Predicting Disability in Progressive Supranuclear Palsy Using Bedside Frontal-Lobe Signs.

Area of Science:

• Neurology
• Neuroscience
• Clinical Medicine

Background:

• Frontal lobe signs are common and appear early in progressive supranuclear palsy (PSP).
• Systematic investigation is needed to understand the neurological basis and prognostic value of these signs in PSP.

Purpose of the Study:

• To investigate the predictive value of frontal lobe signs in PSP.
• To describe the neuropsychological and anatomical correlations of these frontal signs.

Main Methods:

• Assessed nine frontal lobe dysfunction signs in 61 PSP patients.
• Identified signs predicting baseline PSP Rating Scale (PSPRS) scores.
• Conducted survival analysis and correlated signs with neuropsychological tests and MRI-derived cortical thickness.

Main Results:

• Grasping, anosognosia, and orobuccal apraxia predicted PSPRS score, independent of other factors.
• Early groping (within 4 years) potentially predicted survival.
• Grasping/anosognosia linked to frontal dysfunction; orobuccal apraxia/groping associated with broader cognitive and cortical atrophy (prefrontal, temporal, parietal).

Conclusions:

• Grasping, groping, anosognosia, and orobuccal apraxia are valuable bedside signs in PSP.
• These signs indicate distinct disease progression stages.
• Grasping, anosognosia, orobuccal apraxia predict PSP disability, while early groping may predict survival.