A case of progressive supranuclear palsy in association with vascular and senile brain changes in a 70-year-old woman is described. Neuropathological study with immunocytochemistry anti-tau-1 revealed widely distributed neurofibrillary tangles (NFT) and neuropil threads (NT) in several subcortical nuclei, including pallidum, subthalamic nucleus, substantia nigra, brain stem tegmentum and, to a lesser extent, in cerebral cortex. Moreover, the tau-1 positive NT were observed in many fiber bundles of the subcortical white matter. All NFT and NT were immunonegative against ubiquitin. Electron microscopic study disclosed straight filaments of about 15 nm diameter in the axoplasm of large myelinated fibers. Ultrastructural findings and appearance of abnormal tau in the white matter indicate an extension of characteristic cytoskeletal pathology with subcortical projection fibers involvement in the presented case.
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