Progressive supranuclear palsy (PSP) is a condition classified as atypical parkinsonism. Pathologically, it is a four-repeat tauopathy; clinically, it is a disease comprising oculomotor dysfunction, postural instability, akinesia, and cognitive/language disorders. Its pathogenesis is not fully recognized; however, neuroinflammation is considered to likely be a significant aspect, though it is not known whether inflammation is a cause or consequence of neurodegeneration. In this study, the authors analyzed the association between inflammatory/neurotrophic factors and parameters linked to quality of life, based on examinations of 10 controls and 11 patients with PSP. They found a negative correlation between mPSPRS (Modified Progressive Supranuclear Palsy Rating Scale) and the glial cell-line-derived neurotrophic factor levels (GDNF) (r = −0.772727, p = 0.003) in the serum, a less pronounced negative correlation between progressive supranuclear palsy–quality of life parameter (PSP-QoL) and GDNF (r = −0.68390, p = 0.011) in the serum, and no correlations were observed in the analyses of inflammatory factors. The obtained results show the association between lower levels of GDNF and more pronounced clinical deterioration. Further analysis in the field based on larger groups of patients is required.

Background: Research has associated chronic inflammation with the evolution of neurological and psychiatric disorders. Neurodegenerative diseases, including Parkinson’s Disease (PD), Alzheimer’s Disease (AD), and less common ones such as Progressive Supranuclear Palsy (PSP), are commonly linked to depression. However, the pathomechanisms and the role of neuroinflammation in these disorders remain unclear; therefore, interest is increasing in easily accessible inflammatory morphological assessments of blood samples, such as the neutrophil-to-lymphocyte ratio (NLR), the neutrophil-to-monocyte ratio (NMR), and the neutrophil-to-hemoglobin ratio (N/HGBR). Methods: The authors analyzed 15 age-matched controls and 21 patients with PSP; the PSP group was additionally divided into 11 patients without depression (PSP) and 10 with depression (Beck Depression Inventory [BDI] ≥ 14) (PSP-D). Results: In the PSP-D group, the level of N/HGBR was significantly lower than in the controls (p = 0.01), but there were no significant differences in any other neutrophil-derived parameters or comparisons of morphological blood assessment. Patients with PSP-D exhibited a marginally significant decrease in neutrophil levels compared to the controls. Conclusions: This is the first study highlighting the possible significance of peripheral inflammatory factors in patients with PSP affected by depression. It highlights possible tendencies in the area of non-specific inflammatory markers and suggests their relation to affective disorders in PSP.

Transcranial sonography is one of the methods of examination used in atypical parkinsonian syndromes. The assessment is not indicated in the diagnostic criteria of entities in this group e.g., Progressive Supranuclear Palsy, Corticobasal Degeneration, Multiple System Atrophy and Dementia with Lewy Bodies. Atypical parkinsonisms are a group of diseases affected by diverse pathologies including alpha-synuclein or tau among others. Recently broader attention was brought to less common atypical parkinsonisms as Perry syndrome. Atypical parkinsonisms are related to poor response to levodopa treatment, rapid deterioration and unfavorable prognosis. Additionally, the entities often overlap in terms of clinical manifestation, especially in the early stages. Though atypical parkinsonisms are affected by the lack of possibility of obtaining definite in vivo diagnosis, growing interest is associated to supplementary evaluations including neuroimaging. Among these methods could be mentioned magnetic resonance imaging, positron emission tomography, single photon emission computed tomography and transcranial sonography. Transcranial sonography is associated with high accessibility and low cost. The goal of this paper is to highlight the strengths and weaknesses of transcranial sonography in the examination of atypical parkinsonisms.