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To the Editor:
The partial attribution of the peculiar facial expression in progressive supranuclear palsy (PSP) to a focal dystonia of the procerus muscle in the NeuroImage by Romano and Colosimo1 is difficult to reconcile with the known anatomy of this muscle, which arises in the nasal bone and inserts in the skin of the lower forehead between the two eyebrows. Contraction of the procerus produces transverse wrinkles over the bridge of the nose2 and not the vertical wrinkles in the glabella region, which are prominently displayed in the photographs of two patients with clinically probable PSP. The more likely cause, as described by Charles Darwin in The Expression of the Emotions in Man and …
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