This is an interesting “poster session” on progressive supranuclear palsy (PSP) from a behavioral neurology conference in April 2014. The presenters are researchers from Oklahoma University. They compared cognitive and behavioral features of five patients with PSP-parkinsonism (PSP-P) and six patients with PSP-Richardson syndrome (PSP-R) who were seen at the OU neurology clinic during 2011-12.
Keeping in mind that this is a very small study, “[anxiety] was common in the PSP-R group (3 cases), but was not seen at all in the PSP-P group.” Apathy was a prominent behavioral feature in both groups. And those with PSP-R were more likely “to be demented when they first present to a neurologist’s office.” That’s not surprising since cognitive impairment (or dementia) is a primary symptom of PSP-R.
The full abstract is copied below.
April 30, 2014
Poster Session V
Aging, Dementia, and Cognitive and Behavioral Neurology: Behavioral Neurology of Movement Disorders
Cognitive and Behavioral Changes in PSP: Comparison of PSP-Parkinsonism with PSP-Richardson Syndrome
Saria Refai, Linda Hershey, David Thompson and Jennifer Lippoldt
Neurology April 8, 2014 vol. 82 no. 10 Supplement P5.240
OBJECTIVE: To compare cognitive and behavioral features of patients with progressive supranuclear palsy-parkinsonism (PSP-P) and PSP-Richardson syndrome (PSP-R) at their initial visit.
BACKGROUND: The PSP-P variant of PSP is characterized by bradykinesia and rigidity that responds to levodopa for 1-2 years. PSP-P patients may still be able to look down at their initial visit, while most all PSP-R patients have vertical gaze palsy at onset. Few PSP-P cases have dementia at onset, but little is known about the behavioral differences between these two syndromes.
DESIGN/METHODS: This was a retrospective chart review of PSP patients seen in one neurology clinic during 2011-12. Patients met NINDS criteria for possible or probable PSP. They met criteria for PSP-P or PSP-R, according to Williams et al, (2005; 2008). They were tested with the Neuropsychiatric Inventory (NPI) of Cummings et al (1994) and with the MMSE of Folstein et al (1975).
RESULTS: We saw 5 patients with PSP-P (mean age at presentation = 71.0 yrs) and 6 patients with PSP-R (mean age at presentation = 74.3 yrs). M:F ratio in the PSP-P group was 1.5:1, whereas M:F ratio in the PSP-RS group was 2:1. The initial MMSE score in the PSP-P group (mean=25.0+/-4.8) was significantly higher than that of the PSP-RS group (mean=12.7+/-9.8; p=0.041). The initial NPI score in the PSP-P group (mean=3.0+/-1.6) was not significantly different from that of the PSP-RS group (mean=4.2+/-1.2; p=0.214). Apathy was the most common behavioral symptom seen in both groups (all 6 of the PSP-RS patients and 4 of the 5 PSP-P patients). Anxiety was common in the PSP-R group (3 cases), but was not seen at all in the PSP-P group.
CONCLUSIONS: Patients with PSP-P are less likely than PSP-R patients to be demented when they first present to a neurologist’s office. Both PSP subtypes are likely to have apathy as a prominent behavioral feature of their disease.
Study Supported by: None.
Wednesday, April 30 2014, 3:00 pm-6:30 pm
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