{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T04:46:37Z","timestamp":1777869997589,"version":"3.51.4"},"reference-count":41,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["R01\u2010 NS89757"],"award-info":[{"award-number":["R01\u2010 NS89757"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["R01\u2010DC12519"],"award-info":[{"award-number":["R01\u2010DC12519"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["R01\u2010DC14942"],"award-info":[{"award-number":["R01\u2010DC14942"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Classic progressive supranuclear palsy RS syndrome (PSP\u2010RS) is characterized by early postural instability\/falls and vertical supranuclear gaze palsy, although other signs\/symptoms can occur, for example, axial rigidity, bradykinesia, and cognitive dysfunction. The Movement Disorders Society\u2010PSP (MDS\u2010PSP) criteria consider probable PSP\u2010RS a homogenous syndrome, but this has not been tested.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We aim to investigate relationships between signs\/symptoms of PSP\u2010RS beyond its core features and determine whether PSP\u2010RS is a homogeneous syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      118 participants who met MDS\u2010PSP criteria for probable PSP\u2010RS were analyzed. All participants received an independent clinical diagnosis based on clinical judgment. We first performed a Network Analysis using\n                      <jats:italic>qgraph<\/jats:italic>\n                      with Spearman's correlation to quantify relationships between 16 signs\/symptoms followed by a k\u2010means clustering analysis using the same signs\/symptoms to identify possible heterogeneity of the PSP\u2010RS designation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five network clusters were identified, reflecting: (1) tremor, (2) sensitivity to bright light, (3) oculomotor function, (4) cognition, and (5) akinetic\u2010rigidity\u2010praxis. Worse akinetic\u2010rigidity was associated with better oculomotor function, but worse cognition. Cluster analysis revealed two clusters. Cluster I (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200989) had more severe clinical features than Cluster II (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200929). Cluster II had a higher frequency of participants (37.9%) clinically judged as not PSP\u2010RS: these participants were less likely to have PSP pathology on autopsy (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Some signs\/symptoms of PSP\u2010RS strongly associate and are more likely to co\u2010occur. PSP\u2010RS, as defined by the MDS\u2010PSP criteria includes a subset of participants not clinically judged as PSP\u2010RS who are less likely to have PSP pathology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mdc3.70134","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T04:56:37Z","timestamp":1747630597000},"page":"1560-1570","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the Homogeneity of the\n                    <scp>PSP<\/scp>\n                    \u2010\n                    <scp>RS<\/scp>\n                    Syndrome beyond Core Features"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8708-6726","authenticated-orcid":false,"given":"Mahesh","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of Neurology Mayo Clinic  Rochester MN 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C.","family":"Stephens","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic  Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2543-0627","authenticated-orcid":false,"given":"Rodolfo","family":"Savica","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic  Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis W.","family":"Dickson","sequence":"additional","affiliation":[{"name":"Department of Neuroscience Mayo Clinic  Jacksonville FL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6914-1563","authenticated-orcid":false,"given":"Jennifer L.","family":"Whitwell","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic  Rochester MN 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