Objective: This study aims to investigate volumetric brain MRI features, clinical parameters and their correlations in the Study of Comprehensive ANd multimodal marker-based Cohort of Progressive Supranuclear Palsy (SCAN-PSP, NCT05579301) cohort.

Background: Despite numerous clinical trials, no effective disease-modifying treatment has been established in PSP. It is necessary to develop biomarkers effectively reflecting disease progression and predicting prognosis. Here, we present the baseline properties of the SCAN-PSP cohort.

Method: Sixty-nine patients were prospectively enrolled from the two referral hospitals (SNU-SMG Boramae Medical Center and SNU Hospital) between Jan 2022 and Aug 2023. Data from thirty-two age-matched healthy controls (HC) of SNU-BMC were included. Patients were evaluated with the PSP-rating scale and classified according to the MDS-PSP diagnostic criteria. Clinical status was also evaluated with SEADL, MMSE, MoCA, and the H&Y scales. To explore the relationship between clinical parameters and brain volume, we conducted partial correlations controlling for age, sex, and TIV. To assess volumetric differences between groups, we adjusted for the same covariates using ANCOVA followed by the FDR method.

Results: PSP patients consisted of 46 (66.7%) males with age at onset of 67.2 ± 6.4 years and disease duration of 4.4 ± 2.4 years. Compared to HC, PSP group showed significant cognitive decline and atrophy in the cortex, subcortex, and brainstem. In subgroup analysis, PSP-RS (n=36) group showed more volume loss in the midbrain, pons, bilateral lateral temporal cortex than PSP-PGF (n=7). PSP-RS group also showed more atrophic change in midbrain and SCP than PSP-P (n=22). No volume difference was found between PSP-P and PSP-PGF. Total PSP-rating score and SEADL were well correlated with bilateral frontal, lateral temporal, occipital and right medial temporal cortex. A significant intercorrelation was also observed between the Total PSP-rating scale and SEADL scores. SEADL was a good indicator of overall brain atrophy in PSP patients across various subtypes.

Conclusion: In our study, the correlation between atrophy of the frontal lobe and clinical parameters aligns with previous studies. Brain volumetric indices may serve as an indicator of PSP severity or progression. Research on the follow-up of brain volume and clinical parameters are on-going in this cohort.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-characteristics-and-brain-atrophy-pattern-in-the-prospective-multicenter-cohort-of-progressive-supranuclear-palsy/