Objective: To find out the ability of the Frontal Assessment Battery (FAB) for quantitative analysis of the executive dysfunction of PSP and PD.
To find out the relation between FAB with other cognitive and neuropsychological test.
To find out the practical utility of the FAB in differentiating PSP and PD.

Background: PSP is an atypical parkinsonian disorder characterized by vertical gaze palsy, progressive axial rigidity, frontal lobe syndromes, and subcortical dementia. PSP diagnosis in the early phase is a clinical challenge due to the overlapping clinical symptoms with PD. PSP is widely known as a disorder of tau metabolism whereas PD belongs to the α- synucleinopathy group (Borroni et al). PSP and PD have distinct motor features on which they can be differentiated. But the difference in cognitive and behavioural symptoms between the two have been less well studied.

Method: 39 patients with PSP diagnosed on the basis of National Institute of Neurological Disorder and Stroke-Progressive Supranuclear Palsy (NINDS- PSP) criteria, and 39 patients with PD diagnosed on the basis of UK Parkinson ’s Disease Society Brain Bank Criteria were assessed on socio demographic and clinical profile. Executive functions were assessed using Frontal assessment Battery (FAB), Cognitive screening was done using Mini Mental State Examination. Cognitive profile and severity of cognitive impairment was assessed using Mattis Dementia Rating Scale and Neuropsychiatric Inventory was used to find out the neuropsychological manifestations.

Results: The mean age of these patients was 64.08 years (SD ±9.00) and 84.6% were male. 35 (58.3%) patients with PSP and 25 (41.7%) patients with PD were found to have below 15 score in FAB (Dysexecutive). 26 (68.4%) patients with PSP and 12 (31.6%) with PD were having severely cognitive impairment. The prevalence of neuropsychological symptoms and severity of cognitive impairment were found to be more with the patient with dysexecutive function (86.8% Anxiety, 82.8% Delusion, 79.2% Depression & Apathy, 83.3% Irritability)

Conclusion: FAB score is correlated with other cognitive and neuropsychological test. We can conclude that using FAB might help to differentiate between PD and PSP.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/progressive-supranuclear-palsy-psp-vs-parkinsons-disease-pd-whether-frontal-assessment-battery-fab-can-differentiate/