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The PSP\u2010related metabolic pattern (PSPRP) has proved useful for differentiating PSP from other parkinsonian syndromes, but type\u2010specific metabolic patterns remain incompletely characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to identify type\u2010specific metabolic patterns in PSP and evaluate their ability to monitor progression and predict conversion of variant PSP (vPSP) to PSP with Richardson's syndrome (PSP\u2010RS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      PSP\u2010RS, PSP with predominant parkinsonism (PSP\u2010P), PSP with predominant gait freezing (PSP\u2010PGF), and PSP with predominant postural instability (PSP\u2010PI) underwent baseline and follow\u2010up positron emission tomography with\n                      <jats:sup>18<\/jats:sup>\n                      F\u2010fluorodeoxyglucose (\n                      <jats:sup>18<\/jats:sup>\n                      F\u2010FDG PET) imaging. First, the PSP\u2010RS\u2013related pattern, PSP\u2010P\u2013related pattern, PSP\u2010PGF\u2013related pattern (PGFRP), and PSP\u2010PI\u2013related pattern (PIRP) were identified by scaled subprofile modeling\/principal\u2010component analysis. Furthermore, we evaluated the similarity of these patterns to previously reported PSPRP and tested their ability to classify clinical phenotypes. Finally, we evaluated these patterns longitudinally for monitoring disease progression and predicting conversion of vPSP to PSP\u2010RS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All type\u2010specific patterns showed significant topographic similarity and association with PSPRP. The PGFRP exhibited more extensive involvement in the striatum than other type\u2010specific patterns. In general, both type\u2010specific patterns and PSPRP demonstrated similar performance in distinguishing PSP\u2010RS from vPSP. Pattern expressions increased at follow\u2010up and correlated with clinical progression. Higher baseline pattern expressions significantly predicted conversion from vPSP to PSP\u2010RS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PSP phenotypes exhibit type\u2010specific metabolic covariance patterns that largely overlap with PSPRP but show phenotype\u2010relevant differences. These patterns hold promise for longitudinal monitoring of disease progression and prediction of vPSP conversion to PSP\u2010RS. \u00a9 2026 International Parkinson and Movement Disorder Society.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mds.70369","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T09:42:08Z","timestamp":1780306928000},"page":"2422-2431","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Disease\u2010Specific Metabolic Patterns in Progressive Supranuclear Palsy with Richardson's Syndrome and Variants: A Longitudinal Study"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2246-0951","authenticated-orcid":false,"given":"Fangyang","family":"Jiao","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine The First Affiliated Hospital of Chongqing Medical University  Chongqing 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National Research Center for Aging and Medicine, National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology Huashan Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine &amp; PET Center, National Clinical Research Center for Aging and Medicine, National Center for Neurological Disorders Huashan Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianjun","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurology, National Research Center for Aging and Medicine, National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology Huashan Hospital, Fudan University  Shanghai 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