Neuropsychiatry of corticobasal degeneration and progressive supranuclear palsy

Marla B. Bruns, Keith Anthony Josephs

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Corticobasal syndrome (CBS) and progressive supranuclear palsy syndrome (PSPS) are two of the atypical Parkinsonism syndromes, in that patients exhibit rigidity, occasional tremor and postural instability, but do not symptomatically respond to dopamine replacement. CBS and PSPS can often present with complex cognitive difficulties and neuropsychiatric disturbances. Symptoms of depression, apathy, or agitation can be subtle and are often overlooked as reactions to learning a new diagnosis of Parkinsonism. These symptoms may be the earliest presenting evidence of CBS or PSPS, and these syndromes can be misdiagnosed with a primary psychiatric disorder rather than a neurodegenerative condition. Patients may be inappropriately treated with antipsychotic medications that exacerbate the extra-pyramidal motor features of the syndromes. When symptoms are considered to comprise a neurodegenerative syndrome, it may be an inaccurate diagnosis as many features of CBS and PSPS not only overlap with each other, but also with other dementia syndromes. This review discusses similarities and differences between the syndromes of CBS and PSPS in terms of neuropsychiatric features. Improved characterization of the clinical syndromes is necessary to better predict underlying pathology. Improved education about these diseases would help patients, caregivers and clinicians to anticipate symptom progression and avoid premature nursing home placement.

Original languageEnglish (US)
Pages (from-to)197-209
Number of pages13
JournalInternational Review of Psychiatry
Volume25
Issue number2
DOIs
StatePublished - Apr 2013

Fingerprint

Neuropsychiatry
Progressive Supranuclear Palsy
Parkinsonian Disorders
Apathy

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Neuropsychiatry of corticobasal degeneration and progressive supranuclear palsy. / Bruns, Marla B.; Josephs, Keith Anthony.

In: International Review of Psychiatry, Vol. 25, No. 2, 04.2013, p. 197-209.

Research output: Contribution to journalArticle

@article{ada107d8d3314decab42bfcf23392497,
title = "Neuropsychiatry of corticobasal degeneration and progressive supranuclear palsy",
abstract = "Corticobasal syndrome (CBS) and progressive supranuclear palsy syndrome (PSPS) are two of the atypical Parkinsonism syndromes, in that patients exhibit rigidity, occasional tremor and postural instability, but do not symptomatically respond to dopamine replacement. CBS and PSPS can often present with complex cognitive difficulties and neuropsychiatric disturbances. Symptoms of depression, apathy, or agitation can be subtle and are often overlooked as reactions to learning a new diagnosis of Parkinsonism. These symptoms may be the earliest presenting evidence of CBS or PSPS, and these syndromes can be misdiagnosed with a primary psychiatric disorder rather than a neurodegenerative condition. Patients may be inappropriately treated with antipsychotic medications that exacerbate the extra-pyramidal motor features of the syndromes. When symptoms are considered to comprise a neurodegenerative syndrome, it may be an inaccurate diagnosis as many features of CBS and PSPS not only overlap with each other, but also with other dementia syndromes. This review discusses similarities and differences between the syndromes of CBS and PSPS in terms of neuropsychiatric features. Improved characterization of the clinical syndromes is necessary to better predict underlying pathology. Improved education about these diseases would help patients, caregivers and clinicians to anticipate symptom progression and avoid premature nursing home placement.",
author = "Bruns, {Marla B.} and Josephs, {Keith Anthony}",
year = "2013",
month = "4",
doi = "10.3109/09540261.2013.766154",
language = "English (US)",
volume = "25",
pages = "197--209",
journal = "International Review of Psychiatry",
issn = "0954-0261",
publisher = "Informa Healthcare",
number = "2",

}

TY - JOUR

T1 - Neuropsychiatry of corticobasal degeneration and progressive supranuclear palsy

AU - Bruns, Marla B.

AU - Josephs, Keith Anthony

PY - 2013/4

Y1 - 2013/4

N2 - Corticobasal syndrome (CBS) and progressive supranuclear palsy syndrome (PSPS) are two of the atypical Parkinsonism syndromes, in that patients exhibit rigidity, occasional tremor and postural instability, but do not symptomatically respond to dopamine replacement. CBS and PSPS can often present with complex cognitive difficulties and neuropsychiatric disturbances. Symptoms of depression, apathy, or agitation can be subtle and are often overlooked as reactions to learning a new diagnosis of Parkinsonism. These symptoms may be the earliest presenting evidence of CBS or PSPS, and these syndromes can be misdiagnosed with a primary psychiatric disorder rather than a neurodegenerative condition. Patients may be inappropriately treated with antipsychotic medications that exacerbate the extra-pyramidal motor features of the syndromes. When symptoms are considered to comprise a neurodegenerative syndrome, it may be an inaccurate diagnosis as many features of CBS and PSPS not only overlap with each other, but also with other dementia syndromes. This review discusses similarities and differences between the syndromes of CBS and PSPS in terms of neuropsychiatric features. Improved characterization of the clinical syndromes is necessary to better predict underlying pathology. Improved education about these diseases would help patients, caregivers and clinicians to anticipate symptom progression and avoid premature nursing home placement.

AB - Corticobasal syndrome (CBS) and progressive supranuclear palsy syndrome (PSPS) are two of the atypical Parkinsonism syndromes, in that patients exhibit rigidity, occasional tremor and postural instability, but do not symptomatically respond to dopamine replacement. CBS and PSPS can often present with complex cognitive difficulties and neuropsychiatric disturbances. Symptoms of depression, apathy, or agitation can be subtle and are often overlooked as reactions to learning a new diagnosis of Parkinsonism. These symptoms may be the earliest presenting evidence of CBS or PSPS, and these syndromes can be misdiagnosed with a primary psychiatric disorder rather than a neurodegenerative condition. Patients may be inappropriately treated with antipsychotic medications that exacerbate the extra-pyramidal motor features of the syndromes. When symptoms are considered to comprise a neurodegenerative syndrome, it may be an inaccurate diagnosis as many features of CBS and PSPS not only overlap with each other, but also with other dementia syndromes. This review discusses similarities and differences between the syndromes of CBS and PSPS in terms of neuropsychiatric features. Improved characterization of the clinical syndromes is necessary to better predict underlying pathology. Improved education about these diseases would help patients, caregivers and clinicians to anticipate symptom progression and avoid premature nursing home placement.

UR - http://www.scopus.com/inward/record.url?scp=84876746108&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84876746108&partnerID=8YFLogxK

U2 - 10.3109/09540261.2013.766154

DO - 10.3109/09540261.2013.766154

M3 - Article

VL - 25

SP - 197

EP - 209

JO - International Review of Psychiatry

JF - International Review of Psychiatry

SN - 0954-0261

IS - 2

ER -