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JMD : Journal of Movement Disorders



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The Non-Motor Symptom Profile of Progressive Supranuclear Palsy
Sudhakar Pushpa Chaithra, Shweta Prasad, Vikram Venkappayya Holla, Albert Stezin, Nitish Kamble, Ravi Yadav, Pramod Kumar Pal
J Mov Disord. 2020;13(2):118-126.   Published online April 6, 2020
  • 7,759 View
  • 256 Download
  • 17 Web of Science
  • 13 Crossref
AbstractAbstract PDF
Non-motor symptoms (NMSs) significantly contribute to increased morbidity and poor quality of life in patients with parkinsonian disorders. This study aims to explore the profile of NMSs in patients with progressive supranuclear palsy (PSP) using the validated Non-Motor Symptom Scale (NMSS).
Seventy-six patients with PSP were evaluated in this study. Motor symptoms and NMSs were evaluated using the PSP Rating Scale (PSPRS), Unified Parkinson’s Disease Rating Scale-III, Montreal Cognitive Assessment, Hamilton Depression (HAMD) and Anxiety Rating Scales, Parkinson’s Disease Sleep Scale (PDSS) and NMSS. NMS severity and prevalence were also compared between patients with PSP-Richardson syndrome (PSP-RS) and those with PSP-parkinsonism.
All subjects in this cohort reported at least 2 NMSs. The most prevalent NMSs in patients with PSP were in the domains of sleep/fatigue, mood/cognition, and sexual function. The least prevalent NMSs were in the domains of cardiovascular including falls, and perceptual problems/hallucinations. Significant correlations were observed between the NMSS scores and HAM-D, PDSS, PSPRS scores and PSPRS sub-scores. The severity of NMSs was unrelated to the duration of illness. Patients with PSP-RS reported a higher severity of drooling, altered smell/taste, depression and altered interest in sex and a higher prevalence of sexual dysfunction.
NMSs are commonly observed in patients with PSP, and the domains of sleep, mood and sexual function are most commonly affected. These symptoms contribute significantly to disease morbidity, and clinicians should pay adequate attention to identifying and addressing these symptoms.


Citations to this article as recorded by  
  • Autonomic dysfunction in progressive supranuclear palsy
    Francesca Baschieri, Maria Vitiello, Pietro Cortelli, Giovanna Calandra-Buonaura, Francesca Morgante
    Journal of Neurology.2023; 270(1): 109.     CrossRef
  • PDQ-8: A Simplified and Effective Tool Measuring Life Quality in Progressive Supranuclear Palsy
    Xin-Yi Li, Ming-Jia Chen, Xiao-Niu Liang, Rui-Xin Yao, Bo Shen, Bin Wu, Gen Li, Yi-Min Sun, Jian-Jun Wu, Feng-Tao Liu, Yu-Jie Yang, Jian Wang
    Journal of Parkinson's Disease.2023; 13(1): 83.     CrossRef
  • Non-motor symptoms in multiple system atrophy: A comparative study with Parkinson's disease and progressive supranuclear palsy
    Wen-Zheng Hu, Ling-Xiao Cao, Jin-Hui Yin, Xue-Song Zhao, Ying-Shan Piao, Wei-Hong Gu, Jing-Hong Ma, Zhi-Rong Wan, Yue Huang
    Frontiers in Neurology.2023;[Epub]     CrossRef
  • Neurological update: the palliative care landscape for atypical parkinsonian syndromes
    Noreen O’Shea, Shane Lyons, Stephen Higgins, Sean O’Dowd
    Journal of Neurology.2023; 270(4): 2333.     CrossRef
  • Structural correlates of survival in progressive supranuclear palsy
    Duncan Street, W Richard Bevan-Jones, Maura Malpetti, P Simon Jones, Luca Passamonti, Boyd CP. Ghosh, Timothy Rittman, Ian TS. Coyle-Gilchrist, Kieren Allinson, Catherine E. Dawson, James B. Rowe
    Parkinsonism & Related Disorders.2023; 116: 105866.     CrossRef
  • Migraine and Tension-type Headache in Parkinson’s Disease and Progressive Supranuclear Palsy/Corticobasal Syndrome
    Vinayak Jatale, Ashutosh Tiwari, Mritunjai Kumar, Ravi Gupta, Niraj Kumar
    Annals of Indian Academy of Neurology.2023; 26(5): 708.     CrossRef
  • A Systematic Review of Apathy and Depression in Progressive Supranuclear Palsy
    Joshua Flavell, Peter J. Nestor
    Journal of Geriatric Psychiatry and Neurology.2022; 35(3): 280.     CrossRef
  • The Burden of Progressive Supranuclear Palsy on Patients, Caregivers, and Healthcare Systems by PSP Phenotype: A Cross-Sectional Study
    Demetris Pillas, Alexander Klein, Teresa Gasalla, Andreja Avbersek, Alexander Thompson, Jack Wright, Jennifer Mellor, Anna Scowcroft
    Frontiers in Neurology.2022;[Epub]     CrossRef
  • Fatigue in hypokinetic, hyperkinetic, and functional movement disorders
    Ilaria Antonella Di Vico, Giovanni Cirillo, Alessandro Tessitore, Mattia Siciliano, Massimo Venturelli, Cristian Falup-Pecurariu, Gioacchino Tedeschi, Francesca Morgante, Michele Tinazzi
    Parkinsonism & Related Disorders.2021; 86: 114.     CrossRef
  • Prevalence and Characteristics of Polyneuropathy in Atypical Parkinsonian Syndromes: An Explorative Study
    Rachel Rohmann, Eva Kühn, Raphael Scherbaum, Lovis Hilker, Saskia Kools, Leonard Scholz, Katharina Müller, Sophie Huckemann, Christiane Schneider-Gold, Ralf Gold, Kalliopi Pitarokoili, Lars Tönges, Eun Hae Kwon
    Brain Sciences.2021; 11(7): 879.     CrossRef
  • Understanding fatigue in progressive supranuclear palsy
    Jong Hyeon Ahn, Joomee Song, Dong Yeong Lee, Jinyoung Youn, Jin Whan Cho
    Scientific Reports.2021;[Epub]     CrossRef
  • “Parkinson’s disease” on the way to progressive supranuclear palsy: a review on PSP-parkinsonism
    Ján Necpál, Miroslav Borsek, Bibiána Jeleňová
    Neurological Sciences.2021; 42(12): 4927.     CrossRef
  • Clinical progression of progressive supranuclear palsy: impact of trials bias and phenotype variants
    Duncan Street, Maura Malpetti, Timothy Rittman, Boyd C P Ghosh, Alexander G Murley, Ian Coyle-Gilchrist, Luca Passamonti, James B Rowe
    Brain Communications.2021;[Epub]     CrossRef
Analysis of the Substantia Innominata Volume in Patients with Parkinson’s Disease with Dementia, Dementia with Lewy Bodies, and Alzheimer’s Disease
Hee Jin Kim, Ji Eun Lee, Soo Jeong Shin, Young Ho Sohn, Phil Hyu Lee
J Mov Disord. 2011;4(2):68-72.
  • 13,525 View
  • 81 Download
  • 12 Crossref
AbstractAbstract PDF
Background and Purpose

The substantia innominata (SI) contains the nucleus basalis of Meynert, which is the major source of cholinergic input to the cerebral cortex. We hypothesized that degeneration of the SI and its relationship to general cognitive performance differs in amyloidopathy and synucleinopathy.


We used magnetic resonance imaging (MRI)-based volumetric analysis to evaluate the SI volume in patients with amnestic mild cognitive impairment (aMCI), Alzheimer’s disease (AD), Parkinson’s disease-mild cognitive impairment (PD-MCI), PD with dementia (PDD), dementia with Lewy bodies (DLB), and healthy elderly controls. The correlation between SI volume and general cognitive performance, measured using the Korean version of the Mini-Mental State Examination (K-MMSE), was examined.


Compared to control subjects, the mean normalized SI volume was significantly decreased in all of the other groups. The normalized SI volume did not differ between the subjects with PDD and DLB, whereas it was significantly smaller in subjects with PDD (p = 0.029) and DLB (p = 0.011) compared with AD. In subjects with PD-related cognitive impairment (PD-MCI, PDD, or DLB), there was a significant positive correlation between the SI volume and K-MMSE score (r = 0.366, p < 0.001), whereas no correlation was seen in subjects with AD-related cognitive impairment (aMCI or AD).


Our data suggest that the SI loss is greater in synucleinopathy-related dementia (PDD or DLB) than in AD and that the contribution of the SI to cognitive performance is greater in synucleinopathy than in amyloidopathy.


Citations to this article as recorded by  
  • Deep Learning Segmentation of the Nucleus Basalis of Meynert on 3T MRI
    D.J. Doss, G.W. Johnson, S. Narasimhan, J.S. Shless, J.W. Jiang, H.F.J. González, D.L. Paulo, A. Lucas, K.A. Davis, C. Chang, V.L. Morgan, C. Constantinidis, B.M. Dawant, D.J. Englot
    American Journal of Neuroradiology.2023; 44(9): 1020.     CrossRef
  • Manual and automated analysis of atrophy patterns in dementia with Lewy bodies on MRI
    Eya Khadhraoui, Sebastian Johannes Müller, Niels Hansen, Christian Heiner Riedel, Philip Langer, Charles Timäeus, Jens Wiltfang, Caroline Bouter, Claudia Lange, Marielle Ernst
    BMC Neurology.2022;[Epub]     CrossRef
  • Cholinergic white matter pathways in dementia with Lewy bodies and Alzheimer’s disease
    Julia Schumacher, Nicola J Ray, Calum A Hamilton, Paul C Donaghy, Michael Firbank, Gemma Roberts, Louise Allan, Rory Durcan, Nicola Barnett, John T O’Brien, John-Paul Taylor, Alan J Thomas
    Brain.2022; 145(5): 1773.     CrossRef
  • Metric magnetic resonance imaging analysis reveals pronounced substantia-innominata atrophy in dementia with Lewy bodies with a psychiatric onset
    Niels Hansen, Sebastian Johannes Müller, Eya Khadhraoui, Christian Heiner Riedel, Philip Langer, Jens Wiltfang, Charles-Arnold Timäus, Caroline Bouter, Marielle Ernst, Claudia Lange
    Frontiers in Aging Neuroscience.2022;[Epub]     CrossRef
  • In vivo nucleus basalis of Meynert degeneration in mild cognitive impairment with Lewy bodies
    Julia Schumacher, John-Paul Taylor, Calum A. Hamilton, Michael Firbank, Ruth A. Cromarty, Paul C. Donaghy, Gemma Roberts, Louise Allan, Jim Lloyd, Rory Durcan, Nicola Barnett, John T. O'Brien, Alan J. Thomas
    NeuroImage: Clinical.2021; 30: 102604.     CrossRef
  • EEG alpha reactivity and cholinergic system integrity in Lewy body dementia and Alzheimer’s disease
    Julia Schumacher, Alan J. Thomas, Luis R. Peraza, Michael Firbank, Ruth Cromarty, Calum A. Hamilton, Paul C. Donaghy, John T. O’Brien, John-Paul Taylor
    Alzheimer's Research & Therapy.2020;[Epub]     CrossRef
  • Transcriptional network analysis in frontal cortex in Lewy body diseases with focus on dementia with Lewy bodies
    Gabriel Santpere, Paula Garcia‐Esparcia, Pol Andres‐Benito, Belen Lorente‐Galdos, Arcadi Navarro, Isidro Ferrer
    Brain Pathology.2018; 28(3): 315.     CrossRef
  • Nucleus Basalis of Meynert Stimulation for Dementia: Theoretical and Technical Considerations
    Deepak Kumbhare, Viktoras Palys, Jamie Toms, Chathurika S. Wickramasinghe, Kasun Amarasinghe, Milos Manic, Evan Hughes, Kathryn L. Holloway
    Frontiers in Neuroscience.2018;[Epub]     CrossRef
  • Dementia with Lewy Bodies: Molecular Pathology in the Frontal Cortex in Typical and Rapidly Progressive Forms
    Paula Garcia-Esparcia, Irene López-González, Oriol Grau-Rivera, María Francisca García-Garrido, Anusha Konetti, Franc Llorens, Saima Zafar, Margarita Carmona, José Antonio del Rio, Inga Zerr, Ellen Gelpi, Isidro Ferrer
    Frontiers in Neurology.2017;[Epub]     CrossRef
  • Meynert’s Nucleus Complex White Matter Abnormalities in Autism Spectrum Disorders: An MRI Study
    Matteo Pardini, Francesco G. Garaci, Laszlo Zaborszky, Filadelfo Coniglione, Gianluca Serafini, Martina Siracusano, Francesca Benassi, Leonardo Emberti Gialloreti
    Journal of Intellectual Disability - Diagnosis and Treatment.2017; 4(4): 185.     CrossRef
  • Biomarkers for dementia and mild cognitive impairment in Parkinson's disease
    Manuel Delgado‐Alvarado, Belén Gago, Irene Navalpotro‐Gomez, Haritz Jiménez‐Urbieta, María C. Rodriguez‐Oroz
    Movement Disorders.2016; 31(6): 861.     CrossRef
  • Nucleus basalis of Meynert revisited: anatomy, history and differential involvement in Alzheimer’s and Parkinson’s disease
    Alan King Lun Liu, Raymond Chuen-Chung Chang, Ronald K. B. Pearce, Steve M. Gentleman
    Acta Neuropathologica.2015; 129(4): 527.     CrossRef

JMD : Journal of Movement Disorders