Department of Neurology, University of Utah, Salt Lake City, UT, USA.
Department of Neurology, Loyola University Medical Center, Maywood, IL, USA.
Clin Neuropsychol. 2020 Apr;34(3):529-540. doi: 10.1080/13854046.2019.1670865. Epub 2019 Sep 27.
Progressive supranuclear palsy (PSP) is associated with a variety of cognitive deficits, but few studies have reported on its cognitive trajectory across time, especially on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Two hundred twenty participants diagnosed with Richardson's syndrome of PSP (PSP-RS) were evaluated with the RBANS at baseline, six months, and one year with alternate forms. When using dependent -tests, significant declines were observed on all Indexes of the RBANS from baseline to six months (ps < 0.01). Between six months and one year, significant declines were observed on three Indexes of the RBANS (ps < 0.05). Using existing regression-based change formulae from cognitively intact older adults, these participants with PSP showed significant decline on all RBANS Indexes (ps < 0.01) across one year. Finally, new regression-based change formulae were developed on this sample of individuals with PSP-RS to more precisely evaluate cognitive change in this condition. In this large, longitudinal cohort of participants with PSP-RS, many (but not all) showed notable cognitive decline across six months and one year on the RBANS. The different methods of examining change across time yielded different results, with regression-based methods appearing to more accurately capture decline in this sample. These findings are expected to allow clinicians to more accurately evaluate cognitive trajectories in patients with PSP, as well as make better estimates of prognosis and offer more appropriate treatment recommendations. Such findings are also expected to inform clinical trials as to the changes in cognitive outcomes with this neurological condition.
进行性核上性麻痹(PSP)与多种认知缺陷有关,但很少有研究报告其随时间的认知轨迹,特别是在重复性成套神经心理状态评估量表(RBANS)上。220 名被诊断为 PSP 的 Richardson 综合征(PSP-RS)的参与者在基线、6 个月和 1 年时使用交替形式接受 RBANS 评估。使用依赖检验,从基线到 6 个月时,RBANS 的所有指数都观察到显著下降(ps<0.01)。在 6 个月到 1 年之间,RBANS 的三个指数观察到显著下降(ps<0.05)。使用认知正常的老年人的现有基于回归的变化公式,这些 PSP 患者在所有 RBANS 指数上都表现出显著下降(ps<0.01),持续一年。最后,针对 PSP-RS 个体的这一样本开发了新的基于回归的变化公式,以更准确地评估这种情况下的认知变化。在这个 PSP-RS 的大型纵向队列中,许多(但不是全部)参与者在 RBANS 上显示出在 6 个月和 1 年内明显的认知下降。随着时间推移检查变化的不同方法产生了不同的结果,基于回归的方法似乎更准确地捕捉到了该样本中的下降。这些发现有望使临床医生更准确地评估 PSP 患者的认知轨迹,并对预后做出更好的估计,提供更合适的治疗建议。这些发现还将为临床试验提供信息,了解这种神经状况下认知结果的变化。