Gait Analysis in Progressive Supranuclear Palsy Phenotypes.

Marina Picillo,Filomena Abate,Paolo Barone,Roberto Erro,Carlo Ricciardi,Immacolata Carotenuto,Marianna Amboni,Mario Cesarelli,Michela Russo,Sofia Cuoco,Maria Francesca Tepedino,Gianluca Ricciardelli

doi:10.3389/fneur.2021.674495

Abstract

The objective of the present study was to describe gait parameters of progressive supranuclear palsy (PSP) phenotypes at early stage verifying the ability of gait analysis in discriminating between disease phenotypes and between the other variant syndromes of PSP (vPSP) and Parkinson's disease (PD). Nineteen PSP (10 PSP-Richardson's syndrome, five PSP-parkinsonism, and four PSP-progressive gait freezing) and nine PD patients performed gait analysis in single and dual tasks. Although phenotypes showed similar demographic and clinical variables, Richardson's syndrome presented worse cognitive functions. Gait analysis demonstrated worse parameters in Richardson's syndrome compared with the vPSP. The overall diagnostic accuracy of the statistical model during dual task was almost 90%. The correlation analysis showed a significant relationship between gait parameters and visuo-spatial, praxic, and attention abilities in PSP-Richardson's syndrome only. vPSP presented worse gait parameters than PD. Richardson's syndrome presents greater gait dynamic instability since the earliest stages than other phenotypes. Computerized gait analysis can differentiate between PSP phenotypes and between vPSP and PD.

Highlights

Progressive supranuclear palsy (PSP) is a rare, rapidly progressive, neurodegenerative disease characterized by dysfunction in four core domains including ocular motor function, postural instability, akinesia, and cognition [1]
The present study shows quantitative gait parameters in progressive supranuclear palsy (PSP) phenotypes at early stages
We demonstrate that PSPRS patients show increased measures of dynamic instability compared with variant syndromes of PSP (vPSP), mainly during a dual task (COG task)

Summary

Introduction

Progressive supranuclear palsy (PSP) is a rare, rapidly progressive, neurodegenerative disease characterized by dysfunction in four core domains including ocular motor function, postural instability, akinesia, and cognition [1]. While PSP-Richardson’s syndrome (PSP-RS) is the most common clinical phenotype, other distinct variants of the disease (vPSP) have been described, each featured by a specific predominant symptom [1]. Specific algorithms have been developed [1, 2], evidence shows that available clinical and radiological assessments do not support the differentiation of the PSP phenotypes [3,4,5]. Irrespective of the phenotype, PSP patients feature a profound gait dysfunction compared with other movement disorders [8,9,10,11]. There is no study comparing quantitative gait parameters between PSP phenotypes

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Conclusion