Qualitative evaluation of the Rey-Osterrieth Complex Figure Test in patients with progressive supranuclear palsy

Area of Science:

• Neuroscience
• Neurology
• Cognitive Psychology

Background:

• Differentiating early-stage Parkinson's Disease (PD) from atypical parkinsonism like Progressive Supranuclear Palsy (PSP) is clinically challenging.
• Neuropsychological markers are increasingly investigated for diagnosing degenerative parkinsonism.
• The Rey-Osterrieth Complex Figure Test (ROCFT) copy performance may distinguish PSP from PD, but the specific cognitive abilities involved are unclear.

Purpose of the Study:

• To investigate which cognitive abilities, assessed by the Boston Qualitative Scoring System (BQSS), underlie performance in the ROCFT copy trial for PSP patients.
• To evaluate the utility of BQSS scores in discriminating PSP from PD.

Main Methods:

• Thirty patients with PSP-Richardson's Syndrome (PSP-RS), 30 with PD, and 30 healthy controls (HC) were enrolled.
• All participants completed a neuropsychological evaluation, including the ROCFT copy assessed with the 36-Point Score and the BQSS.
• Statistical analysis, including logistic regression, was used to identify discriminating BQSS scores.

Main Results:

• PSP-RS patients exhibited poorer performance on the ROCFT 36-Point Score and several BQSS measures compared to PD patients and HC.
• "Perseveration" and "Vertical Expansion" BQSS scores were the most effective in discriminating PSP-RS from PD.
• A logistic regression model incorporating "Perseveration" and "Vertical Expansion" achieved 83.3% diagnostic accuracy for PSP-RS.

Conclusions:

• The BQSS scores for "Perseveration" and "Vertical Expansion" are valuable tools for differentiating PSP-RS from PD.
• These qualitative BQSS scores should be considered alongside quantitative measures in the cognitive evaluation for suspected PSP cases.