Characteristics of non-motor symptoms in different subtypes of progressive supranuclear palsy
10.3760/cma.j.cn113694-20240614-00409
- VernacularTitle:进行性核上性麻痹不同亚型的非运动症状特征分析
- Author:
Yinlian HAN
1
;
Min TIAN
1
;
Heyin LIU
1
;
Xinxin WANG
1
;
Yiming LIU
1
Author Information
1. 山东大学齐鲁医院神经内科，济南 250012
- Publication Type:Journal Article
- Keywords:
Supranuclear palsy, progressive;
Autonomic nervous system;
Non-motor symptoms
- From:
Chinese Journal of Neurology
2025;58(3):244-253
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the non-motor symptom characteristics of patients with different subtypes of progressive supranuclear palsy (PSP).Methods:Demographic data were collected from patients diagnosed with probable or possible PSP in the PSP cohort at Qilu Hospital of Shandong University from June 2019 to June 2023. Motor symptoms were evaluated using the Progressive Supranuclear Palsy Rating Scale (PSPRS), Unified Parkinson′s Disease Rating Scale-Ⅲ , and the Freezing of Gait Questionnaire. Non-motor symptoms were assessed using the Non-Motor Symptoms Scale (NMSS), the Montreal Cognitive Assessment, the Hamilton Depression Rating Scale, and the Hamilton Anxiety Rating Scale. Patients were grouped into PSP with Richardson syndrome (PSP-RS), PSP with Parkinsonism (PSP-P), PSP with progressive gait freezing (PSP-PGF), and other subtypes (PSP-other) based on clinical classification. The study compared the non-motor symptom characteristics among the 4 groups and used linear regression models to evaluate the influencing factors of PSP non-motor symptoms.Results:A total of 153 PSP patients were included in this study, with a male-to-female ratio of 89∶64 and an age of (66.0±6.6) years. Among them, 83 were in the PSP-RS group (54.2%), 32 in the PSP-P group (20.9%), 27 in the PSP-PGF group (17.6%), and 11 in the PSP-other group (7.2%). The total NMSS score for non-motor symptoms in PSP patients was 62.6±38.5, with 8.8±4.7 non-motor symptoms per patient. The most common non-motor symptoms among all PSP patients were sleep/fatigue [130/153 (85.0%)], gastrointestinal symptoms [129/153 (84.3%)], urinary symptoms [113/153 (73.9%)], attention/memory impairment [112/153 (73.2%)], and mood symptoms [108/153 (70.6%)]. The total NMSS score of the PSP-RS group (70.8±36.0) was higher than that of the PSP-PGF group (49.4±40.3; t=2.561, P=0.011). The number of non-motor symptoms in the PSP-RS group (9.9±4.4) was greater than that in the PSP-P group (7.7±5.5; t=2.365, P=0.019) and the PSP-PGF group (6.9±4.3; t=2.978, P=0.003). The incidence of memory decline in the PSP-RS group [52/83 (62.7%)] was higher than that in the PSP-P group [10/32 (31.3%); χ 2=9.165, Bonferroni-corrected P=0.012], and the incidence of constipation in the PSP-RS group [49/83 (59.0%)] was higher than that in the PSP-PGF group [8/27 (29.6%); χ 2=7.056, Bonferroni-corrected P=0.048]. Multivariate regression analysis showed that the bulbar symptom score ( β=5.591, 95% CI 1.792-9.389, P=0.005), limb motor score ( β=1.786, 95% CI 0.398-3.174, P=0.013), and gait/axial score ( β=1.956, 95% CI 0.149-3.763, P=0.036) in PSPRS were all associated with non-motor symptom scores. Conclusions:Different PSP subtypes exhibit distinct non-motor symptom profiles. PSP-RS patients bear a heavier non-motor symptom burden, with higher incidences of memory decline and constipation than other subtypes. These findings may aid in the early recognition and clinical diagnosis of PSP.
