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Unravelling the tangled web of atypical parkinsonism

Ling, H; (2014) Unravelling the tangled web of atypical parkinsonism. Doctoral thesis , UCL (University College London). Green open access

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Abstract

This thesis focuses on sporadic parkinsonian syndromes that are associated with neurofibrillary degeneration and the accumulation of abnormal tau protein in the brain. The classic clinical presentation of corticobasal degeneration is a specific constellation of cortical and extrapyramidal signs, collectively termed corticobasal syndrome. The evaluation of all the archival cases with corticobasal degeneration in the Queen Square Brain Bank for Neurological Disorders reveals the high frequency of other phenotypic presentations. The result indicates that corticobasal degeneration commonly presents with a clinical picture, closely resembling progressive supranuclear palsy (PSP) or Richardson’s syndrome. On the other hand, cases with typical PSP pathology may occasionally present with a corticobasal syndrome. A quantitative assessment of the severity of tau pathology in different brain regions of the two phenotypic presentations of PSP reveals topographical differences that are closely linked with their respective clinical features. The features of repetitive finger tapping and handwriting in patients with PSP and Parkinson’s disease are compared and a distinct abnormality is identified in PSP which may be useful in differentiating PSP-parkinsonism from Parkinson’s disease. Twelve cases clinically presenting with a levodopa-responsive parkinsonian syndrome and post-mortem findings of nigral degeneration and predominant tau inclusions, which could not be readily classified into any recognised clinicopathological entity are also studied.

Type: Thesis (Doctoral)
Title: Unravelling the tangled web of atypical parkinsonism
Open access status: An open access version is available from UCL Discovery
Language: English
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Movement Neurosciences
URI: https://discovery.ucl.ac.uk/id/eprint/1418946
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