Comparison of cognitive characteristics in patients with early stage progressive supranuclear palsy and Parkinson’s disease

Abstract

Objective To explore the differences of clinical and cognitive characteristics in patients with early progressive supranuclear palsy (PSP) and Parkinson’s disease (PD). Methods A total of 53 outpatients and inpatients whose Hoehn-Yahr (H&Y) stage was ≤3 were recruited (PSP 22, PD 31) from Guangdong General Hospital between January 2010 and February 2014. All participants underwent a detailed series of clinical investigations (such as H&Y Scale, Activity of Daily Living Scale) and cognitive assessments including Minimum Mental State Examination (MMSE), Montreal Cognitive Assessment（MoCA）, Wechsler Intelligence Scale and Wechsler Memory Scale neuropsychology tests. Then the differences of clinical and cognitive characteristics were analyzed in early PSP and PD groups. Results The scores of Activity of Daily Living Scale and H&Y Scale in PSP group were significantly higher than PD group (24.53±10.67 vs 16.57±3.97, 2.71±0.47 vs 1.92±1.01, t=-3.033，-3.874，both P<0.05). Global cognitive assessment: MMSE and MoCA scores of PSP patients were obviously lower than PD group (24.95±3.35 vs 27.55±2.08, 17.55±4.99 vs 23.29±4.50, t=-3.480，-4.374，both P<0.05). MoCA scores in visuospatial and executive function, naming, attention and orientation of PSP group were lower than PD group (1.91±1.67 vs 3.26±1.81, 2.36±0.79 vs 2.81±0.48, 4.27±1.24 vs 5.39±0.84, 4.73±1.32 vs 5.58±0.72, Z=-2.769，-2.399，-3.654，-2.504，all P<0.05). These PSP patients also scored less than PD patients on similarities, graphic arrangement, the block design test and digit span (6.45±2.89 vs 9.97±3.53, 5.86±2.03 vs 9.42±2.09, 4.91±1.97 vs 8.23±2.81, 6.50± 2.30 vs 9.42±2.09, Z=-3.488，-3.885，-4.138，-2.180，all P<0.05). Conclusions The ability of daily life and stage of illness in early PSP patients are worse than PD patients. The cognitive impairments are more serious in PSP group than PD group, mainly in the aspects of visuospatial, attention and executive function. Key words: Supranuclear palsy, progressive; Parkinson disease; Cognition disorders; Activities of daily living; Severity of illness index