INS NYC 2024 Program

Paper	Paper Session 05 Program Schedule 02/15/2024 02:15 pm - 03:45 pm Room: West Side Ballroom - Salon 1 Paper Session 05: Movement Disorders Final Abstract #1 Differences in Neuropsychological Performance Across Clinical Variants of Progressive Supranuclear Palsy Elizabeth Boots, Mayo Clinic, Rochester, United States Sarah Boland, Mayo Clinic, Rochester, United States Farwa Ali, Mayo Clinic, Rochester, United States Heather Clark, Mayo Clinic, Rochester, United States Julie Stierwalt, Mayo Clinic, Rochester, United States Hugo Botha, Mayo Clinic, Rochester, United States Yehkyoung Stephens, Mayo Clinic, Rochester, United States Keith Josephs, Mayo Clinic, Rochester, United States Jennifer Whitwell, Mayo Clinic, Rochester, United States Mary Machulda, Mayo Clinic, Rochester, United States Category: Movement and Movement Disorders Keyword 1: movement disorders Keyword 2: cognitive functioning Keyword 3: neuropsychological assessment Objective: Despite updated subtype diagnostic criteria for progressive supranuclear palsy (PSP), there is limited work characterizing cognitive features of PSP subtypes using comprehensive neuropsychological evaluations in large samples. Our aim was to investigate differences in cognition between PSP-Richardson (PSP-RS) and subcortical and cortical variants of PSP. Participants and Methods: The Neurodegenerative Research Group at Mayo Clinic Rochester recruited 140 individuals with PSP (mean age=71.3±6.9 years; mean education=15.0±2.8 years; 49.3% female; 95.7% white) from 2009-2023 as part of a longitudinal study involving annual neurological and neuropsychological assessments. Participants received diagnoses of PSP clinical variants at their baseline evaluation (or retrospectively if evaluated before 2017) according to MDS-PSP criteria. Of the 140 participants, 62 had a diagnosis of PSP-RS, 27 had PSP-parkinsonism (PSP-P), 11 had PSP-progressive gait freezing (PSP-PGF), 6 had PSP-postural instability (PSP-PI), 9 had PSP-corticobasal syndrome (PSP-CBS), and 25 had PSP-speech/language (PSP-SL). For this study, we grouped diagnostic subtypes as PSP-RS, PSP-Subcortical (PSP-P, PSP-PGF, PSP-PI) and PSP-Cortical (PSP-CBS, PSP-SL). We used ANCOVA adjusted for age to assess for differences in baseline neuropsychological performance between PSP-RS, PSP-Subcortical, and PSP-Cortical variants across tests assessing attention, executive function, memory, language, visuospatial function, and global cognition. Results: There were no sex or education differences between PSP-RS, PSP-Subcortical, and PSP-Cortical groups; however, there were differences in age (p=.05) and length between symptom onset and baseline evaluation (p<.001). Age-adjusted ANCOVAS revealed no differences in overall cognition (MoCA; p=.36) but did reveal differences for MoCA visuospatial/executive (p=.011), attention (p=.010), and language subscales (p=.006), with worse performances for PSP-Cortical participants. For attention/processing speed, there were group differences for WMS-III Spatial Span Forward (p=.009), Backward (p=.026), and Total (p=.004) as well as WMS-III Digit Span Forward (p=.029), but not Trails A (p=.430). For Spatial Span, PSP-Subcortical performed better than PSP-RS and PSP-Cortical groups while for Digit Span, PSP-RS performed better than PSP-Subcortical and PSP-Cortical groups. For executive function, there were group differences for the Frontal Assessment Battery (p=.001) with worse performance for PSP-Cortical compared with PSP-RS and PSP-Subcortical groups; there were no differences for Trails B (p=.27) or D-KEFS 20 questions (p=.25). For memory, there were group differences for Camden Words (p=.028) with worse performance for PSP-RS compared to PSP-Subcortical; there were no differences for Camden Faces (p=.068). For language, there were group differences for letter fluency (p=.001) with worst performance for PSP-Cortical followed by PSP-RS and PSP-Subcortical. Otherwise, there were no differences for Boston Naming Test-15 (p=.99) or Animal Fluency (p=.44). There were no differences for visuoperceptual/spatial function (VOSP letter and cube; p’s>.075). ANCOVAs additionally adjusted for disease duration showed similar findings except for differences in Trails A performance (p=.049; worse for PSP-Subcortical compared with PSP-RS) and trends for WMS-III Digit Span Forward (p=.053) and Camden Words (p=.060). Conclusions: In a large sample of individuals with PSP, there were significant differences in neuropsychological performance across PSP-RS, PSP-Subcortical, and PSP-Cortical variants. The PSP-Cortical group, and to a lesser extent PSP-RS, performed worse particularly on tests of attention/processing speed and executive function. These findings suggest possible cognitive distinctions among PSP subtypes.

Paper

02/15/2024
02:15 pm - 03:45 pm
Room: West Side Ballroom - Salon 1

Paper Session 05: Movement Disorders

Final Abstract #1

Differences in Neuropsychological Performance Across Clinical Variants of Progressive Supranuclear Palsy

Elizabeth Boots, Mayo Clinic, Rochester, United States
Sarah Boland, Mayo Clinic, Rochester, United States
Farwa Ali, Mayo Clinic, Rochester, United States
Heather Clark, Mayo Clinic, Rochester, United States
Julie Stierwalt, Mayo Clinic, Rochester, United States
Hugo Botha, Mayo Clinic, Rochester, United States
Yehkyoung Stephens, Mayo Clinic, Rochester, United States
Keith Josephs, Mayo Clinic, Rochester, United States
Jennifer Whitwell, Mayo Clinic, Rochester, United States
Mary Machulda, Mayo Clinic, Rochester, United States

Category: Movement and Movement Disorders

Keyword 1: movement disorders
Keyword 2: cognitive functioning
Keyword 3: neuropsychological assessment

Objective:

Despite updated subtype diagnostic criteria for progressive supranuclear palsy (PSP), there is limited work characterizing cognitive features of PSP subtypes using comprehensive neuropsychological evaluations in large samples. Our aim was to investigate differences in cognition between PSP-Richardson (PSP-RS) and subcortical and cortical variants of PSP.

Participants and Methods:

The Neurodegenerative Research Group at Mayo Clinic Rochester recruited 140 individuals with PSP (mean age=71.3±6.9 years; mean education=15.0±2.8 years; 49.3% female; 95.7% white) from 2009-2023 as part of a longitudinal study involving annual neurological and neuropsychological assessments. Participants received diagnoses of PSP clinical variants at their baseline evaluation (or retrospectively if evaluated before 2017) according to MDS-PSP criteria. Of the 140 participants, 62 had a diagnosis of PSP-RS, 27 had PSP-parkinsonism (PSP-P), 11 had PSP-progressive gait freezing (PSP-PGF), 6 had PSP-postural instability (PSP-PI), 9 had PSP-corticobasal syndrome (PSP-CBS), and 25 had PSP-speech/language (PSP-SL). For this study, we grouped diagnostic subtypes as PSP-RS, PSP-Subcortical (PSP-P, PSP-PGF, PSP-PI) and PSP-Cortical (PSP-CBS, PSP-SL). We used ANCOVA adjusted for age to assess for differences in baseline neuropsychological performance between PSP-RS, PSP-Subcortical, and PSP-Cortical variants across tests assessing attention, executive function, memory, language, visuospatial function, and global cognition.

Results:

There were no sex or education differences between PSP-RS, PSP-Subcortical, and PSP-Cortical groups; however, there were differences in age (p=.05) and length between symptom onset and baseline evaluation (p<.001). Age-adjusted ANCOVAS revealed no differences in overall cognition (MoCA; p=.36) but did reveal differences for MoCA visuospatial/executive (p=.011), attention (p=.010), and language subscales (p=.006), with worse performances for PSP-Cortical participants. For attention/processing speed, there were group differences for WMS-III Spatial Span Forward (p=.009), Backward (p=.026), and Total (p=.004) as well as WMS-III Digit Span Forward (p=.029), but not Trails A (p=.430). For Spatial Span, PSP-Subcortical performed better than PSP-RS and PSP-Cortical groups while for Digit Span, PSP-RS performed better than PSP-Subcortical and PSP-Cortical groups. For executive function, there were group differences for the Frontal Assessment Battery (p=.001) with worse performance for PSP-Cortical compared with PSP-RS and PSP-Subcortical groups; there were no differences for Trails B (p=.27) or D-KEFS 20 questions (p=.25). For memory, there were group differences for Camden Words (p=.028) with worse performance for PSP-RS compared to PSP-Subcortical; there were no differences for Camden Faces (p=.068). For language, there were group differences for letter fluency (p=.001) with worst performance for PSP-Cortical followed by PSP-RS and PSP-Subcortical. Otherwise, there were no differences for Boston Naming Test-15 (p=.99) or Animal Fluency (p=.44). There were no differences for visuoperceptual/spatial function (VOSP letter and cube; p’s>.075). ANCOVAs additionally adjusted for disease duration showed similar findings except for differences in Trails A performance (p=.049; worse for PSP-Subcortical compared with PSP-RS) and trends for WMS-III Digit Span Forward (p=.053) and Camden Words (p=.060).

Conclusions:

In a large sample of individuals with PSP, there were significant differences in neuropsychological performance across PSP-RS, PSP-Subcortical, and PSP-Cortical variants. The PSP-Cortical group, and to a lesser extent PSP-RS, performed worse particularly on tests of attention/processing speed and executive function. These findings suggest possible cognitive distinctions among PSP subtypes.