| Title: |
Cognitive and neuropsychiatric profiles distinguish atypical parkinsonian syndromes |
| Authors: |
Hu, MT; Coma, AQ; Rowe, JB; Zerenner, T; Church, A; Fumi, R; Costantini, A; Jabbari, E; Jensen, MT; Gerhard, A; Pavese, N; Kobylecki, C; Leigh, PN; Koychev, I; Morris, HR; Manohar, SG |
| Publisher Information: |
Oxford University Press |
| Publication Year: |
2025 |
| Collection: |
Oxford University Research Archive (ORA) |
| Description: |
Atypical parkinsonian syndromes are distinguished from Parkinson's disease (PD) by additional neurological signs and characteristic underlying neuropathology. However, they can be diagnostically challenging, rapidly progressive and are often diagnosed late in disease course. Their different demographic features and prognoses are well studied, but the accompanying cognitive and psychiatric features may also facilitate diagnosis. Progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS) may cause cognitive and behavioural manifestations that overlap with frontotemporal dementia, including non-fluent aphasia, apathy and impulsivity. Clinical diagnostic criteria have limited sensitivity, with pathologically confirmed PSP often having presented an initial clinical syndrome other than PSP-Richardson's syndrome. Here, we integrate cross-sectional multicentre baseline data from the PROSPECT-M-UK and Oxford Discovery cohorts. This allowed us to compare cognitive and psychiatric features across a total of 1138 people with PSP, CBS, multiple-system atrophy (MSA) and idiopathic PD. Data from the different cohorts were harmonized and compared using multiple linear regression. There were five key results: (i) different syndromes showed distinctive cognitive profiles, using readily applicable ‘bedside’ screening tools. Frontal executive dysfunction was most evident in PSP, visuospatial deficits in CBS, with milder deficits in memory and executive function in MSA, as compared with PD; (ii) the most prevalent neuropsychiatric features were depression and anxiety in CBS, apathy in PSP, with sleep disturbances common in PD. As expected, apathy correlated positively with impulsivity across all disorders. Neuropsychiatric features were generally better at discriminating between atypical parkinsonian syndromes than were the cognitive domains; (iii) both cognitive function and motor severity declined with disease duration, and motor function predicted cognition in PSP, CBS and PD but not in MSA, suggesting that in MSA ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
https://doi.org/10.1093/brain/awaf132 |
| DOI: |
10.1093/brain/awaf132 |
| Availability: |
https://doi.org/10.1093/brain/awaf132; https://ora.ox.ac.uk/objects/uuid:83e04b65-b071-457b-964a-2e3e2f6d2a0f |
| Rights: |
info:eu-repo/semantics/openAccess ; CC Attribution-NonCommercial (CC BY-NC) |
| Accession Number: |
edsbas.D2FE8B03 |
| Database: |
BASE |