Date: Monday, June 5, 2017
Session Title: Parkinsonism, MSA, PSP (Secondary and Parkinsonism-Plus)
Session Time: 1:45pm-3:15pm
Location: Exhibit Hall C
Objective: To determine the utility of pulmonary function tests in the differential diagnosis and monitoring of disease progression of Progressive Supranuclear Palsy.
Background: Pulmonary complications such as aspiration pneumonia are a leading cause for hospitalisation and death in patients with Parkinson’s Disease (PD) and Progressive Supranuclear Palsy (PSP). While respiration has been extensively studied in PD, little is known about respiratory dysfunction in PSP. The aim of this study was to determine whether pulmonary function tests (PFT) reflect pulmonary dysfunction in PSP and may serve as additional tools for differential diagnosis and monitoring of disease progression.
Methods: Patients with PSP and PD were evaluated concerning differences in multiple readout parameters of PFT including VC, FEV1, PEF and MVV in a retrospective (PSP: n=29; PD: n=28) and a prospective (PSP: n=44; PD: n=22) cohort. PSP patients further underwent a follow-up investigation after one year. PFT were correlated with symptom burden as measured by Hoehn&Yahr (retrospective analyses) as well as Schwab & England Activities of Daily Living scale (SEADL), Frontal Assessment Battery (FAB), Mini mental state examination (MMSE) and PSP rating scale (PSPRS).
Results: In PSP, respiration is affected earlier and more severely than in PD at comparable levels of disability. Maximum Ventilatory Volume (MVV) was the most sensitive PFT parameter to differentiate PSP and PD and correlated well with disease severity in PSP (as measured by PSP-RS), but not in PD. Furthermore, our analyses demonstrate that MVV changes over one year may prove to be a valid additional parameter of disease progression in PSP.
Conclusions: PFT may be a useful additional tool in the differential diagnosis between PD and PSP. Since pulmonary dysfunction showed a stronger correlation with motor symptoms than with cognitive dysfunction, it can be speculated to be more likely due to axial rigidity than due to breathing apraxia. Furthermore, PFT should be evaluated further as an objective marker of disease progression and prognostication, and may be useful for future clinical trials.
To cite this abstract in AMA style:G. Nuebling, C. Abright, M. Schuberth, S. Schoenecker, K. Boetzel, J. Levin, S. Lorenzl. Differential diagnosis and progress monitoring in Progressive Supranuclear Palsy – a potential role of pulmonary function tests [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/differential-diagnosis-and-progress-monitoring-in-progressive-supranuclear-palsy-a-potential-role-of-pulmonary-function-tests/. Accessed December 11, 2023.
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