Clinical outcomes and cognitive impairments between progressive supranuclear palsy and multiple system atrophy

Brain Behav. 2022 Dec;12(12):e2827. doi: 10.1002/brb3.2827. Epub 2022 Nov 21.

Abstract

Background: Both progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) belong to atypical parkinsonian syndromes. It is important to differentiate these diseases accurately. We compared clinical outcomes and cognitive impairments between PSP and MSA.

Methods: Eighty-five MSA parkinsonism type (MSA-P) patients and 76 PSP patients participated in this research. The Montreal Cognitive Assessment (MoCA) and the mini-mental state examination (MMSE) evaluated cognitive function.

Results: MSA-P patients had a significantly higher incidence of dyskinesia, fall, urinary symptoms, and constipation, whereas patients with PSP had a higher incidence of tremor and salivation. MSA-P patients had higher MMSE and MoCA scores than PSP patients. The MMSE score showed a diagnostic cut-off score of 24.5 in PSP versus MSA-P. The MoCA score showed a diagnostic cut-off score of 20.5 in PSP versus MSA-P.

Conclusion: In conclusion, patients with PSP had differences in the clinical outcomes and cognitive impairments compared with MSA-P patients. PSP patients had more severe cognitive deficits. The score of MMSE and MoCA could be used in distinguishing MSA-P from PSP.

Keywords: cognitive impairments; multiple system atrophy; progressive supranuclear palsy; the Montreal Cognitive Assessment; the mini-mental state examination.

MeSH terms

  • Cognitive Dysfunction* / diagnosis
  • Cognitive Dysfunction* / etiology
  • Humans
  • Mental Status and Dementia Tests
  • Multiple System Atrophy* / complications
  • Multiple System Atrophy* / diagnosis
  • Parkinsonian Disorders* / complications
  • Parkinsonian Disorders* / diagnosis
  • Supranuclear Palsy, Progressive* / complications
  • Supranuclear Palsy, Progressive* / diagnosis