The impact of white matter damage on cognition in PSP syndrome: a DT MRI study (P1.181)

Objective: To explore the impact of white matter (WM) tract damage on cognitive performances in a relatively large sample of patients with probable progressive supranuclear palsy syndrome (PSPs) using diffusion tensor (DT) MRI. Background: Beside of motor symptoms, PSPs is characterized by behavioral abnormalities and cognitive impairment. This might be related to the disconnection between cortico-cortical and cortico-subcortical structures due to damage of the main WM tracts. Methods: We enrolled 32 patients with probable PSPs in a moderate stage of the disease (mean H&Y score: 3.3) and 22 matched healthy controls. Patients underwent an extensive neuropsychological evaluation. DT MRI and tract-based spatial statistics were used to assess the regional patterns of WM microstructural damage in patients relative to controls. Then, a regression analysis was conducted to correlate DT MRI metrics of the main WM tracts with cognitive variables. Results: PSPs patients showed prominent attentive-executive deficits that were related to the damage of specific WM tracts as revealed by DT MRI. The following significant correlations were observed: attentive matrices scores with WM damage of the fornix, left cingulum, superior longitudinal fasciculus (SLF), right superior fronto-occipital fasciculus and bilateral cortico-spinal tract (CST); Raven matrices scores with fornix; token test scores with DT MRI measures of the fornix, bilateral inferior and middle cerebellar peduncle, cingulum, CST, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, left SLF and splenium of corpus callosum; fluencies scores with damage to bilateral superior cerebellar peduncles, left SLF and CST. Conclusions: In PSPs, WM damage has a central role in the development of executive and language dysfunction. Study supported by: CurePSP Foundation (#MD505-12_001). Disclosure: Dr. Caso has nothing to disclose. Dr. Agosta has received personal compensation for activities with Biogen Idec and Serono Symposia International Foundation. Dr. Volonte has nothing to disclose. Dr. Marcone has nothing to disclose. Dr. Copetti has nothing to disclose. Dr. Spagnolo has nothing to disclose. Dr. Falautano has nothing to disclose. Dr. Falini has nothing to disclose. Dr. Comi has received personal compensation for activities with Teva, Novartis, Genzyme, Merck Serono, Biogen Idec, Bayer, Actelion Pharmaceuticals, Almirall, and Serono. Cure PSP, Alzheimer9s Drug Discovery Foundation, and the Jacques and Gloria Gossweiler