Objective: To know prevalence of neuropsychiatric symptoms in Progressive Supranuclear Palsy along disease stages.

Background: Neuropsychiatric symptoms are common features in patients with Progressive Supranuclear Palsy (PSP). Despite the majority of PSP patients will experience some psychopathology during their lifetime, little is known about the prevalence of these symptoms along disease stages.

Method: Thirty patients with the Richardson´s syndrome variant of PSP (PSP-RS) were selected from a consecutive series. Based on clinical diagnosis and disease duration, patients were classified as early PSP-RS (disease duration 1.6±0.4 years), mid-stage PSP-RS (disease duration 3.3±0.7 years), and advanced PSP-RS (disease duration 6.1±1.4 years). The Neuropsychiatric Inventory (NPI) was used to explore the prevalence and correlates of 11 behavioural symptoms: delusions, hallucinations, agitation/aggression, dysphoria, anxiety, euphoria, apathy, disinhibition, irritability/lability, aberrant motor activity, night-time behavioural disturbances and appetite and eating abnormalities. A NPI severity score ≥2 was used to determine the existence if clinically relevant symptoms.

Results: In early PSP-RS, clinically relevant symptoms of anxiety were present in 11% of patients, sleep disturbances in 22%, eating abnormalities in 22%, depression in 33%, irritability in 55% and apathy in 67%. In mid-stage PSP-RS, delusions, hallucinations and aberrant motor activity were found in 11%, aggression and euphoria in 18%, disinhibition and eating abnormalities in 22%, anxiety and irritability in 33% depression and sleep disorders in 65% and apathy in 78%. In advanced-PSP, hallucinations and aggression increased to 22%, eating abnormalities to 44% and irritability to 55%. A slight decrease on severity was found for depression (55%), anxiety and euphoria (10%), disinhibition (10%), sleep disturbances (22%) and apathy (67%).

Conclusion: Multiple neuropsychiatric features develop in an important proportion of PSP patients since the earliest stages of the disease. Over disease progression some improvement is found for some symptoms (possibly related to drug treatment and management) whereas others worsen over time. Apathy, irritability and depression are the most common neuropsychiatric symptoms in all stages of PSP-RS, and psychosis and eating abnormal behaviours worsen over time.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/neuropsychiatric-symptoms-in-early-to-advanced-patients-with-the-richardsons-syndrome-variant-of-progresive-supranuclear-palsy/