Xin-Yi Li, Yu-Jie Yang, Fang-Yang Jiao, Gan Tang, Ming-Jia Chen, Rui-Xin Yao, Yi-Xin Zhao, Xiao-Niu Liang, Bo Shen, Yi-Min Sun, Jian-Jun Wu, Jian Wang, Feng-Tao Liu
{"title":"Rapid Cognitive Deterioration in Progressive Supranuclear Palsy: A 1-Year Follow-Up Study.","authors":"Xin-Yi Li, Yu-Jie Yang, Fang-Yang Jiao, Gan Tang, Ming-Jia Chen, Rui-Xin Yao, Yi-Xin Zhao, Xiao-Niu Liang, Bo Shen, Yi-Min Sun, Jian-Jun Wu, Jian Wang, Feng-Tao Liu","doi":"10.1002/mdc3.14315","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Nowadays, cognitive impairment has been characterized as one of the most vital clinical symptoms in progressive supranuclear palsy (PSP).</p><p><strong>Objectives: </strong>Based on a relatively large cohort, we aimed to show the cognitive deterioration in different PSP subtypes during 1-year follow-up and investigate potential contributors for disease prognosis.</p><p><strong>Methods: </strong>One hundred seventeen patients from Progressive Supranuclear Palsy Neuroimage Initiative (PSPNI) cohort underwent neuropsychological tests and 1-year follow-up, with 73 diagnosed as PSP-Richardson syndrome (PSP-RS) and 44 as PSP-non-RS. Patients were divided into normal cognition (PSP-NC), mild cognitive impairment (PSP-MCI), and PSP-dementia. Cognitive impairment and progression rates were compared between PSP-RS and PSP-non-RS, and determinants for MCI conversion to dementia were calculated by multiple cox regression.</p><p><strong>Results: </strong>At baseline, 30.8% of PSP patients were diagnosed as dementia, 53.0% as MCI, and only 16.2% as NC. Compared to PSP-non-RS, PSP-RS suffered more from motor symptoms and cognitive impairment. During follow-up, PSP-RS also exhibited faster disease progression in Mini-Mental State Examination and visuospatial function, with cognitive deterioration in attention and executive function, but retained in language and memory subdomains. Twenty-seven of 62 PSP-MCI patients converted to dementia during follow-up, with the diagnosis of RS subtype as the most significant contributor to conversion (hazard ration = 2.993, 95% confidence interval = 1.451, 5.232, P = 0.009).</p><p><strong>Conclusions: </strong>Patients with PSP-RS showed more severe cognitive impairment and faster decline longitudinally than patients with PSP-non-RS. Additionally, the diagnosis of RS subtype appears to be the most contributed factor for MCI conversion to dementia within just 1-year follow-up period.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Movement Disorders Clinical Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/mdc3.14315","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Nowadays, cognitive impairment has been characterized as one of the most vital clinical symptoms in progressive supranuclear palsy (PSP).
Objectives: Based on a relatively large cohort, we aimed to show the cognitive deterioration in different PSP subtypes during 1-year follow-up and investigate potential contributors for disease prognosis.
Methods: One hundred seventeen patients from Progressive Supranuclear Palsy Neuroimage Initiative (PSPNI) cohort underwent neuropsychological tests and 1-year follow-up, with 73 diagnosed as PSP-Richardson syndrome (PSP-RS) and 44 as PSP-non-RS. Patients were divided into normal cognition (PSP-NC), mild cognitive impairment (PSP-MCI), and PSP-dementia. Cognitive impairment and progression rates were compared between PSP-RS and PSP-non-RS, and determinants for MCI conversion to dementia were calculated by multiple cox regression.
Results: At baseline, 30.8% of PSP patients were diagnosed as dementia, 53.0% as MCI, and only 16.2% as NC. Compared to PSP-non-RS, PSP-RS suffered more from motor symptoms and cognitive impairment. During follow-up, PSP-RS also exhibited faster disease progression in Mini-Mental State Examination and visuospatial function, with cognitive deterioration in attention and executive function, but retained in language and memory subdomains. Twenty-seven of 62 PSP-MCI patients converted to dementia during follow-up, with the diagnosis of RS subtype as the most significant contributor to conversion (hazard ration = 2.993, 95% confidence interval = 1.451, 5.232, P = 0.009).
Conclusions: Patients with PSP-RS showed more severe cognitive impairment and faster decline longitudinally than patients with PSP-non-RS. Additionally, the diagnosis of RS subtype appears to be the most contributed factor for MCI conversion to dementia within just 1-year follow-up period.
期刊介绍：
Movement Disorders Clinical Practice- is an online-only journal committed to publishing high quality peer reviewed articles related to clinical aspects of movement disorders which broadly include phenomenology (interesting case/case series/rarities), investigative (for e.g- genetics, imaging), translational (phenotype-genotype or other) and treatment aspects (clinical guidelines, diagnostic and treatment algorithms)
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