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与帕金森病相比,进行性核上性麻痹的认知障碍:按临床亚型和纵向变化进行评估

Cognitive impairment in PSP compared with PD: assessment by clinical subtype and longitudinal change.

作者信息

Tsuboi Takeharu, Tatsumi Hiroshi, Kobayasi Kosuke, Hashimoto Rina, Aiba Ikuko

机构信息

Department of Rehabilitation, National Hospital Organization Higashinagoya National Hospital, Nagoya, Japan.

Aichi Gakuin University, Nissin, Japan.

出版信息

BMJ Neurol Open. 2025 Jan 9;7(1):e000946. doi: 10.1136/bmjno-2024-000946. eCollection 2025.

DOI:10.1136/bmjno-2024-000946
PMID:39850796
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11751889/
Abstract

BACKGROUND

Longitudinal studies investigating cognitive function changes in patients with progressive supranuclear palsy (PSP) are limited. The variability of cognitive impairment across clinical subtypes of PSP remains unclear.

OBJECTIVE

This study aimed to compare the longitudinal changes in cognitive function between patients with PSP and Parkinson's disease (PD) and to assess differences in cognitive impairment among PSP subtypes.

METHODS

A retrospective observational study was conducted using neuropsychological testing data from patients with PSP and PD admitted to our hospital.

RESULTS

The study included 38 patients with PD and 41 patients with PSP (23 PSP-Richardson's syndrome, 14 PSP-progressive gait freezing (PSP-PGF), 3 PSP-Parkinsonism and 1 PSP-predominant corticobasal syndrome). At baseline, cognitive function was significantly lower in the PSP group than in the PD group. Over 12 months, patients with PSP exhibited significant declines in multiple cognitive domains, whereas no significant changes were observed in the PD group. Among PSP subtypes, PSP-RS showed a faster rate of cognitive decline than PD, while PSP-PGF demonstrated a lower progression than PSP-RS.

CONCLUSION

PSP is associated with progressive cognitive impairment, with rates of decline varying by subtype. PSP-PGF exhibited a slower progression than PSP-RS. Clinical management should consider subtype-specific differences in cognitive prognosis to tailor treatment and care.

摘要

背景

关于进行性核上性麻痹(PSP)患者认知功能变化的纵向研究有限。PSP临床亚型间认知障碍的变异性仍不清楚。

目的

本研究旨在比较PSP患者与帕金森病(PD)患者认知功能的纵向变化,并评估PSP各亚型间认知障碍的差异。

方法

利用我院收治的PSP和PD患者的神经心理学测试数据进行一项回顾性观察研究。

结果

该研究纳入了38例PD患者和41例PSP患者(23例PSP-理查森综合征、14例PSP-进行性步态冻结(PSP-PGF)、3例PSP-帕金森综合征和1例PSP-主要皮质基底节综合征)。基线时,PSP组的认知功能显著低于PD组。在12个月的时间里,PSP患者在多个认知领域均出现显著下降,而PD组未观察到显著变化。在PSP各亚型中,PSP-RS的认知衰退速度比PD快,而PSP-PGF的进展比PSP-RS慢。

结论

PSP与进行性认知障碍相关,衰退速度因亚型而异。PSP-PGF的进展比PSP-RS慢。临床管理应考虑认知预后的亚型特异性差异,以制定治疗和护理方案。