Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Mar;11(3):248-256.
doi: 10.1002/mdc3.13958. Epub 2024 Jan 2.

Predicting Disability in Progressive Supranuclear Palsy Using Bedside Frontal-Lobe Signs

Iñigo Ruiz-Barrio  1   2   3   4 , Andrea Horta-Barba  1   2   3   4 , Ignacio Aracil-Bolaños  2   3   4 , Saül Martinez-Horta  2   3   4 , Jaime Kulisevsky  1   2   3   4 , Javier Pagonabarraga  1   2   3   4
Affiliations

Predicting Disability in Progressive Supranuclear Palsy Using Bedside Frontal-Lobe Signs

Iñigo Ruiz-Barrio et al. Mov Disord Clin Pract. 2024 Mar.

Abstract

Background: Frontal lobe signs in progressive supranuclear palsy (PSP) are prevalent and occur early in the disease. Although they are recognized in clinical practice, studies are needed to systematically investigate them for an in-depth understanding of the neurological substrate and their potential prognostic implications in the disease.

Objectives: To study the predictive role of frontal lobe signs in PSP, as well as to describe their neuropsychological and anatomical correlations.

Methods: Nine recognized signs of frontal lobe dysfunction were assessed in 61 patients with PSP. Those signs able to predict PSP Rating Scale (PSPRS) score at baseline were selected, a survival analysis was performed and associations with neuropsychological tests and cortical thickness parameters in brain MRI were studied.

Results: Grasping, anosognosia and orobuccal apraxia predicted the PSPRS score independently of age, gender, clinical subtype and disease duration. The occurrence of groping in the first 4 years could be a predictor of survival. Grasping and anosognosia were associated with frontal cognitive dysfunction, whereas orobuccal apraxia and groping were related to a more widespread cognitive impairment, involving temporal-parietal areas. Presence of groping showed an extensive cortical atrophy, with predominant prefrontal, temporal and superior parietal cortical thinning.

Conclusions: Grasping, groping, anosognosia and orobuccal apraxia are easily evaluable bedside clinical signs that reflect distinct stages of disease progression. Grasping, anosognosia and orobuccal apraxia predict disease disability in patients with PSP, and early onset groping could be a survival predictor.

Keywords: disability in PSP; frontal-lobe signs; prognostic in PSP; progressive supranuclear palsy.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Adjusted PSPRS score for patients with grasping (A), anosognosia (B), groping (C) and orobuccal apraxia (D).
Figure 2
Figure 2
Frequency of frontal lobe signs among PSP subtypes.
Figure 3
Figure 3
Cortical areas in patients with groping showing significant thinning in bilateral middle frontal cortex, right superior frontal cortex, right middle temporal gyrus and right precuneus.
Figure 4
Figure 4
Survival curve of patients with PSP in our sample (A) and survival analysis according to early onset of groping in the first 4 years (B).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Höglinger GU, Respondek G, Stamelou M, et al. Clinical diagnosis of progressive supranuclear palsy: the movement disorder society criteria. Mov Disord Off J Mov Disord Soc 2017;32(6):853–864. - PMC - PubMed
    1. Olfati N, Shoeibi A, Litvan I. Clinical spectrum of tauopathies. Front Neurol 2022;13:944806. - PMC - PubMed
    1. Chatterjee K, Choudhury S, Trivedi S, Basu P, Kumar H. Clinical significance of applause sign in patients with progressive Supranuclear palsy. Can J Neurol Sci J Can Sci Neurol 2022;49(6):809–812. - PubMed
    1. Dubois B, Slachevsky A, Pillon B, Beato R, Villalponda JM, Litvan I. “Applause sign” helps to discriminate PSP from FTD and PD. Neurology 2005;64(12):2132–2133. - PubMed
    1. Luzzi S, Fabi K, Pesallaccia M, Silvestrini M, Provinciali L. Applause sign: is it really specific for parkinsonian disorders? Evidence from cortical dementias. J Neurol Neurosurg Psychiatry 2011;82(8):830–833. - PubMed

MeSH terms

LinkOut - more resources