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Prediagnostic Progressive Supranuclear Palsy - Insights from the UK Biobank
Duncan Street1, David Whiteside1, Timothy Rittman1
1University of Cambridge, Department of Clinical Neurosciences and Cambridge University Hospitals, NHS Trust, Cambridge, United Kingdom.
Parkinsonism & Related Disorders
|January 15, 2022
Summary
Subtle motor and cognitive changes occur nearly 8 years before Progressive Supranuclear Palsy (PSP) diagnosis. Identifying these prediagnostic markers can lead to earlier detection and potential treatments for PSP.
Area of Science:
- Neuroscience
- Neurology
- Gerontology
Background:
- Prediagnostic features of Parkinson's Disease are well-documented, but prediagnostic Progressive Supranuclear Palsy (PSP) remains less understood.
- Diagnosis of PSP is often delayed by approximately three years after symptom onset.
- Understanding prediagnostic changes is crucial for earlier diagnosis, clarifying disease progression, and designing early therapeutic interventions.
Purpose of the Study:
- To identify prediagnostic motor and cognitive markers for Progressive Supranuclear Palsy (PSP).
- To compare these markers with those of Parkinson's Disease (PD) in a large prospective cohort.
- To investigate the duration and nature of the prediagnostic phase in PSP.
Main Methods:
- Utilized baseline data from 502,504 individuals in the UK Biobank (2006-2010).
- Identified 176 PSP cases and 2526 Parkinson's Disease cases using electronic health records and death registries.
- Compared baseline performance of PSP cases with 5404 matched controls on various motor and cognitive tasks.
Main Results:
- Individuals later diagnosed with PSP exhibited slower reaction times, weaker grip strength, and lower scores in fluid intelligence, prospective memory, and digit recall at baseline.
- These objective motor and cognitive deficits were evident an average of 7.8 years before PSP diagnosis.
- The PSP group showed higher mortality rates compared to both Parkinson's Disease and control groups.
Conclusions:
- A significant prediagnostic phase exists for PSP, characterized by subtle motor and cognitive alterations.
- Objective markers for motor slowing and cognitive dysfunction appear years before clinical diagnosis.
- These findings highlight the potential for early identification of PSP through subtle, measurable changes.