Objective: We attempted to identify any sign or symptom to diagnose progressive supranuclear palsy (PSP) earlier.

Background: Early clinical diagnosis of progressive supranuclear palsy PSP remains challenging.

Methods: A total of 401 patients, 40 with PSP and 361 with other neurodegenerative disorders, were included. We followed these patients for at least 1 year since 2009. We reviewed the signs and symptoms of patients with PSP in a standardised manner, and observed four manifestations: “vertical supranuclear gaze abnormality”, “movement disorders”, “pseudobulbar palsy”, and “dementia of frontal type”. Features such as symmetric parkinsonism, freezing of gait, postural instability, dysarthria and/or dysphagia, or dementia of frontal type were considered core clinical features.

Results: In patients with PSP, “movement disorders” was the most common manifestation, whereas “vertical supranuclear gaze abnormality” was uncommon during the early disease course. Sixteen patients fulfilled the National Institute for Neurological Disorders and Stroke and Society for PSP criteria for possible PSP at their first clinic visit. Fifteen of the remaining 24 patients presented with one or more core clinical features before fulfilling the criteria for possible PSP; nine patients had a clinical diagnosis of PSP, but never fulfilled the criteria. Forty-nine of the 361 patients with other neurodegenerative disorders had core clinical features. A comparison revealed that freezing of gait differentiated the groups the best over the disease course.

Conclusions: Freezing of gait is an early feature that may improve the clinical diagnosis of PSP, whereas vertical supranuclear gaze abnormality is not.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/freezing-of-gait-is-an-early-clinical-feature-of-progressive-supranuclear-palsy/