In our single case, taking into account the study design, we found remarkable differences in some risk factors (less exercise, heavy smoking), in the level of blood neurodegenerative and vascular biomarkers (α-synuclein, MMP-2, MB, Apo-A1, Apo-CIII, Apo-H), and in the gut microbiome in PSP-related twin subjects, which was correlated with relevant neuropsychological tests and typical brain MRI abnormalities. This evidence concerns the gene APOA1 and supranuclear palsy, progressive, 1.