Autonomic dysfunction in progressive supranuclear Palsy: A retrospective study

Area of Science:

• Neurology
• Autonomic Nervous System Disorders
• Neurodegenerative Diseases

Background:

• Autonomic dysfunction is a common but often underrecognized feature in neurodegenerative diseases.
• Differentiating between Parkinson's disease (PD), multiple system atrophy-parkinsonian type (MSA-P), and progressive supranuclear palsy (PSP) is crucial due to differing prognoses and management strategies.
• Understanding the specific patterns of autonomic dysfunction in PSP is essential for accurate diagnosis and patient care.

Purpose of the Study:

• To investigate and compare the characteristics of autonomic dysfunction in patients with PSP.
• To differentiate autonomic dysfunction patterns between PSP, MSA-P, and PD.
• To evaluate the utility of the SCOPA-AUT scale and objective measures in assessing autonomic dysfunction in PSP.

Main Methods:

• Retrospective review of 128 patients (16 PSP, 27 MSA-P, 11 PD) treated between March 2021 and November 2023.
• Assessment of autonomic dysfunction using the SCOPA-AUT scale and analysis of medical records.
• Statistical analysis performed using IBM SPSS Statistics 26, including comparisons of SCOPA-AUT scores, orthostatic hypotension, and residual urine volume.

Main Results:

• Autonomic dysfunction was present in all groups, with PSP showing lower total SCOPA-AUT scores than MSA-P (p=0.019).
• Significant differences between PSP and MSA-P were noted in urinary control (p=0.006) and storage (p=0.008).
• Orthostatic hypotension was significantly more prevalent in MSA-P (66.7%) compared to PSP (7.7%) (p<0.001). Residual urine volume was highest in MSA-P.

Conclusions:

• PSP exhibits diverse autonomic dysfunction, sharing some characteristics with both MSA-P and PD.
• Objective assessments like orthostatic blood pressure measurements and residual urine ultrasound are valuable for identifying autonomic dysfunction in PSP.
• These findings aid in distinguishing PSP from other parkinsonian syndromes based on autonomic profiles.