Clinical patterns in social cognition & personality changes in progressive supranuclear palsy

Area of Science:

• Neuroscience
• Psychology
• Clinical Neurology

Background:

• Progressive supranuclear palsy (PSP) is associated with socioemotional deficits, including reduced emotion recognition, impaired perspective-taking, and apathy.
• The variability and specific patterns of social cognition impairments in PSP require further quantification in larger populations.

Purpose of the Study:

• To comprehensively identify and quantify socioemotional changes in early-stage PSP using a multi-modal assessment approach.
• To investigate the relationship between social withdrawal, apathy, depression, and hopelessness in individuals with PSP.

Main Methods:

• Utilized a cohort of 113 individuals with early-stage PSP (CDR < 2) and 174 healthy controls (HC).
• Employed a battery of face-to-face and informant-based measures assessing social cognition, neuropsychiatric symptoms, and personality.
• Analyzed data to compare PSP patients and HC, and to explore correlations between clinical variables.

Main Results:

• Individuals with PSP demonstrated pervasive deficits in social cognition, encompassing emotion reading, social inferencing, theory of mind, and social behavior rule application compared to HC.
• PSP patients exhibited increased self- and informant-reported depression, apathy, and anxiety.
• Significant personality changes were observed, including reduced conscientiousness, openness, and extraversion.
• Social withdrawal in PSP was found to be directly correlated with depression severity and hopelessness, rather than solely apathy or emotion recognition deficits.

Conclusions:

• Early-stage PSP is characterized by more profound socioemotional deficits and personality shifts than commonly recognized.
• Comprehensive assessment, including direct testing and informant reports, is crucial for understanding and managing socioemotional changes in PSP.
• The findings highlight the complex interplay of depression and hopelessness in driving social withdrawal in PSP, suggesting targeted interventions may be beneficial.