Dominance of Tau Burden in Cortical Over Subcortical Regions Mediates Glymphatic Activity and Clinical Severity in PSP

• Published in: Clinical nuclear medicine 2024-05, Vol.49 (5), p.387-396
• Main Authors: Hsu, Jung-Lung, Wei, Yi-Chia, Hsiao, Ing-Tsung, Lin, Kun-Ju, Yen, Tzu-Chen, Lu, Chin-Song, Wang, Han-Cheng, Leemans, Alexander, Weng, Yi-Hsin, Huang, Kuo-Lun
• Format: Article
• Language: English
• ISSN: 0363-9762; 1536-0229
• DOI: 10.1097/RLU.0000000000005141

Progressive supranuclear palsy (PSP) is a tauopathy that involves subcortical regions but also extends to cortical areas. The clinical impact of different tau protein sites and their influence on glymphatic dysfunction have not been investigated. Participants (n = 55; 65.6 ± 7.1 years; 29 women) with PSP (n = 32) and age-matched normal controls (NCs; n = 23) underwent 18 F-Florzolotau tau PET, MRI, PSP Rating Scale (PSPRS), and Mini-Mental State Examination. Cerebellar gray matter (GM) and parametric estimation of reference signal intensity were used as references for tau burden measured by SUV ratios. Glymphatic activity was measured by diffusion tensor image analysis along the perivascular space (DTI-ALPS). Parametric estimation of reference signal intensity is a better reference than cerebellar GM to distinguish tau burden between PSP and NCs. PSP patients showed higher cortical and subcortical tau SUV ratios than NCs ( P < 0.001 and