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Tracking and predicting disease progression in progressive supranuclear palsy: CSF and blood biomarkers
  1. Edwin Jabbari1,
  2. Henrik Zetterberg1,2,
  3. Huw R Morris1
  1. 1 Department of Clinical Neuroscience, UCL Institute of Neurology, London, UK
  2. 2 Institute of Neuroscience and Physiology, Goteborgs Universitet, Gothenburg, Sweden
  1. Correspondence to Prof Huw R Morris, Department of Clinical Neuroscience, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; h.morris{at}


Progressive supranuclear palsy (PSP) is a rare and progressive neurodegenerative condition characterised pathologically by neuronal cell loss due to abnormal tau deposits. Clinically, the condition manifests as parkinsonism with the addition of progressive balance, speech, swallowing, eye movement and cognitive impairment, ultimately leading to death. Measuring change over time in neurodegenerative conditions is central to defining the effects of therapeutic intervention and disease biology. The current gold standard for measuring clinical disease progression in PSP is the PSP Rating Scale score. However, such scales may be affected by intrarater and inter-rater variability. In addition, their use in clinical trials may be hindered by differences in the time interval between pathological disease progression/response to therapeutics and change in clinical state. Therefore, the need for reliable disease progression biomarkers to complement clinical rating scales is clear. Here we discuss the benefits of using biomarkers to predict and track disease progression in both clinical and research settings. Through reviewing the literature to date on the role of cerebrospinal fluid (CSF) and blood biomarkers, we highlight data that reveals the ability of CSF and plasma neurofilament light chain (NF-L) to predict and track clinical disease progression in PSP. We also discuss the need for large-scale longitudinal studies to identify novel biomarkers.

  • Biomarkers
  • Progressive Supranuclear Palsy
  • Disease Progression

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  • Contributors EJ performed the literature review and wrote this manuscript.

    HZ and HRM individually reviewed and edited the manuscript.

  • Funding EJ has been supported by the PSP Association. HZ has been supported by the Swedish and European Research Councils and the Wolfson Foundation. HRM has been supported by the PSP Association, Drake Foundation, Parkinson’s UK and the Medical Research Council.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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