Cognitive and behavioural dysfunctions in a patient with progressive supranuclear palsy (PSP)

Abstract

The aim of the case study was to describe the profile of cognitive and emotional functioning of a patient with possible progressive supranuclear palsy (PSP) from a longitudinal perspective. This study involved an 71-year-old male patient diagnosed with PSP, and 9 matched healthy subjects. Neuropsychological examination of the patient was performed twice with a 6-month interval. A set of neuropsychological tests was used to assess both cognition and behaviour. Neuropsychological assessment revealed executive dysfunction dominance (planning deficits, reduced cognitive flexibility and abstract thinking, impulsiveness), reduced verbal fluency, psychomotor slowness and problems with memory retrieval from the long-term memory storage in contrast to significantly better recognition of the previ-ously learned information. According to emotional functioning, frontal change of personality was observed, with apathy, disinhibition, lack of insights, impulsiveness and “utilization behaviours”. The profile of emotional and cognitive impairments met the criteria for dementia. There was a progression of deficits at visit two in comparison to visit one. The longitudinal perspective allowed the dynamics of emotional, cognitive and behavioural changes to be described over time: from depression related to initially preserved criticism of the illness to apathy and emotional blunting and behavioural frontal syndrome connected with the systematic loss of insight. Cognitive and behavioural profile of progressive supranuclear palsy (PSP)