Depression and Apathy across Different Variants of Progressive Supranuclear Palsy

Bower, Sarah M.; Weigand, Stephen D.; Ali, Farwa; Clark, Heather M.; Botha, Hugo; Stierwalt, Julie A.G.; Whitwell, Jennifer L.; Josephs, Keith A.

doi:10.1002/mdc3.13396

Cited by 11 publications

(11 citation statements)

References 23 publications

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“…In about 40-80% of patients, parkinsonism starts asymmetrically, 50% of patients present with tremor, and about 50-70% of patients have moderate to good response to levodopa early in the disease course (169,172). While some studies found no difference in apathy or depression between PSP-P and RS (76,173), apathy was more frequent in PSP-P in one study (75) and in PSP-R in another (174), but further studies are needed. Early cognitive decline is more common in RS than PSP-P (76,172) and generally, neuropsychiatric and cognitive symptoms are more severe in both PSP variants compared to PD (76).…”

Section: Clinical Syndromes With Less Association To a Primary Tauopa...mentioning

confidence: 98%

Clinical Spectrum of Tauopathies

2022

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Tauopathies are both clinical and pathological heterogeneous disorders characterized by neuronal and/or glial accumulation of misfolded tau protein. It is now well understood that every pathologic tauopathy may present with various clinical phenotypes based on the primary site of involvement and the spread and distribution of the pathology in the nervous system making clinicopathological correlation more and more challenging. The clinical spectrum of tauopathies includes syndromes with a strong association with an underlying primary tauopathy, including Richardson syndrome (RS), corticobasal syndrome (CBS), non-fluent agrammatic primary progressive aphasia (nfaPPA)/apraxia of speech, pure akinesia with gait freezing (PAGF), and behavioral variant frontotemporal dementia (bvFTD), or weak association with an underlying primary tauopathy, including Parkinsonian syndrome, late-onset cerebellar ataxia, primary lateral sclerosis, semantic variant PPA (svPPA), and amnestic syndrome. Here, we discuss clinical syndromes associated with various primary tauopathies and their distinguishing clinical features and new biomarkers becoming available to improve in vivo diagnosis. Although the typical phenotypic clinical presentations lead us to suspect specific underlying pathologies, it is still challenging to differentiate pathology accurately based on clinical findings due to large phenotypic overlaps. Larger pathology-confirmed studies to validate the use of different biomarkers and prospective longitudinal cohorts evaluating detailed clinical, biofluid, and imaging protocols in subjects presenting with heterogenous phenotypes reflecting a variety of suspected underlying pathologies are fundamental for a better understanding of the clinicopathological correlations.

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Section: Clinical Syndromes With Less Association To a Primary Tauopa...mentioning

confidence: 98%

Clinical Spectrum of Tauopathies

2022

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Section: Discussionmentioning

confidence: 99%

“…Patients with PSP frequently experience depression [3][4][5][6]14,15 and are commonly prescribed antidepressants. 14,15 In this case, depres- PSP and corticobasal syndrome, selective serotonin reuptake inhibitors may be used; however, tricyclic antidepressants should be avoided. 16 Nevertheless, in a study of 892 patients with PSP, 231 (26%), 60 (7%), and 114 (13%) patients were prescribed selective serotonin reuptake inhibitors/serotonin-noradrenaline reuptake inhibitors, tricyclic antidepressants, and other antidepressants, respectively.…”

Section: Discussionmentioning

confidence: 99%

A case presenting with a major depressive episode with palilalia and difficulty opening eyes as prodromal symptoms of progressive supranuclear palsy

et al. 2022

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Background: Progressive supranuclear palsy (PSP) is a neurodegenerative disease and patients with PSP frequently experience depression. However, there have been few reports of patients with major depressive disorder as an antecedent diagnosis of PSP.Here, we report a case who presented with a major depressive episode with palilalia and difficulty in opening his eyes as prodromal symptoms of PSP.Case Presentation: A Japanese man developed his first major depressive episode at the age of 75 years. At 76 years old, the patient developed palilalia and difficulty in opening his eyes, which worsened with anxiety and agitation. His depression symptoms were not alleviated following treatment with several antidepressants. He gradually became less depressed but more apathetic. Subsequently, he experienced falls and developed nuchal and axial rigidity. Magnetic resonance imaging and 123 I-ioflupane single-photon emission tomography showed predominant midbrain atrophy and postsynaptic striatal dopaminergic degeneration, respectively. He was diagnosed as having symptoms suggestive of PSP at the age of 80 years. The combination of sertraline and aripiprazole reduced his

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“…The cortical variants of PSP show worse motor disability, cognitive impairment and activities of daily living compared with subcortical variants of PSP [31,33 ▪ ]. Depression is observed across PSP variants, except in PSP-speech/language [34]. The absence of ocular motor impairments was a predictor of long (≥10 years) survival, while early frontal lobe dysfunction predicted shorter survival, in PSP in another study, with PSP-parkinsonism particularly frequent in the long survival group [35 ▪ ].…”

Section: Understanding Clinical and Anatomical Heterogeneitymentioning

confidence: 92%

Clinical and neuroimaging features of the progressive supranuclear palsy- corticobasal degeneration continuum

Whitwell

2023

Current Opinion in Neurology

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Purpose of review The aim of this study was to discuss how recent work has increased our understanding of progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). The investigation of large and autopsy-confirmed cohorts, imaging modalities to assess different aspects of pathophysiology, clinical phenotypes and the application of advanced machine learning techniques, have led to recent advances in the field that will be discussed. Recent findings Literature over the past 18 months will be discussed under the following themes: studies assessing how different neuroimaging modalities can improve the diagnosis of PSP and CBD from other neurodegenerative and parkinsonian disorders, including the investigation of pathological targets such as tau, iron, neuromelanin and dopamine and cholinergic systems; work improving our understanding of clinical, neuroanatomical and pathological heterogeneity in PSP and CBD; and work using advanced neuroimaging tools to investigate patterns of disease spread, as well as biological mechanisms potentially driving spread through the brain in PSP and CBD. Summary The findings help improve the imaging-based diagnosis of PSP and CBD, allow more targeted prognostic estimates for patients accounting for phenotype or disease, and will aid in the development of appropriate and better-targeted disease biomarkers for clinical treatment trials.

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Depression and Apathy across Different Variants of Progressive Supranuclear Palsy

Cited by 11 publications

References 23 publications

Clinical Spectrum of Tauopathies

Clinical Spectrum of Tauopathies

A case presenting with a major depressive episode with palilalia and difficulty opening eyes as prodromal symptoms of progressive supranuclear palsy

Clinical and neuroimaging features of the progressive supranuclear palsy- corticobasal degeneration continuum

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