. 2025 Jun;12(6):764-774.

doi: 10.1002/mdc3.14348. Epub 2025 Jan 27.

A Short Cognitive and Neuropsychiatric Assessment Scale for Progressive Supranuclear Palsy

Sonja Porsche^#¹, Martin Klietz^#¹, Stephan Greten¹, Ines A Piot², Ida Jensen^{1

3}, Florian Wegner¹, Lan Ye¹, Lea Krey¹, Matthias Höllerhage¹, Monika Pötter-Nerger⁴, Molly Zeitzschel⁴, Keno Hagena⁴, Jan Kassubek^{5

6}, Patrick Süß^{7

8}, Jürgen Winkler^{7

8}, Daniela Berg⁹, Steffen Paschen⁹, Lars Tönges^{10

11}, Doreen Gruber^{12

13}, Florin Gandor^{12

13}, Wolfgang H Jost¹⁴, Andrea A Kühn^{15

16}, Inga Claus¹⁷, Tobias Warnecke¹⁸, David J Pedrosa¹⁹, Carsten Eggers²⁰, Claudia Trenkwalder²¹, Joseph Classen²², Johannes Schwarz²³, Alfons Schnitzler²⁴, Patricia Krause¹⁵, Anja Schneider^{25

26}, Moritz Brandt^{27

28}, Björn Falkenburger^{27

28}, Inga Zerr^{29

30}, Mathias Bähr^{29

30

31}, Endy Weidinger^{2

32}, Johannes Levin^{2

3

33}, Sabrina Katzdobler^{2

3

33}, Emrah Düzel^{34

35

36}, Wenzel Glanz^{34

35

37}, Stefan Teipel^{38

39}, Ingo Kilimann^{38

39}, Johannes Prudlo^{38

40}, Thomas Gasser^{41

42}, Kathrin Brockmann^{41

42}, Annika Spottke^{25

43}, Anna Esser²⁵, Gabor C Petzold^{25

43}, Gesine Respondek¹, Günter U Höglinger^{1

3

33}

Affiliations

¹ Department of Neurology, Hannover Medical School, Hannover, Germany.
² German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
³ Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany.
⁴ Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁵ Department of Neurology, University of Ulm, Ulm, Germany.
⁶ German Center for Neurodegenerative Diseases (DZNE), Ulm, Germany.
⁷ Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
⁸ Center of Rare Diseases Erlangen (ZSEER), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
⁹ Department of Neurology, Kiel University, Kiel, Germany.
¹⁰ Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany.
¹¹ Neurodegeneration Research, Protein Research Unit Ruhr (PURE), Ruhr University Bochum, Bochum, Germany.
¹² Movement Disorders Hospital, Beelitz-Heilstätten, Beelitz-Heilstätten, Germany.
¹³ Department of Neurology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
¹⁴ Parkinson-Klinik Ortenau, Wolfach, Germany.
¹⁵ Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité, University Medicine Berlin, Berlin, Germany.
¹⁶ German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.
¹⁷ Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, Muenster, Germany.
¹⁸ Department of Neurology and Neurorehabilitation, Klinikum Osnabrueck, Osnabrueck, Germany.
¹⁹ Department of Neurology, University Hospital of Marburg, Marburg, Germany.
²⁰ Department of Neurology, Knappschaftskrankenhaus Bottrop, Bottrop, Germany.
²¹ Paracelsus-Elena Klinik, Kassel, Germany.
²² Department of Neurology, Leipzig University Medical Center, Leipzig, Germany.
²³ Department of Neurology, Klinik Haag I. OB, Mühldorf a. Inn, Germany.
²⁴ Institute of Clinical Neuroscience and Medical Psychology, and Department of Neurology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
²⁵ German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
²⁶ Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.
²⁷ German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany.
²⁸ Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
²⁹ German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany.
³⁰ Department of Neurology, University Medical Center, Georg August University, Göttingen, Germany.
³¹ Cluster of Excellence Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), University Medical Center Göttingen, Göttingen, Germany.
³² Department of Neurology, University Hospital of Munich, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Germany.
³³ Munich Cluster for Systems Neurology (SyNergy) Munich, Munich, Germany.
³⁴ German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.
³⁵ Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University, Magdeburg, Germany.
³⁶ Institute of Cognitive Neuroscience, University College London, London, United Kingdom.
³⁷ Clinic for Neurology, Medical Faculty, University Hospital Magdeburg, Magdeburg, Germany.
³⁸ German Center for Neurodegenerative Diseases (DZNE), Rostock-Greifswald, Germany.
³⁹ Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany.
⁴⁰ Department of Neurology, University Medical Centre, Rostock, Germany.
⁴¹ German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.
⁴² Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany.
⁴³ Center of Neurology, University Hospital Bonn, Bonn, Germany.

^# Contributed equally.

PMID: 39868903
PMCID: PMC12187960
DOI: 10.1002/mdc3.14348

A Short Cognitive and Neuropsychiatric Assessment Scale for Progressive Supranuclear Palsy

Sonja Porsche et al. Mov Disord Clin Pract. 2025 Jun.

. 2025 Jun;12(6):764-774.

doi: 10.1002/mdc3.14348. Epub 2025 Jan 27.

Authors

Affiliations

¹ Department of Neurology, Hannover Medical School, Hannover, Germany.
² German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
³ Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany.
⁴ Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁵ Department of Neurology, University of Ulm, Ulm, Germany.
⁶ German Center for Neurodegenerative Diseases (DZNE), Ulm, Germany.
⁷ Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
⁸ Center of Rare Diseases Erlangen (ZSEER), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
⁹ Department of Neurology, Kiel University, Kiel, Germany.
¹⁰ Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany.
¹¹ Neurodegeneration Research, Protein Research Unit Ruhr (PURE), Ruhr University Bochum, Bochum, Germany.
¹² Movement Disorders Hospital, Beelitz-Heilstätten, Beelitz-Heilstätten, Germany.
¹³ Department of Neurology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
¹⁴ Parkinson-Klinik Ortenau, Wolfach, Germany.
¹⁵ Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité, University Medicine Berlin, Berlin, Germany.
¹⁶ German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.
¹⁷ Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, Muenster, Germany.
¹⁸ Department of Neurology and Neurorehabilitation, Klinikum Osnabrueck, Osnabrueck, Germany.
¹⁹ Department of Neurology, University Hospital of Marburg, Marburg, Germany.
²⁰ Department of Neurology, Knappschaftskrankenhaus Bottrop, Bottrop, Germany.
²¹ Paracelsus-Elena Klinik, Kassel, Germany.
²² Department of Neurology, Leipzig University Medical Center, Leipzig, Germany.
²³ Department of Neurology, Klinik Haag I. OB, Mühldorf a. Inn, Germany.
²⁴ Institute of Clinical Neuroscience and Medical Psychology, and Department of Neurology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
²⁵ German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
²⁶ Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.
²⁷ German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany.
²⁸ Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
²⁹ German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany.
³⁰ Department of Neurology, University Medical Center, Georg August University, Göttingen, Germany.
³¹ Cluster of Excellence Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), University Medical Center Göttingen, Göttingen, Germany.
³² Department of Neurology, University Hospital of Munich, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Germany.
³³ Munich Cluster for Systems Neurology (SyNergy) Munich, Munich, Germany.
³⁴ German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.
³⁵ Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University, Magdeburg, Germany.
³⁶ Institute of Cognitive Neuroscience, University College London, London, United Kingdom.
³⁷ Clinic for Neurology, Medical Faculty, University Hospital Magdeburg, Magdeburg, Germany.
³⁸ German Center for Neurodegenerative Diseases (DZNE), Rostock-Greifswald, Germany.
³⁹ Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany.
⁴⁰ Department of Neurology, University Medical Centre, Rostock, Germany.
⁴¹ German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.
⁴² Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany.
⁴³ Center of Neurology, University Hospital Bonn, Bonn, Germany.

^# Contributed equally.

PMID: 39868903
PMCID: PMC12187960
DOI: 10.1002/mdc3.14348

Abstract

Background: Patients with Progressive Supranuclear Palsy (PSP) suffer from several neuropsychological impairments. These mainly affect the frontal lobe and subcortical brain structures. However, a scale for the assessment of cognitive and neuropsychiatric disability in PSP is still missing.

Objectives: To create and validate a new scale for cognitive and neuropsychiatric impairment in PSP.

Methods: The Short Cognitive and Neuropsychiatric (ShoCo) scale was developed containing five items (bradyphrenia, apathy, aphasia, dysexecution and disinhibition). Each item can be categorized into 0 = no deficit, 1 = mild deficit, 2 = moderate deficit and 3 = severe deficit. The total score includes 15 points, 0 meaning no deficit and 15 severe deficits. Cross-sectional and longitudinal data from 201 baseline and 71 follow up patients were analyzed.

Results: Baseline ShoCo scale results were 5.9 ± 2.9. No significant differences between patients with Richardson syndrome (PSP-RS) and variants (vPSP) could be detected in the PSP-ShoCo scale scores (PSP-RS 6.1 ± 3.0, n = 160, vPSP 5.1 ± 2.6, n = 41, P = 0.057). The scale showed good correlation with established scores (eg, Montreal cognitive assessment r = -0.535, P = 0.001). The ShoCo scale showed significant annualized change within the PSP-RS patients (baseline 6.2 ± 2.9, follow up 6.9 ± 3.1, annualized diff. 1.0 ± 3.1, n = 57, P = 0.022).

Conclusions: The ShoCo scale seems a promising and valid tool to measure specific neuropsychological disabilities of PSP patients in clinical routine and research.

Keywords: 4‐repeat tauopathies; Progressive Supranuclear Palsy; cognition; depression; quality of life.

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Figures

**Figure 1**
Displayed are box plots of the baseline and follow‐up data of the respective items (**B–F**) of the ShoCo scale and the total score (A). The whiskers span from minimum to maximum. The box spans from lower to upper quartile and beyond, presenting the median. P values are calculated with Wilcoxon sign rank test. *P < 0.05. ShoCo, Short Cognitive and Neuropsychiatric; ns, non significant.

See this image and copyright information in PMC

References

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A Short Cognitive and Neuropsychiatric Assessment Scale for Progressive Supranuclear Palsy

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A Short Cognitive and Neuropsychiatric Assessment Scale for Progressive Supranuclear Palsy

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