMedCrossRefGoogle Scholar
  89. 89.
    Odetti P, Garibaldi S, Norese R, et al.: Lipoperoxidation is selectively involved in progressive supranuclear palsy. J Neuropathol Exp Neurol 2000, 59: 393–397.PubMedGoogle Scholar
  90. 90.
    Beal MF: Bioenergetic approaches for neuroprotection in Parkinson’s disease. Ann Neurol 2003, 53(Suppl 3):S39-S47; discussion S-8.PubMedCrossRefGoogle Scholar
  91. 91.
    Beal MF: Mitochondrial dysfunction and oxidative damage in Alzheimer’s and Parkinson’s diseases and coenzyme Q10 as a potential treatment. J Bioenerg Biomembr 2004, 36: 381–386.PubMedCrossRefGoogle Scholar
  92. 92.
    Golbe LI, Rubin RS, Cody RP, et al.: Follow-up study of risk factors in progressive supranuclear palsy. Neurology 1996, 47: 148–154.PubMedGoogle Scholar
  93. 93.
    Caparros-Lefebvre D, Lees AJ: Atypical unclassifiable parkinsonism on Guadeloupe: an environmental toxic hypothesis. Mov Disord 2005, 20(Suppl 12):S114-S118.PubMedCrossRefGoogle Scholar
  94. 94.
    Levi-Montalcini R, Hamburger V: Selective growth stimulating effects of mouse sarcoma on the sensory and sympathetic nervous system of the chick embryo. J Exp Zool 1951, 116: 321–361.PubMedCrossRefGoogle Scholar
  95. 95.
    Kordower JH, Palfi S, Chen EY, et al.: Clinicopathological findings following intraventricular glial-derived neurotrophic factor treatment in a patient with Parkinson’s disease. Ann Neurol 1999, 46: 419–424.PubMedCrossRefGoogle Scholar
  96. 96.
    Tuszynski MH: Growth-factor gene therapy for neurodegenerative disorders. Lancet Neurol 2002, 1: 51–57.PubMedCrossRefGoogle Scholar
  97. 97.
    Gash DM, Zhang Z, Ai Y, et al.: Trophic factor distribution predicts functional recovery in parkinsonian monkeys. Ann Neurol 2005, 58: 224–233.PubMedCrossRefGoogle Scholar
  98. 98.
    Patel NK, Bunnage M, Plaha P, et al.: Intraputamenal infusion of glial cell line-derived neurotrophic factor in PD: a two-year outcome study. Ann Neurol 2005, 57: 298–302.PubMedCrossRefGoogle Scholar
  99. 99.
    Lang AE, Gill S, Patel NK, et al.: Randomized controlled trial of intraputamenal glial cell line-derived neurotrophic factor infusion in Parkinson’s disease. Ann Neurol 2006, In Press.Google Scholar
  100. 100.
    Blesch A, Tuszynski MH: Gene therapy and cell transplantation for Alzheimer’s disease and spinal cord injury. Yonsei Med J 2004, 45(Suppl):28–31.PubMedGoogle Scholar
  101. 101.
    Fjord-Larsen L, Johansen JL, Kusk P, et al.: Efficient in vivo protection of nigral dopaminergic neurons by lentiviral gene transfer of a modified Neurturin construct. Exp Neurol 2005, 195: 49–60.PubMedCrossRefGoogle Scholar
  102. 102.
    Tuszynski MH, Thal L, Pay M, et al.: A phase 1 clinical trial of nerve growth factor gene therapy for Alzheimer disease. Nat Med 2005, 11: 551–555.PubMedCrossRefGoogle Scholar
  103. 103.
    Clarkson ED: Fetal tissue transplantation for patients with Parkinson’s disease: a database of published clinical results. Drugs Aging 2001, 18: 773–785.PubMedCrossRefGoogle Scholar
  104. 104.
    WilliamsDR, de Silva R, Paviour DC, et al.: Characteristics of two distinct clinical phenotypes in pathologically proven progressive supranuclear palsy: Richardson’s syndrome and PSP-parkinsonism. Brain 2005, 128: 1247–1258. Evaluation of the clinical manifestations of the disorder in a large sample of pathologically confirmed PSP cases.PubMedCrossRefGoogle Scholar
  105. 105.
    Neophytides A, Lieberman AN, Goldstein M, et al.: The use of lisuride, a potent dopamine and serotonin agonist, in the treatment of progressive supranuclear palsy. J Neurol Neurosurg Psychiatry 1982, 45: 261–263.PubMedGoogle Scholar
  106. 106.
    Parkes JD, Schachter M, Marsden CD, et al.: Lisuride in parkinsonism. Ann Neurol 1981, 9: 48–52.PubMedCrossRefGoogle Scholar
  107. 107.
    Jankovic J: Controlled trial of pergolide mesylate in Parkinson’s disease and progressive supranuclear palsy. Neurology 1983, 33: 505–507.PubMedGoogle Scholar
  108. 108.
    Weiner WJ, Minagar A, Shulman LM: Pramipexole in progressive supranuclear palsy. Neurology 1999, 52: 873–874.PubMedGoogle Scholar
  109. 109.
    Fabbrini G, Barbanti P, Bonifati V, et al.: Donepezil in the treatment of progressive supranuclear palsy. Acta Neurol Scand 2001, 103: 123–125.PubMedCrossRefGoogle Scholar
  110. 110.
    Blin J, Mazetti P, Mazoyer B, et al.: Does the enhancement of cholinergic neurotransmission influence brain glucose kinetics and clinical symptomatology in progressive supranuclear palsy? Brain 1995, 118: 1485–1495.PubMedCrossRefGoogle Scholar
  111. 111.
    Foster NL, Aldrich MS, Bluemlein L, et al.: Failure of cholinergic agonist RS-86 to improve cognition and movement in PSP despite effects on sleep. Neurology 1989, 39: 257–261.PubMedGoogle Scholar
  112. 112.
    Yamashi M, Sanada J, Miyazaki Y, Ikeda H: Short-term treatment of progressive supranuclear palsy with amitriptyline. Rinsho Shinkeigaku 1986, 26: 1138–1141.PubMedGoogle Scholar
  113. 113.
    Sandyk R, Snider SR: Naloxone in progressive supranuclear palsy. Clin Neuropharmacol 1985, 8: 198–199.PubMedCrossRefGoogle Scholar

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© Current Science Inc 2006

Authors and Affiliations

  • Irene van Balken
  • Irene Litvan
    • 1
  1. 1.Department of NeurologyUniversity of Louisville School of MedicineLouisvilleUSA

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