Objective: To prospectively evaluate and subtype the patients of Progressive supranuclear palsy being referred to a tertiary care movement disorders facility in South India.

Background: Progressive Supranuclear Palsy (PSP) is the 3^rd most common neurodegenerative disorder globally. Several clinical sub phenotypes have been described, with PSP- Steele Richardson (PSP-RS)  and PSP-Parkinsonism (PSP-P) type being the commonest in various cohort studies and brain autopsy studies. However, there is little literature from South Asia and more so from India using the Movement disorders society diagnostic criteria for PSP.

Method: This prospective case-control hospital-based study was conducted at the Departments of Neurology and Human Genetics at the National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, for a duration of three years from September 2019 to September 2022. Clinical history and examination according to a structured questionnaire following the diagnosis of PSP as per the Movement disorders society- Progressive Supranuclear Palsy criteria.

Results: The mean age of the PSP patient group was 62.05±7.19 years. Among 104 patients, 32.6% (n=34) were female, and 67.4% (n=70) were male. The mean age for female was 59.29±7.19 years, and for males, 63.39±6.85 years. About 26.9% (n=28) patients had hypertension, 42.3% (n=44) diabetes, 5.7% (n=6) hypothyroidism, and 0.009% (n=1) had ischemic heart disease. The age of onset for the patient group was 59.3±6.8 years. In male the mean age at onset was 60.6±6.5 years, while 56.6±6.7 years for female. In the patient group, the average disease duration was 30.9±17.4 months. In males, the mean duration of disease was 32.8±17.0 months, and in females 26.8±17.0 months. The maximum and minimum duration of illness was six years and three months, respectively. Among the 104 patients, 58% patients were diagnosed as PSP- Richardson Syndrome (PSP-RS) followed by 20% with PSP-Parkinsonism (PSP-P), 9% as PSP-Cortico-basal syndrome (PSP-CBS), 6% as PSP- predominant speech/language disorder (PSP-SL), 5% as a patient diagnosed with PSP-PGF and 2% as PSP-Frontotemporal dementia (PSP-F).

Conclusion: The sub-phenotypes of PSP form almost one-third of the total referrals of PSP. The clinical assessment using the various validated scales are useful in characterizing these patients for use in future therapeutic interventions.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/phenotypic-characterization-of-104-patients-with-progressive-supranuclear-palsy-a-tertiary-care-experience-from-south-india/