Objective: The aim of this study was to evaluate whether a novel computerised test could offer an inexpensive and reliable tool that can aid diagnosis and provide early detection of progression.

Background: Progressive Supranuclear Palsy is a rapidly progressive neurodegenerative tauopathy with no cure. To maximise benefit from novel disease-modifying treatments an early and accurate diagnosis will be required, and to evaluate such treatments, we need a robust quantitative measure of disease progression.Background: Progressive Supranuclear Palsy is a rapidly progressive neurodegenerative tauopathy with no cure. To maximise benefit from novel disease-modifying treatments an early and accurate diagnosis will be required, and to evaluate such treatments, we need a robust quantitative measure of disease progression.

Method: 27 Progressive Supranuclear Palsy, 51 Parkinson’s disease, and 21 control participants were assessed at three month intervals. We tested verbal fluencies and performance on a cancellation task. In addition to conventional analysis, the computerised delivery of the cancellation task enabled examination of a new concept, termed strategy adherence.

Results: Poor verbal fluency was predictive of progressive supranuclear palsy, with a receiver operating characteristic area under the curve of 0.91.  Incorporating cancellation score increased this to 0.93. Strategy adherence declined very rapidly, with significant change detectable at group level over just 3 months (baseline strategy adherence 52%, declining to 30% at 3 months, p = 0.031).

Conclusion: Verbal fluency is a simple and inexpensive task that discriminates Progressive Supranuclear Palsy from Parkinson’s disease. Its accuracy can be improved modestly by combining it with the cancellation task, but the real value of the latter lies in its ability to demonstrate whether patients can devise and follow a problem-solving strategy. This ability is irreversibly lost during progression, and this is a promising group level longitudinal marker.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/novel-cognitive-markers-for-early-diagnosis-and-monitoring-of-progressive-supranuclear-palsy/