A 45-year-old male patient presented to the medicine OPD with the chief complaints of progressive forgetfulness over the past few years along with ataxia. O/E, Wide based shuffling gait Generalized rigidity Hyperextension of neck On examination of eye Restricted eye movements Slow ocular saccades impairment of downward gaze MRI brain Which protein will be deposited most commonly in the subcoical structures in the above condition: -

This is a case of Progressive supranuclear palsy MRI images show the classical humming bird and mickey mouse signs respectively. Progressive supranuclear palsy: - Parkinsonism plus disorder/ Atypical parkinsonism disorder Male > Female Gradually progressive Age > 40 years Present as: - Dementia Progressive supranuclear ophthalmoplegia (HALLMARK) Gait disorder and postural instability Dysphagia, dysahria and rigidity Accumulation of hyperphosphorylated 4-repeat tau is seen within neurons and glia.