Utility of the Short Cognitive and Neuropsychiatric Assessment Scale (ShoCo) in a multiethnic Asian cohort of patients with progressive supranuclear palsy.

BACKGROUND

Progressive supranuclear palsy (PSP) is characterized not only by motor and oculomotor deficits, but also significant cognitive and behavioural impairments. The Short Cognitive and Neuropsychiatric Assessment Scale (ShoCo) was recently published and appears to be an efficient instrument to evaluate these deficits. However, feasibility testing and validation in real-world cohorts are needed.

METHODS

In this cross-sectional study, the ShoCo was administered in 304 consecutively recruited multi-ethnic Malaysian patients (75 PSP, and for comparison Parkinson's disease patients with dementia [PDD; n = 53] and without dementia [PDND; n = 176]). Clinico-demographic features including disease severity (PSP Clinical Deficits Scale [PSP-CDS] and Cortical Basal ganglia Functional Scale [CBFS]) and Montreal Cognitive Assessment (MoCA), were collected. A subset of PSP patients (n = 16) also underwent a comprehensive neuropsychological battery by a neuropsychologist blinded to the ShoCo results.

RESULTS

Highly significant differences were found between PSP and PDD vs. PDND for the ShoCo total and all subdomain scores (all P < 0.001). PSP showed greater disinhibition, whereas PDD had more severe bradyphrenia, apathy and dysexecution. In PSP patients, the ShoCo correlated significantly and moderately with the PSP-CDS (rs = 0.39), CBFS (rs = 0.39), and MoCA (rs = -0.46). There were also significant and strong correlations between the ShoCo and neuropsychological tests of executive function and attention/processing speed (rs∼0.5-0.6).

CONCLUSIONS

The ShoCo is a practical cognitive-behavioural screening tool that quantifies clinically relevant deficits in PSP. It enables the inclusion of severely affected patients in clinical and research settings and may reduce missing data while enhancing the representativeness of phenotypic datasets.