A-92: Neuropsychological Profiles of Progressive Supranuclear Palsy and Parkinson’s Disease: Implications for Differential Diagnosis
TL;DR
Compared to PD, PSP demonstrates a more severe neuropsychological profile marked by frontal and visuospatial deficits, which can improve diagnostic accuracy, early intervention, and differential diagnosis across diverse populations.
Abstract
Objective: Progressive supranuclear palsy (PSP) and Parkinson’s disease (PD) are neurodegenerative disorders with overlapping features, frequently leading to diagnostic uncertainty. PSP is associated with rapid progression, frontal-subcortical dysfunction, and impairments in gait, speech, and cognition. Accurate neuropsychological differentiation is critical given the diseases’ diverging prognoses and treatments. This review aimed to identify neuropsychological features that distinguish PSP from PD, assessment tools sensitive to PSP-specific decline, and sociodemographic factors influencing disease presentation. Method/Data Selection: Literature was obtained via searches of journals in the following databases: APA PsycInfo and Google Scholar, using combinations of the following search terms: ‘Progressive Supranuclear Palsy’, ‘Parkinson’s, ‘Neurocognitive Profile’, ‘Cultural Factors.’ A total of 11 peer-reviewed journal articles from 2009 – 2025 were deemed eligible for inclusion. Results/Data Synthesis: A review of findings suggests PSP is associated with earlier and more severe impairment in executive functioning, cognitive flexibility, inhibition, visuospatial processing, and working memory. Specific assessments (e.g., Digit Span, Stroop, etc.) demonstrated sensitivity to PSP-related decline. PSP patients also exhibited distinct gait abnormalities (reduced cadence and vertical displacement) and speech features (slower articulation rate, increased hesitancy, and altered phonation). Apathy was more severe in PSP. Cultural and geographic factors influenced age of onset, symptom profile, and genetic expression. Conclusions: Compared to PD, PSP demonstrates a more severe neuropsychological profile marked by frontal and visuospatial deficits. While neuropsychological findings increase confidence in differentiation, holistic approaches incorporate neurological exams and imaging. Nevertheless, comprehensive neuropsychological assessment, integrated with motor and speech markers, can improve diagnostic accuracy, early intervention, and differential diagnosis across diverse populations.