Objective: To examine the clinical patterns, diagnostic types, and daily functional impact of atypical parkinsonian disorders (APD) within a Sri Lankan patient group
Background: Atypical parkinsonian disorders (APD) are a heterogeneous group of neurodegenerative diseases characterized by parkinsonism accompanied by additional neurological features and poor response to levodopa. Major syndromes include Progressive Supranuclear Palsy (PSP), Multiple System Atrophy (MSA), Dementia with Lewy Bodies (DLB), and Corticobasal Syndrome (CBS).
Method: As part of the Global Parkinson’s Genetics Program (GP2), this multicentre cross-sectional study (November 2025–February 2026) evaluated 62 patients diagnosed or clinically suspected of APD. Clinical features were mapped using standardized MDS-PPS (Parkinson Plus Syndrome) scores.
Results: A total of 62 patients with definite, probable, or possible atypical parkinsonism were identified. The most common diagnosis was PSP (n= 36, 58%; Probable 25, Definite 6, Possible 5), followed by MSA (n= 15, 24.2%; MSA-Cerebellar 11, MSA-Parkinsonism 2, Clinically probable MSA 2), DLB (n= 7, 11.3%; Probable 4, Possible 3), and CBS (n= 4, 6.5%; Probable 3, Possible 1). The median age at symptom onset was 67 (IQR 61–73) with a female predominance (n= 35, 56.5%). Early recurrent falls were noted in 94.4% (n= 34) of PSP patients, and 58.3% (n= 21) had vertical supranuclear gaze palsy. In contrast, autonomic dysfunction was seen in 73.33% (n= 11) of MSA patients. Visual hallucinations (57.1%, n= 4) and cognitive impairment (100%, n= 7) were seen in DLB, while asymmetric limb rigidity (100%, n= 4) and alien limb phenomenon (75%, n= 3) were noted in CBS. The median Barthel Index score was 65 (IQR 53.75–86.2) and the median MoCA score was 13 (IQR 13–22.75), indicating moderate functional dependence and significant cognitive impairment across the cohort.
Conclusion: Atypical parkinsonian disorders demonstrate distinct but overlapping clinical features. This study provides important regional data on the clinical spectrum of atypical parkinsonism and highlights the need for improved diagnostic pathways and longitudinal research in these disorders
To cite this abstract in AMA style:
V. Vithudsha, A. Pathirage, P. Ruwanpathirana, B. Senanayake. Clinical Spectrum of Atypical Parkinsonian Disorders in Sri Lanka: Preliminary Results from a Global Parkinson’s Genetic Programme (GP2) Collaborative Study [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/clinical-spectrum-of-atypical-parkinsonian-disorders-in-sri-lanka-preliminary-results-from-a-global-parkinsons-genetic-programme-gp2-collaborative-study/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-spectrum-of-atypical-parkinsonian-disorders-in-sri-lanka-preliminary-results-from-a-global-parkinsons-genetic-programme-gp2-collaborative-study/