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. 2025 Jun;32(6):e70248.
doi: 10.1111/ene.70248.

The Impact of Neuropsychiatric Symptoms in Perceived Quality of Life in Patients With Progressive Supranuclear Palsy

Alonso Morales-Rivero  1   2 , Indira Garcia-Cordero  3   4 , Abeer Khoja  1   5 , Juan-Camilo Vargas-Gonzalez  1 , Blas Couto  6   7   8 , Jeffrey Antwi  7 , Johnathan Sasitharan  7 , Puja Bhakta  7 , Gabor G Kovacs  3   7   8   9 , Susan Fox  7   8 , David F Tang-Wai  1   9 , Anthony E Lang  3   7   8   10 , Maria Carmela Tartaglia  1   3   8   9   10
Affiliations

The Impact of Neuropsychiatric Symptoms in Perceived Quality of Life in Patients With Progressive Supranuclear Palsy

Alonso Morales-Rivero et al. Eur J Neurol. 2025 Jun.

Abstract

Background and objectives: Progressive supranuclear paralysis (PSP) is an atypical parkinsonian disorder associated with oculomotor features, motor disturbances, along with cognitive problems and neuropsychiatric symptoms. Quality of life (QoL) is often assessed in relation to the motor symptoms. Our aim was to investigate the impact of neuropsychiatric symptoms on QoL.

Methods: We used data from 40 patients meeting criteria for probable PSP from the Rossy PSP Centre. Motor and neuropsychiatric symptoms, cognition, functionality, disease severity, and quality of life were examined using validated scales. We performed a linear regression model using multiple imputations with chained equations with 500 sets.

Results: We found that lower quality of life scores were related to higher anxiety and depression and the interaction between these two. There was a decrease in the quality of life of -3.7 points (95% CI: -6.1 to -1.1) for every one point of increase on the depression scale; there was a decrease in the quality of life scale of -4.3 points for each point of increase on the depression score (95% CI: -7.8 to -0.8). The fully adjusted linear model showed that motor scores, cognition, and other neuropsychiatric symptoms were not associated with quality of life.

Conclusion: We found that both anxiety and depression significantly impacted quality of life. Given the prevalence of non-motor manifestations in PSP, these results emphasize the importance of comprehensive evaluations to better capture the multi-faceted impairments seen in PSP that have a meaningful impact on the patient's life.

Keywords: depression; movement disorders; neuropsychiatric symptoms; progressive supranuclear PALSY; quality of life.

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Conflict of interest statement

Alonso Morales‐Rivero: has served as an advisor to Janssen, Lundbeck Adium. Indira Garcia Cordero: receives research support from the Association for Frontotemporal Degeneration (AFTD) through the Pathways for Hope Pilot Grant (#2025‐002). Blas Couto is funded by CurePSP Foundation Research Grant 684‐2023‐06‐Pathway; Alzheimer's Association 24AACSFD‐1244095. Gabor Kovacs: Reports Consultancies for Parexel, he is employed in UHN and receives royalties from Wiley, Cambridge University press. He has a Shared patent for 5G4 antibody and is currently funded by Edmond J Safra Philanthropic Foundation, Rossy Family Foundation, Krembil Foundation, Michael J. Fox Foundation, Parkinson Canada, The MSA Coalition, Rainwater Charitable Foundation, Ontario Research Fund and Canada Foundation for Innovation, and National Institutes of Health (NIH). David F. Tang‐Wai: reports unpaid medical advisory board member for Hydrocephalus Canada and medical advisory committee for Eisai for the potential rollout of antiamyloid. Susan Fox: has received Clinic support from the Edmond J. Safra Foundation for Parkinson Research, Parkinson Foundation, and the Toronto Western and General Foundation. Research Funding from Michael J. Fox Foundation for Parkinson Research, NIH (Dystonia Coalition); Parkinson Canada. Honoraria from the International Parkinson and Movement Disorder Society; Site PI for Clinical Trials for Alexion, Biotie, Consultancy/Speaker fees from Abbvie, Bial, Ipsen, Sunovion; Paladin and Royalties from Oxford University Press. Anthony E. Lang: has served as an advisor for AbbVie, AFFiRis, Alector, Amylyx, Biogen, BioAdvance, BlueRock, BMS, Denali, Janssen, Jazz, Lilly, Novartis, Paladin, Retrophin, Roche, Sun Pharma, and UCB; received honoraria from Sun Pharma, AbbVie, and Sunovion; received grants from Brain Canada, Canadian Institutes of Health Research, Edmond J. Safra Philanthropic Foundation, Michael J. Fox Foundation, the Ontario Brain Institute, Parkinson Foundation, Parkinson Canada, and W. Garfield Weston Foundation; received publishing royalties from Elsevier, Saunders, Wiley‐Blackwell, Johns Hopkins Press, and Cambridge University Press. Maria Carmela Tartaglia: has served as an advisor to EISAI and Lilly. She is a member of the Scientific Advisory Board for the Women's Brain Project, PSP Canada, and Brain Injury Canada. She is an investigator in clinical trials for Avanex, Biogen, Janssen, Merck, Novo Nordisk, Passage Bio, and UCB. All the other authors declare no conflicts of interest.

Figures

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FIGURE 1
Directed acyclic graph for linear regression analysis.
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