Objective: To analyze neuropsychiatric symptoms among phenotypes of patients with Progressive supranuclear palsy  (PSP) in movement disorder centers in Colombia and Mexico.

Background: Progressive supranuclear palsy (PSP) is a rare neurodegenerative disorder (1-2), and multiple clinical features have been described, in addition to the most common presentation, supranuclear ophthalmoplegia with vertical gaze palsy, parkinsonism, pseudobulbar palsy, dysarthria, postural instability, and early falls. Phenotypic classification has been useful for diagnosis due to the wide clinical variability; however, the neuropsychiatric profile of the variants has not been described as extensively.

Method: 71 Patients with probable PSP, were evaluated with clinical assessment and motor and non-motor scales, PSP phenotypes were defined by international criteria (3)  by two movement disorders neurologist  and descriptive data  between phenotypes were presented as mean  and  standard deviation  or median and interquartile rank, or frequencies where appropriate. Pearson’s chi square and ANOVA or Kruzkal-Wallis tests, were used for comparison.  Statistical significance was set at 0.05. Statistical analysis was performed with the SPSS statistical package (version 25; Chicago, IL, USA).

Results: 29 (40.8%) of PSP patients had a classical form (PSP-RS), a higher disease duration was found in PSP-P, most of the patients had anxiety or depression, however there were not significant differences between phenotypes. (Table 1). Significant higher scores  were found in NPI-Q  in PSP-F  over PSP-RS, mostly in domains of delusion, disinhibition,  agitation, and irritability(Figure 1) . Just one patient reported psychotic symptoms in the Positive and negative syndrome scale (PANSS) so the scale was retired of the analysis.

Conclusion: Most patients with PSP presented severe motor impairment, regardless of their clinical phenotype, and a high degree of neuropsychiatric symptom involvement, with the domains of delirium, disinhibition, agitation, and irritability predominating in the PSP-F compared to the PSP-RS. However, this study found no differences between other scales applied, which prevents differentiation between phenotypes as previous studies. (4)  Additional multicenter studies with larger samples are suggested to better understand the neuropsychiatric profiles of PSP variants.

Table 1. Neuropsychiatric scores by phenotypes PSP

Figure 1. Neuropsychiatric Inventory Questionnarie

References: (1) Swallow, D.M.; Zheng, C.S.; Counsell, C.E. Systematic review of prevalence studies of progressive supranuclear palsy and corticobasal syndrome. Mov. Disord. Clin. Pract. 2022, 9, 604–613. [CrossRef]
(2) 2- Barer Y, Chodick G, Cohen R, Grabarnik-John M, Ye X, Zamudio J, Gurevich T. Epidemiology of Progressive Supranuclear Palsy: Real World Data from the Second Largest Health Plan in Israel. Brain Sci. 2022 Aug 24;12(9):1126. doi: 10.3390/brainsci12091126. PMID: 36138862; PMCID: PMC9496895
(3) Höglinger GU, Respondek G, Stamelou M, Kurz C, Josephs KA, Lang AE, Mollenhauer B, Müller U, Nilsson C, Whitwell JL, Arzberger T, Englund E, Gelpi E, Giese A, Irwin DJ, Meissner WG, Pantelyat A, Rajput A, van Swieten JC, Troakes C, Antonini A, Bhatia KP, Bordelon Y, Compta Y, Corvol JC, Colosimo C, Dickson DW, Dodel R, Ferguson L, Grossman M, Kassubek J, Krismer F, Levin J, Lorenzl S, Morris HR, Nestor P, Oertel WH, Poewe W, Rabinovici G, Rowe JB, Schellenberg GD, Seppi K, van Eimeren T, Wenning GK, Boxer AL, Golbe LI, Litvan I; Movement Disorder Society-endorsed PSP Study Group. Clinical diagnosis of progressive supranuclear palsy: The movement disorder society criteria. Mov Disord. 2017 Jun;32(6):853-864. doi: 10.1002/mds.26987.
(4) Horta-Barba A, Pagonabarraga J, Martínez-Horta S, Busteed L, Pascual-Sedano B, Illán-Gala I, Marin-Lahoz J, Aracil-Bolaños I, Pérez-Pérez J, Sampedro F, Bejr-Kasem H, Kulisevsky J. Cognitive and behavioral profile of progressive supranuclear palsy and its phenotypes. J Neurol. 2021 Sep;268(9):3400-3408. doi: 10.1007/s00415-021-10511-y.

« Back to 2025 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/neuropsychiatric-profile-of-progressive-supranuclear-palsy-phenotypes/