Clinical outcomes and cognitive impairments between progressive supranuclear palsy and multiple system atrophy

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Peifei Jia1,2, Jinhong Zhang1,3, Jiuyan Han4

  • 1Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China.

Brain and Behavior
|November 21, 2022
PubMed
Abstract

Insights

Differentiating atypical parkinsonian syndromes like progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) is crucial. PSP patients exhibit more severe cognitive deficits than MSA-P patients, with cognitive test scores aiding diagnosis.

Area of Science:

  • Neurology
  • Neuroscience
  • Clinical Medicine

Background:

  • Progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) are distinct atypical parkinsonian syndromes.
  • Accurate differentiation between PSP and MSA is clinically significant.
  • Understanding their unique clinical and cognitive profiles aids diagnosis.

Purpose of the Study:

  • To compare clinical outcomes and cognitive impairments between PSP and MSA-P patients.
  • To identify key differentiating features for accurate diagnosis.
  • To evaluate the utility of cognitive assessments in distinguishing these conditions.

Main Methods:

  • A cohort of 85 MSA parkinsonism type (MSA-P) patients and 76 PSP patients were included.
  • Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and mini-mental state examination (MMSE).
  • Clinical outcomes such as dyskinesia, falls, and autonomic symptoms were recorded.

Main Results:

  • MSA-P patients showed higher rates of dyskinesia, falls, urinary symptoms, and constipation compared to PSP patients.
  • PSP patients had a higher incidence of tremor and salivation.
  • MSA-P patients achieved significantly higher scores on both MMSE and MoCA tests than PSP patients.

Conclusions:

  • PSP and MSA-P present with distinct clinical features and cognitive profiles.
  • PSP is associated with more severe cognitive impairments compared to MSA-P.
  • MMSE and MoCA scores, with specific cut-offs (MMSE 24.5, MoCA 20.5), can effectively differentiate between PSP and MSA-P.
Keywords:
cognitive impairmentsmultiple system atrophyprogressive supranuclear palsythe Montreal Cognitive Assessmentthe mini-mental state examination

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