Objective: To correlate blood and electrophysiological biomarkers in Progressive Supranuclear Palsy – Richardson’s type (PSP-RS) patients with brain structural alterations using neuromorphometry.

Background: Various biomarkers, including blood-based, electrophysiological, and neuroimaging markers, have been individually studied in progressive supranuclear palsy-Richardson syndrome (PSP-RS). However, the relationships and correlations between these different biomarkers remain unexplored. Our research aims to investigate the interconnections between multiple biomarkers and their collective role in PSP-RS.

Method: We recruited 11 PSP-RS patients and 13 healthy controls. The PSP rating scale assessed disease severity. The Montreal Cognitive Assessment (MoCA) and Frontal Assessment Battery (FAB) assessed cognitive and executive function. Subjects had 3D T1 MPRAGE brain MRIs. Software Freesurfer was used for neuromorphometry. ELISA for the GFAP, NfL, GDNF, and IL-6 were performed. Response inhibition measured by a portable device.

Results: In PSP, NfL levels increased significantly (p < 0.0001) and correlated with disease severity (p < 0.001). NfL levels correlated with the left rostral anterior cingulate volume (p = 0.007) and surface area (p = 0.035), left transverse temporal surface area (p = 0.016), and left superior parietal and right supramarginal curvature. GFAP/NfL significantly decreased (p = 0.014) in PSP. FAB and MoCA(p<0.001), PSPRS and MoCA (p=0.002), MoCA and NfL (p < 0.001), MoCA and GFAP/NfL (p=0.007), FAB and NfL (P<0.001), FAB and GFAP/NfL (p < 0.001), Median of reaction time (MedRT) and IL-6 (p=0.025), GDNF/NfL and SSRT-Stop signal reaction time (p=0.020), MedRT and CSF volume (p=0.033),SSRT and Right inferior lateral ventricle (p=0.018), SSRT and Cerebral white matter volume (p=0.003),SSRT and right caudal anterior cingulate volume (p=0.017) & SSRT and right temporalpole volume (p<0.001) significantly correlated.

Conclusion: Higher NfL levels linked with disease severity and brain anatomical abnormalities in PSP-RS patients. A low GFAP/NfL ratio suggests neuronal injury over glial involvement in PSP pathophysiology. Response inhibition as an electrophysiological metric indicates executive dysfunction in the patient group. The findings show that neuromorphometric measurements, blood and electrophysiological biomarkers may help identify PSP early.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/exploring-the-correlation-of-neuroimaging-molecular-and-electrophysiological-biomarkers-in-patients-with-progressive-supranuclear-palsy-richardson-type/