Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China.
Department of Neurology, The Second Affiliated Hospital of Baotou Medical College, Baotou, China.
Brain Behav. 2022 Dec;12(12):e2827. doi: 10.1002/brb3.2827. Epub 2022 Nov 21.
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.
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.
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.
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.
进行性核上性麻痹（PSP）和多系统萎缩（MSA）均属于非典型帕金森综合征。准确地区分这些疾病很重要。我们比较了 PSP 和 MSA 之间的临床结果和认知障碍。
本研究纳入 85 例 MSA 帕金森病型（MSA-P）患者和 76 例 PSP 患者。采用蒙特利尔认知评估量表（MoCA）和简易精神状态检查量表（MMSE）评估认知功能。
MSA-P 患者发生运动障碍、跌倒、尿便症状和便秘的比例显著高于 PSP 患者，而 PSP 患者发生震颤和流涎的比例高于 MSA-P 患者。MSA-P 患者的 MMSE 和 MoCA 评分均高于 PSP 患者。MMSE 评分在 PSP 与 MSA-P 之间的诊断截断值为 24.5。MoCA 评分在 PSP 与 MSA-P 之间的诊断截断值为 20.5。
综上所述，与 MSA-P 患者相比，PSP 患者的临床结局和认知障碍存在差异。PSP 患者的认知缺陷更为严重。MMSE 和 MoCA 评分可用于区分 MSA-P 和 PSP。
