BACKGROUND: Progressive supranuclear palsy (PSP) can cause structural and functional brain reconstruction. There is a lack of knowledge about the consistency between structural-functional (S-F) connection networks in PSP, despite growing evidence of anomalies in various single brain network parameters. PURPOSE: To study the changes in the structural and functional networks of PSP, network's topological properties including degree, and the consistency of S-F coupling. The relationship with clinical scales was examined including the assessment of PSP severity, and so on. STUDY TYPE: Retrospective. SUBJECTS: A total of 51 PSP patients (70.04 ± 7.46, 25 females) and 101 healthy controls (64.58 ± 8.84, 58 females). FIELD STRENGTH/SEQUENCE: 3-T, resting-state functional MRI, diffusion tensor imaging, and T1-weighted images. ASSESSMENT: A graph-theoretic approach was used to evaluate structural and functional network topology metrics. We used the S-F coupling changes to explore the consistency of structural and functional networks. STATISTICAL TESTS: Independent samples t tests were employed for continuous variables, χ RESULTS: PSP showed variations within and between modules. Specifically, PSP had decreased network properties changes (t = -2.0136
t = 2.5409
t = -2.5338
t = -2.4296
t = -2.5338
t = 2.8079). PSP showed a lower coupling in the thalamus and left putamen and a higher coupling in the visual, somatomotor, dorsal attention, and ventral attention network. S-F coupling was related to the number of network connections (r = 0.32, r = 0.22) and information transmission efficiency (r = 0.55, r = 0.28). S-F coupling was related to basic academic ability (r = 0.39) and disinhibition (r = 0.49). DATA CONCLUSION: PSP may show abnormal S-F coupling and intramodular and intermodular connectome in the structural and functional networks. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY: Stage 3.