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Pupil diameter in darkness differentiates progressive supranuclear palsy (PSP) from other extrapyramidal syndromes

Authors

  • Claudia Schmidt MD,

    1. Autonomic and Neuroendocrinological laboratory, University Clinic Carl Gustav Carus, Dresden University of Technology, Germany
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    • C.S. and B.H. contributed equally to this work as first authors.

  • Birgit Herting MD,

    1. Department of Neurology, Movement Disorders Research Group, University Clinic Carl Gustav Carus, Dresden University of Technology, Germany
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    • C.S. and B.H. contributed equally to this work as first authors.

  • Silke Prieur,

    1. Autonomic and Neuroendocrinological laboratory, University Clinic Carl Gustav Carus, Dresden University of Technology, Germany
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  • Susann Junghanns MD,

    1. Department of Neurology, Movement Disorders Research Group, University Clinic Carl Gustav Carus, Dresden University of Technology, Germany
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  • Katherine Schweitzer MD,

    1. Center of Neurology, Department of Neurodegeneration and Hertie-Institute of Clinical Brain Research University of Tübingen, Germany
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  • Christoph Globas MD,

    1. Center of Neurology, Department of Neurodegeneration and Hertie-Institute of Clinical Brain Research University of Tübingen, Germany
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  • Ludger Schöls MD,

    1. Center of Neurology, Department of Neurodegeneration and Hertie-Institute of Clinical Brain Research University of Tübingen, Germany
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  • Sabine Antoni PhD,

    1. Department of Mathematics, Dresden University of Technology, Germany
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  • Dietmar Ferger PhD,

    1. Department of Mathematics, Dresden University of Technology, Germany
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  • Heinz Reichmann MD,

    1. Department of Neurology, Movement Disorders Research Group, University Clinic Carl Gustav Carus, Dresden University of Technology, Germany
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  • Helmut Wilhelm MD,

    1. Department of Neuroophthalmology, University Eye Hospital, Tübingen, Germany
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  • Daniela Berg MD,

    1. Center of Neurology, Department of Neurodegeneration and Hertie-Institute of Clinical Brain Research University of Tübingen, Germany
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  • Tjalf Ziemssen MD

    Corresponding author
    1. Autonomic and Neuroendocrinological laboratory, University Clinic Carl Gustav Carus, Dresden University of Technology, Germany
    • ANF Labor, Klinik und Poliklinik für Neurologie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstraβe 74, D-01307 Dresden, Germany
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Abstract

The most important features that characterize and differentiate progressive supranuclear palsy from other Parkinsonian syndromes are postural instability, supranuclear gaze palsy, pseudobulbar palsy, parkinsonism, and cognitive disturbances. In this article, we demonstrate that progressive supranuclear palsy patients exhibit pathologically decreased pupil diameters after dark adaptation recorded by TV pupillography. A cut off value of 3.99 mm was defined to differentiate progressive supranuclear palsy patients from patients with other extrapyramidal disorders like Parkinson's disease and multiple system atrophy with a specificity of 86.4% and a sensitivity of 70.8%. Other pupil abnormalities could not be described in patients with extrapyramidal syndromes. © 2007 Movement Disorder Society

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