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We identified features affecting PSP diagnosis within the National Alzheimer's Coordinating Center (NACC) dataset, a cognitive\/behavioral research database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Autopsied NACC participants with clinical or neuropathologic PSP diagnoses were categorized by diagnostic modality (Clinical\u2010only, Neuropathology\u2010only, both). Group differences in clinical, demographic, neuropsychologic, and neuropathologic features were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Only 38.8% of neuropathologically identified PSP had clinical PSP diagnosis while 63.5% of clinically identified PSP had PSP pathology. Neuropathology\u2010only cases had fewer motor symptoms and better processing speed\/executive functioning than the Clinical\u2010Neuropathology group. Nearly 70% demonstrated co\u2010neuropathologies including Alzheimer\u2010type, Lewy body, and corticobasal degeneration pathologies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>\n                      Within NACC, discordant clinical and neuropathologic PSP diagnoses highlight the heterogeneity of PSP presentation, possibly driven by reliance on \u201cclassic\u201d\n                      <jats:italic>ante mortem<\/jats:italic>\n                      symptoms. Further studies should assess the impact of co\u2010pathology on clinical neurodegenerative disease presentations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>A high rate of clinico\u2010pathologic PSP diagnostic discordance is seen within NACC.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Cases without clinical PSP diagnosis had fewer classic motor and cognitive symptoms.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Isolated PSP neuropathology is uncommon, with nearly 70% showing co\u2010neuropathology.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.70248","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T23:36:44Z","timestamp":1746833804000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["High rates of diagnostic discordance and co\u2010pathology: Insights into PSP from the NACC dataset"],"prefix":"10.1002","volume":"21","author":[{"given":"Tanav","family":"Popli","sequence":"first","affiliation":[{"name":"Michigan Alzheimer's Disease Research Center Ann Arbor Michigan USA"},{"name":"Department of Neurology University of Michigan Ann Arbor Michigan USA"},{"name":"VA Ann Arbor Healthcare System, Neurology Service Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subhamoy","family":"Pal","sequence":"additional","affiliation":[{"name":"Michigan 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Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly M.","family":"Bakulski","sequence":"additional","affiliation":[{"name":"Michigan Alzheimer's Disease Research Center Ann Arbor Michigan USA"},{"name":"Department of Epidemiology University of Michigan, School of Public Health Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arijit","family":"Bhaumik","sequence":"additional","affiliation":[{"name":"Michigan Alzheimer's Disease Research Center Ann Arbor Michigan USA"},{"name":"Department of Neurology University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emile","family":"Pinarbasi","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Paulson","sequence":"additional","affiliation":[{"name":"Michigan Alzheimer's 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