Progressive Supranuclear Palsy

UT Southwestern Medical Center offers compassionate care for people with progressive supranuclear palsy (PSP), providing accurate diagnosis and symptom management based on the latest research.

Our clinicians and researchers are on a mission to make advances in PSP and lessen the burden of this disease for as many patients as possible.

Why Choose UT Southwestern for Progressive Supranuclear Palsy Care?

Progressive supranuclear palsy is a degenerative condition that affects brain functions such as mobility, speech, and cognition. PSP affects 1 in 10,000 people in the U.S. – men and women equally – and most commonly develops after age 60.

As a regional referral center for a wide range of movement and neurodegenerative disorders, UT Southwestern provides accurate diagnosis and the best available services for PSP patients and their caregivers.

What Are Symptoms of Progressive Supranuclear Palsy?

The early symptoms of PSP are often attributed to the aging process. In many cases, after a few months, it becomes increasingly apparent that the changes are not part of normal aging.

Early symptoms can include subtle changes in speech, mood, cognition, and behavior. For example, a person can become apathetic or seem slow to comprehend new information. In addition, early symptoms include:

Slowing of movement
Stiffness in the muscles of the neck and limbs
Unsteadiness and loss of balance, leading to falls
Vision problems, such as blurriness, dry eyes, or difficulty focusing and following

Sometimes these symptoms lead to a misdiagnosis of Parkinson’s disease. Other symptoms that can distinguish PSP from Parkinson’s include:

A staring face
Furrowed forehead
Reduced blink rate
Slow, dream-like gestures and movements
Strained, slow voice
Tendency to drop uncontrollably into a chair instead of lowering oneself

The disease affects different people differently. Function declines over the course of five to 10 years, but the rate of change and the symptoms can vary. As the disease progresses, patients might experience:

Confusion
Decreased skill in hand function
Dementia
Depression
Heightened emotions (laughing or crying at minor stimuli)
Impaired speech and swallowing
Postural instability leading to recurrent falls, especially backward falls when changing direction
Slower movements

In very advanced PSP, maintaining proper nutrition becomes more difficult, and declining lung clearance is common in the final stages of illness.

How Is Progressive Supranuclear Palsy Diagnosed?

Many patients with PSP have been misdiagnosed as having Parkinson’s disease, Alzheimer’s disease, or a vascular disease (such as a stroke). Specialists at UT Southwestern Medical Center have the experience and expertise to recognize and accurately diagnose PSP.

Diagnosis begins with a thorough physical examination and assessment of the patient’s symptoms. Other tests that are done include:

A magnetic resonance image (MRI) of the brain, which can show areas with shrunken volume, particularly in the midbrain
Blood and spinal fluid tests, which cannot confirm a diagnosis of PSP but can rule out other possible causes for the symptoms

A physician who is familiar with PSP can make a clinical diagnosis based on symptoms, a brain MRI, and absence of a better explanation for the patient’s problems.

How Is Progressive Supranuclear Palsy Treated?

While there is no cure for PSP and no treatment that slows the disease’s progression, treatment can relieve some of the symptoms, such as:

Emotional volatility
Eyelid closure
Fall risk
Insomnia
Motor slowing
Muscle spasms
Swallowing difficulty

UT Southwestern physicians and researchers also combat PSP by:

Collaborating and sharing knowledge with colleagues throughout the country and around the world
Educating patients, families, caregivers, physicians, and the community about PSP
Providing excellent clinical care for people with PSP
Researching cures and symptomatic treatments
Studying the disease process itself

What Clinical Trials Are Available for Progressive Supranuclear Palsy?

PSP is less common than Parkinson’s and Alzheimer’s diseases, which means historically there has been far less research into PSP. Specialists at UT Southwestern are part of a growing community of clinicians and researchers who are investigating treatments to relieve PSP symptoms and improve understanding of the disease itself. Learn more about research into PSP.