Glossary of key terms in PSP

Grasping PSP's intricacies hinges on understanding key definitions and concepts. Familiarity with these principles will help you navigate its complexities.

Hyperphosphorylated tau (p-tau)

Tau protein with an excessive number of phosphate groups attached, causing it to detach from microtubules, misfold, and aggregate into toxic NFTs that disrupt neuronal function.

[42]

Hypokinesis

Significant impairment in the ability to perform normal motor actions.

[43]

Hypometabolism (in this case, referred to the brain)

A reduction in glucose uptake and energy activity in specific brain regions, seen as areas of low tracer signal on FDG-PET, usually reflecting neuronal dysfunction or loss.

[44]

Imaging-supported diagnosis

A diagnosis reinforced by findings from imaging techniques (e.g., MRI, PET) that show disease-specific changes.

[5]

Immunotherapy

A type of therapy based on stimulating or suppressing the immune system.

[25]

Incidence

The number of new cases of a disease occurring in a specific population over a specific period of time.

[45]

Intracellular

Located or occurring within the interior of a cell.

[46]

Isoforms

Variants of a protein that can slightly differ in structure and function. E.g. tau can appear as 3R and 4R.

[47] [48]

Macro square wave jerks

Involuntary, large-amplitude, horizontal eye movements that temporarily move the eyes away from and then back to a fixation point.

[5]

Mechanism of action (MoA)

The specific physiological process through which a drug produces its therapeutic effect in the body.

[49]

Mentation

Refers to cognitive and mental functioning, such as thinking, memory, attention and judgement.

[6]

Microtubules (MTs)

Cylindrical protein filaments forming part of the cell’s cytoskeleton, essential for maintaining cell shape, intracellular transport, and cell division.

[12]

Misdiagnosis

An incorrect identification of a disease, often leading to inappropriate treatment or delays in receiving appropriate treatment.

[50]

Monoclonal antibodies (mAb)

Laboratory-produced antibodies engineered to recognize and bind specific antigens.

[51]

Mortality

In medicine, the term is used as the number of deaths in a population during a specific period of time.

[52]

Movement disorders (MD)

Group of neurological conditions primarily affecting the control of voluntary and involuntary movements, resulting in symptoms such as stiffness, slowness or tremors.

[53]

Multidisciplinary

An integrated approach to care provided by a team of specialists. In the case of PSP, the multidisciplinary team may include, but are not limited to: neurologist, nurses, physiotherapist, speech therapist, psychologist, dietician, social worker, etc.

[54]

Myoclonus

Brief, involuntary muscle contractions.

[55]

Neurodegenerative disorder (NDD)

Condition characterized by progressive loss or damage of neurons.

[56]

Neurofibrillary tangles (NFT)

Clumps of abnormal tau inside neurons that disrupt their function and lead to cell death.

[57]

Neurofilaments (NfL)

Structural proteins of neurons; their breakdown products in blood or CSF reflect non-specific axonal damage and neurodegeneration.

[39]

Neuroinflammation

Chronic inflammatory response of the central nervous system to damage, often contributing to neurodegeneration and disease progression.

[58]

O-GlcNAcylation

A reversible post-translational modification in which an N-acetylglucosamine (GlcNAc) molecule is added to a protein, regulating its folding, phosphorylation, and degradation. Increased O-GlcNAcylation of tau may counterbalance hyperphosphorylation and promote neuronal survival.

[34]

Ocular motor dysfunction

Abnormalities in controlling eye movements, affecting gaze stability and visual tracking.

[5]

OGA inhibitor

A molecule that inhibits O-GlcNAcase, increasing protein O-GlcNAcylation and reducing phosporilation, proposed to restore tau homeostasis and reduce neurodegeneration in PSP (i.e. Egalognastat / FNP-223).

[34]

Oligodendroglial coiled bodies

Abnormal tau-positive inclusions found within the cytoplasm of oligodendrocytes.

[59]

p-tau217

p-tau217 is a phosphorylated form of the tau protein at threonine residue 217, and it serves as a highly specific and sensitive biomarker for Alzheimer's disease (AD) pathology. Measurement of p-tau 217 in plasma or cerebrospinal fluid (CSF) reflects abnormal tau phosphorylation associated with neurofibrillary tangle formation. Compared to other phosphorylated tau isoforms (such as p-tau181), p-tau 217 demonstrates superior diagnostic accuracy for distinguishing AD from non-AD neurodegenerative disorders, including progressive supranuclear palsy (PSP).

[60]

Parkinsonism

Clinical syndrome characterized by bradykinesia plus rigidity, tremor, or postural instability.

[5]

Patient journey

The sequence of patients’ experiences and perspectives through stages of care - from symptom onset to diagnosis, treatment, and ongoing disease management.

[61]

PET scan

An imaging technique using positron emission tomography (PET) to visualize and measure metabolic or molecular activity in tissues, often applied in neurology to assess brain function or pathology. 

[62]

Pharmacodynamics (PD)

The biological and physiological effects of drugs on the body, including the mechanism of action at the target site. (It answers the question: "What does the drug do to the body?").

[3]

Pharmacokinetic profile (PK)

The characterization of how a drug is absorbed, distributed, metabolized, and eliminated by the body over time. (It answers the question: "What does the body do to the drug?).

[9]

Phase 1 study

The first stage of clinical research in humans, primarily assessing a drug’s safety in a small group of healthy volunteers or patients.

[3]

Phase 2 study

The second stage of a clinical trial aimed to evaluate a drug’s efficacy and short-term safety in patients.

[3]

Phase 3 study

The last stage of a clinical trial before licensing. A large-scale clinical trial designed to confirm a drug’s efficacy and safety to support regulatory approval.

[3]

Phenotype

The set of observable characteristics (symptoms, clinical signs) that define different forms of a disease. In PSP, several variants have been described: PSP-RS, PSP-P, PSP-PGF, PSP-CBS, PSP-SL, PSP-PI, PSP-OM, PSP-F, PSP-C, PSP-PLS.

[5]

Phosphorylation

A post-translational modification in which a phosphate group is added to a protein or other molecule, regulating its activity, function, or signaling properties.

[42]

Photophobia

Extreme sensitivity to light.

[5]

Placebo

An inactive substance designed to resemble the experimental treatment, used as a control to measure the true effect of the active drug.

[3]

Placebo-controlled

Trial design in which the effects of an active treatment are compared with those of an inactive substance (placebo) to assess the true efficacy of the intervention.

[3]

Post-translational modifications (PTMs)

Chemical or structural changes made to proteins after their synthesis, altering their function, stability, or interactions.

[63]

Postsynaptic striatal dopaminergic degeneration

Loss or dysfunction of dopamine-receiving neurons in the striatum, leading to impaired motor signaling.

[5]

Preclinical

Research conducted before testing in humans, using laboratory and animal studies to evaluate the pharmacological, toxicological, and pharmacokinetic properties of a drug.

[64]

Presymptomatic

Stage where the disease is already present in the brain, but no symptoms are visible yet.

[8]

Prevalence

The total number of cases of a disease in a population at a specific point in time or over a defined period.

[65]

Prion-like propagation

Process in which abnormal proteins (e.g., NFTs) spread from cell to cell, converting healthy proteins into the same harmful form and spreading the disease throughout the brain.

[66]

Prognosis

The predicted outcome of a disease, including likelihood of recovery or recurrence.

[67]

Progressive (disease)

A disease that worsens over time in terms of extent or severity.

[68]

PROSPER

PROSPER is an ongoing multinational, randomised, double-blind, placebo-controlled Phase 2 study to assess the safety, tolerability and efficacy of FNP-223 administered orally at a dose of 300 mg three times a day in adults aged 50–80 years with early-stage possible or probable PSP-RS.

[30]

Protein aggregation

Process in which misfolded proteins clump together, forming toxic deposits in the brain, like tau in tauopathies.

[48]

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