Neuropsychiatric symptoms of progressive supranuclear palsy in a dementia clinic.

BACKGROUND

Progressive supranuclear palsy (PSP) is a neurodegenerative disease characterized by supranuclear gaze palsy, postural instability, akinesia and other parkinsonism. Recently, the relationship between PSP and frontotemporal dementia (FTD) has been recognized, which includes clinical, pathological, biochemical and genetic features. However, there have been few studies that directly compared neuropsychiatric symptoms between PSP and FTD. The aim of the present study was to investigate comprehensive psychiatric and behavioural symptoms in PSP and compared them with those in FTD.

METHODS

Patients with PSP (n = 10) and FTD (n = 13) were selected on the basis of inclusion/exclusion criteria from a consecutive series in the dementia clinic of Kumamoto University Hospital. We assessed their comprehensive neuropsychiatric features by using the Neuropsychiatric Inventory (NPI), the Stereotypy Rating Inventory (SRI) and a specific antisocial behaviour checklist.

RESULTS

There were no significant differences in the total NPI and NPI subscale scores between the two groups. Both groups showed quite a similar pattern in the features of neuropsychiatric symptoms: apathy showed the highest score, followed by aberrant motor behaviour and disinhibition. The PSP group was significantly lower in the total SRI and eating and cooking behaviour scores than those in the FTD group. The prevalence of antisocial behaviours in PSP (50%) was equal to those in the FTD group (46%).

CONCLUSIONS

In a dementia clinic, the neuropsychiatric profile in patients with PSP closely resembled those in the FTD group. The present results suggest that PSP should be considered as not only a movement disorder, but also a disorder with a wide range of neuropsychiatric symptoms.