Neuropsychiatric aspects of progressive supranuclear palsy

Administering the Neuropsychiatric Inventory (NPI), we examined the behavioral symptoms of 22 patients with progressive supranuclear palsy (PSP), 50 patients with Alzheimer's disease, and 40 controls.PSP patients exhibited apathy (91%), disinhibition (36%), dysphoria (18%) and anxiety (18%), but rarely (<9%) irritability, abnormal motor behaviors, or agitation. Apathy in PSP was significantly associated with executive dysfunction. The presence of high apathy and low agitation and anxiety scale scores correctly identified the PSP patients 85% of the time. Evaluating the behavioral abnormalities of patients with neurodegenerative disorders will aid diagnosis and facilitate management. NEUROLOGY 1996;47: 1184-1189

[1]  M. Folstein,et al.  Clinical diagnosis of Alzheimer's disease , 1984, Neurology.

[2]  C. Fowler,et al.  Investigation of the neurogenic bladder. , 1996, Journal of neurology, neurosurgery, and psychiatry.

[3]  Y. Agid,et al.  Progressive supranuclear palsy: anatomoclinical and biochemical considerations. , 1987, Advances in neurology.

[4]  G. Stebbins,et al.  Risk factors for nursing home placement in advanced Parkinson's disease , 1993, Neurology.

[5]  J. Cummings,et al.  Frontotemporal dementia versus Alzheimer's disease , 1996, Neurology.

[6]  R. Daroff.  Progressive Supranuclear Palsy , 1993, Neurology.

[7]  J. Kurtzke,et al.  On the production of neurologists in the United States , 1991, Neurology.

[8]  I Litvan,et al.  Accuracy of clinical criteria for the diagnosis of progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome) , 1996, Neurology.

[9]  P V Rabins,et al.  The impact of dementia on the family. , 1982, JAMA.

[10]  I Litvan,et al.  Preliminary NINDS neuropathologic criteria for Steele‐Richardson‐Olszewski syndrome (progressive supranuclear palsy) , 1994, Neurology.

[11]  L. Schneider,et al.  Progressive Supranuclear Palsy With Agitation: Response to Trazodone but not to Thiothixine or Carbamazepine , 1989, Journal of geriatric psychiatry and neurology.

[12]  F Lhermitte,et al.  Heterogeneity of cognitive impairment in progressive supranuclear palsy, Parkinson's disease, and Alzheimer's disease , 1986, Neurology.

[13]  M. Mega,et al.  The Neuropsychiatric Inventory , 1994, Neurology.

[14]  Y. Agid,et al.  Severity and specificity of cognitive impairment in Alzheimer's, Huntington's, and Parkinson's diseases and progressive supranuclear palsy , 1991, Neurology.

[15]  H. Mayberg,et al.  Reliability, validity, and clinical correlates of apathy in Parkinson's disease. , 1992, The Journal of neuropsychiatry and clinical neurosciences.

[16]  L. Schneider,et al.  Progressive Supranuclear Palsy Manifesting With Depressive Features , 1986, Journal of the American Geriatrics Society.

[17]  G. Stebbins,et al.  Mortality and hallucinations in nursing home patients with advanced Parkinson's disease , 1995, Neurology.

[18]  A. Destée,et al.  [Obsessive-compulsive behavior and progressive supranuclear palsy]. , 1990, Revue neurologique.

[19]  L. F. Haas.  Casper Wistar (1760-1818). , 1994, Journal of neurology, neurosurgery, and psychiatry.

[20]  F. Viader,et al.  [Frontal syndrome of progressive supranuclear palsy]. , 1985, Revue neurologique.

[21]  R. Rosenberg.  Autosomal dominant cerebellar phenotypes , 1990, Neurology.

[22]  T. Rasmussen,et al.  Rasmussen's encephalitis and the new hat , 1996, Neurology.

[23]  K. Digre,et al.  Idiopathic intracranial hypertension associated with tetracycline use in fraternal twins , 1995, Neurology.

[24]  J. Cummings.  Frontal-subcortical circuits and human behavior. , 1993, Journal of psychosomatic research.

[25]  Jeffrey L. Cummings,et al.  The spectrum of behavioral changes in Alzheimer's disease , 1996, Neurology.

[26]  F. Stocchi,et al.  Differential diagnosis of Parkinson’s disease , 1990 .

[27]  I. Litvan,et al.  Cognitive disturbances in progressive supranuclear palsy. , 1994, Journal of neural transmission. Supplementum.

[28]  D. Benson,et al.  Psychological dysfunction accompanying subcortical dementias. , 1988, Annual review of medicine.

[29]  A. Jacobson,et al.  Psychological issues in diabetes mellitus. , 1984, Psychosomatics.

[30]  M. Albert,et al.  The `subcortical dementia' of progressive supranuclear palsy , 1974, Journal of neurology, neurosurgery, and psychiatry.

[31]  R. Mayeux,et al.  Depression, intellectual impairment, and Parkinson disease , 1981, Neurology.

[32]  R. Mayeux,et al.  Coexisting dementia and depression in Parkinson's disease. , 1989, Archives of neurology.

[33]  J. Cummings.  Frontal-subcortical circuits and human behavior. , 1998, Archives of neurology.

[34]  J. Cummings.  Depression and Parkinson's disease: a review. , 1992, The American journal of psychiatry.

[35]  F Lhermitte,et al.  Slowing of cognitive processing in progressive supranuclear palsy. A comparison with Parkinson's disease. , 1988, Archives of neurology.

[36]  M. Folstein,et al.  Delusions in newly admitted residents of nursing homes. , 1990, The American journal of psychiatry.

[37]  J. Grafman,et al.  Frontal lobe function in progressive supranuclear palsy. , 1990, Archives of neurology.

[38]  K. Jellinger,et al.  Overview of morphological changes in Parkinson's disease. , 1987, Advances in neurology.

[39]  F. Javoy‐Agid.  Cholinergic and peptidergic systems in PSP. , 1994, Journal of neural transmission. Supplementum.

[40]  R. L. Rogers,et al.  Decreased cerebral blood flow precedes multi‐infarct dementia, but follows senile dementia of Alzheimer type , 1986, Neurology.

[41]  Y. Agid,et al.  Does frontal cortex hypometabolism in progressive supranuclear palsy result from subcortical dysfunction? , 1995, European journal of neurology.

[42]  Y. Agid,et al.  Alterations of GABAergic neurons in the basal ganglia of patients with progressive supranuclear palsy , 1995, Neurology.

[43]  R. Daroff.  A new look and feel , 1996, Neurology.

[44]  A M Graybiel,et al.  Neuronal loss in the pedunculopontine tegmental nucleus in Parkinson disease and in progressive supranuclear palsy. , 1987, Proceedings of the National Academy of Sciences of the United States of America.

[45]  R Kakigi,et al.  [Event-related brain potentials]. , 1997, Nihon rinsho. Japanese journal of clinical medicine.

[46]  I Litvan,et al.  Natural history of progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome) and clinical predictors of survival: a clinicopathological study. , 1996, Journal of neurology, neurosurgery, and psychiatry.

[47]  B. O’Donnell,et al.  Incontinence and Troublesome Behaviors Predict Institutionalization in Dementia , 1992, Journal of geriatric psychiatry and neurology.

[48]  J. Grafman,et al.  Memory impairment in patients with progressive supranuclear palsy. , 1989, Archives of neurology.

[49]  J. Morris,et al.  Behavioral changes in patients with mild senile dementia of the Alzheimer's type , 1987, Psychiatry Research.

[50]  J. K. Cooper,et al.  Relation of Cognitive Status and Abnormal Behaviors in Alzheimer's Disease , 1990, Journal of the American Geriatrics Society.

[51]  G. E. Alexander,et al.  Parallel organization of functionally segregated circuits linking basal ganglia and cortex. , 1986, Annual review of neuroscience.

[52]  L. Golbe,et al.  Psychiatric symptoms in progressive supranuclear palsy. , 1995, Psychosomatics.

[53]  R. Necker.  Cells of origin of ascending and descending as well as branching fibers in the cervical spinal cord of the pigeon , 1990, Neuroscience Letters.

[54]  J. Grafman,et al.  Progressive supranuclear palsy , 1991, Neurology.

[55]  Y Agid,et al.  Positron emission tomography study in progressive supranuclear palsy. Brain hypometabolic pattern and clinicometabolic correlations. , 1990, Archives of neurology.

[56]  G A Chase,et al.  Psychiatric symptoms and nursing home placement of patients with Alzheimer's disease. , 1990, The American journal of psychiatry.

[57]  J. Dartigues,et al.  Dementia in Parkinson's disease , 1995, Neurology.

[58]  M. Folstein,et al.  Psychosis and physical aggression in probable Alzheimer's disease. , 1991, The American journal of psychiatry.

[59]  A. Tröster,et al.  The influence of depression on cognition in Parkinson's disease , 1995, Neurology.

[60]  G. Rütter.  Requirements for safety and quality of intravenous immunoglobulin G preparations. , 1994, Journal of neurology, neurosurgery, and psychiatry.

[61]  J. Cummings,et al.  Personality alterations in dementia of the Alzheimer type. , 1988, Archives of neurology.