Objective: To assess the clinical utility of the Short Cognitive and Neuropsychiatric Assessment (ShoCo) scale in a multi-ethnic Malaysian cohort of patients with progressive supranuclear palsy (PSP); with Parkinson’s disease with dementia (PDD) and without dementia (PDND) cohorts included for contextual comparison. We examined associations between ShoCo scores and PSP disease severity, duration, and subtypes; and validated the scale against a neuropsychological battery.

Background: PSP features substantial cognitive-behavioural impairments alongside characteristic motor and oculomotor deficits [1-3]. The newly published ShoCo scale enables efficient evaluation of these deficits, which is currently an unmet need in the field [4,5]. Nonetheless, real-world feasibility and validation testing are still needed.

Method: In this cross-sectional study, the ShoCo was administered to 304 consecutively recruited patients (75 PSP, 53 PDD, 176 PDND). Clinico-demographic data, including disease severity (PSP Clinical Deficits Scale [PSP-CDS] [6] and Cortical Basal ganglia Functional Scale [CBFS]) and Montreal Cognitive Assessment (MoCA) scores, were collected. A subset of PSP patients (n=16) underwent testing by a neuropsychologist blinded to ShoCo scores.

Results: PSP and PDD had significantly poorer ShoCo scores than PDND (total and all subdomain scores; P < 0.001). PSP showed greater disinhibition, whereas PDD had more severe bradyphrenia and dysexecution [Fig. 1A, 1C]. PSP Richardson syndrome (PSP-RS) had significantly poorer ShoCo scores than variant PSP (8.0 vs 5.0) [Fig. 1B, 1D]. ShoCo scores correlated significantly and moderately with the PSP-CDS (r_s=0.39) [Fig. 1E], CBFS (r_s=0.39), and MoCA (r_s=-0.46); as well as with disease duration in the PSP-RS subgroup (r_s=0.45) [Fig. 1F]. Significant, strong, correlations were also documented between ShoCo and executive function and attention/processing speed tests (r_s~0.5-0.6) [Table 1].

Conclusion: ShoCo is a practical cognitive-behavioural screening tool that quantifies clinically-relevant deficits in PSP. It can be applied broadly across the spectrum of PSP patients, and can help mitigate the missingness of phenotypic data collection in clinical and research efforts.

Figure 1

Table 1

References: [1] G.U. Höglinger, G. Respondek, M. Stamelou, C. Kurz, K.A. Josephs, A.E. Lang, B. Mollenhauer, U. Müller, C. Nilsson, J.L. Whitwell, Clinical diagnosis of progressive supranuclear palsy: the movement disorder society criteria, Mov. Disord. 32(6) (2017) 853-864.
[2] S.-Y. Lim, A.M.F.D. Closas, A.H. Tan, J.L. Lim, Y.J. Tan, Y. Vijayanathan, Y.W. Tay, W.K. Ng, R. Kanesalingam, P. Martinez-Martin, New insights from a multi-ethnic Asian progressive supranuclear palsy cohort, Parkinsonism Relat. Disord. 108 (2023) 105296.
[3] P.L. Kukkle, R. Neupane, A. Pantelyat, A.M. Wills, E. Jabbari, E.G. Dopper, G.G. Kovacs, G. Hoglinger, I. Aiba, I. Litvan, Progressive Supranuclear Palsy—A Global Review, Movement Disorders Clinical Practice (2025).
[4] S. Porsche, M. Klietz, S. Greten, I.A. Piot, I. Jensen, F. Wegner, L. Ye, L. Krey, M. Höllerhage, M. Pötter‐Nerger, A short cognitive and neuropsychiatric assessment scale for progressive supranuclear palsy, Movement disorders clinical practice 12(6) (2025) 764-774.
[5] S.Y. Lim, K.B. Lim, J.W. Hor, A.H. Tan, Brief clinical rating scales should not be overlooked, Mov. Disord. 35(10) (2020) 1884-1885.
[6] Y.Z. Lim, S.J. Ngim, J.C. Fernandiz, A.M.F.D. Closas, T.S. Toh, A.N.K. Anuar, E.S.W. Chang, J.J.W. Cheok, Y.W. Tay, H.X. Ding, The Progressive Supranuclear Palsy-Clinical Deficits Scale Accurately Reflects Functional as well as Patient

« Back to 2026 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/utility-of-the-short-cognitive-and-neuropsychiatric-assessment-scale-shoco-in-a-multiethnic-asian-cohort-of-patients-with-progressive-supranuclear-palsy/