ArticleMovement disorders clinical practice2025
Evaluating the Homogeneity of the PSP-RS Syndrome beyond Core Features.
Article in Movement disorders clinical practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundClassic progressive supranuclear palsy RS syndrome (PSP-RS) is characterized by early postural instability/falls and vertical supranuclear gaze palsy, although other signs/symptoms can occur, for example, axial rigidity, bradykinesia, and cognitive dysfunction. The Movement Disorders Society-PSP (MDS-PSP) criteria consider probable PSP-RS a homogenous syndrome, but this has not been tested.
objectivesWe aim to investigate relationships between signs/symptoms of PSP-RS beyond its core features and determine whether PSP-RS is a homogeneous syndrome.
methods118 participants who met MDS-PSP criteria for probable PSP-RS were analyzed. All participants received an independent clinical diagnosis based on clinical judgment. We first performed a Network Analysis using qgraph with Spearman's correlation to quantify relationships between 16 signs/symptoms followed by a k-means clustering analysis using the same signs/symptoms to identify possible heterogeneity of the PSP-RS designation.
resultsFive network clusters were identified, reflecting: (1) tremor, (2) sensitivity to bright light, (3) oculomotor function, (4) cognition, and (5) akinetic-rigidity-praxis. Worse akinetic-rigidity was associated with better oculomotor function, but worse cognition. Cluster analysis revealed two clusters. Cluster I (n = 89) had more severe clinical features than Cluster II (n = 29). Cluster II had a higher frequency of participants (37.9%) clinically judged as not PSP-RS: these participants were less likely to have PSP pathology on autopsy (P = 0.03).
conclusionsSome signs/symptoms of PSP-RS strongly associate and are more likely to co-occur. PSP-RS, as defined by the MDS-PSP criteria includes a subset of participants not clinically judged as PSP-RS who are less likely to have PSP pathology.
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