Neuropsychological follow-up of patients with degenerative parkinsonisms: Parkinson's disease (PD), striatonigral degeneration (SND) and progressive supranuclear palsy (PSP)

Many studies have attempted to identify differences in the cognitive pattern of degenerative parkinsonisms to assist the diagnosis however no longitudinal studies have compared their amount of cognitive deterioration over the time. In this preliminary study we compared 10 patients with PD, 10 with SND and 10 with PSP using a comprehensive neuropsychological battery and retesting the same patients after two years. Patients differed only in disease duration. At first examination PSP patients were worse in the apraxia, verbal fluency, attention and visuo-spatial tests. At final examination PSP patients were still worse in the apraxia, fluency and MMSE tests. PSP and SND patients had greater motor impairment than PD patients at second evaluation. Although cognitive functions deteriorated in all patients, statistical analysis was significant only for the apraxia and Nelson tests in PSP probably due to the small sample size. The results highlight the greater impairment of PSP patients in the tests exploring ability to make gestures and executive functions, and their faster motor and cognitive deterioration.