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Disease course and treatment patterns in progressive supranuclear palsy: A real-world study
Journal of the Neurological Sciences ( IF 4.4 ) Pub Date : 2021-02-01 , DOI: 10.1016/j.jns.2020.117293
John C. Morgan , Xiaolan Ye , Jennifer A. Mellor , Keisha J. Golden , Jorge Zamudio , Louis A. Chiodo , Yanjun Bao , Tao Xie

BACKGROUND Progressive supranuclear palsy (PSP) is a neurodegenerative disorder with symptoms including vertical gaze palsy, frequent falls, abnormal gait, and cognitive/language/behavioral changes, making diagnosis and treatment challenging. METHODS Descriptive analysis was undertaken of cross-sectional, real-world data for patients with PSP provided by neurologists in France, Germany, Italy, Spain, UK, and USA. RESULTS Data on 892 PSP patients were obtained from patient records. Common initial symptoms included difficulty walking/maintaining gait, confusion/disorientation, loss of balance/falling, and rigidity. These symptoms and vertical gaze palsy commonly aided diagnosis. At data collection, dysphagia and blepharospasm were also very common. Mean times from symptom-onset to consulting a healthcare professional and PSP diagnosis were 5.2 and 15.0 months, respectively. General practitioners or movement disorder specialists were most commonly consulted initially; 98% of patients were diagnosed with PSP by a movement disorder specialist or general neurologist. Alternative diagnoses, including Parkinson's disease (67%) and dementia (10%), were considered for 41% of patients prior to PSP diagnosis. Non-wheelchair walking aids and wheelchairs were used by 60% and 23% of patients, respectively, with mean times from symptom-onset to use being 20.8 and 39.5 months, respectively. Symptomatic medication, most often levodopa and antidepressants, was prescribed for 87% of patients. CONCLUSION This study provided information on disease course and treatment for a large number of PSP patients from various countries. PSP carries a considerable clinical burden. Diagnosis is often delayed. Consulting a movement disorder specialist might expediate diagnosis. Currently, only symptomatic treatments are available with a poor satisfaction, and there is an urgent need for disease-modifying agents.

中文翻译:

进行性核上性麻痹的病程和治疗模式:一项真实世界的研究

背景进行性核上性麻痹 (PSP) 是一种神经退行性疾病,其症状包括垂直凝视麻痹、频繁跌倒、步态异常和认知/语言/行为改变,这使得诊断和治疗具有挑战性。方法 对法国、德国、意大利、西班牙、英国和美国的神经科医生提供的 PSP 患者的横断面真实数据进行描述性分析。结果 从患者记录中获得了 892 名 PSP 患者的数据。常见的初始症状包括行走困难/保持步态困难、意识模糊/定向障碍、失去平衡/跌倒和僵硬。这些症状和垂直凝视麻痹通常有助于诊断。在收集数据时,吞咽困难和眼睑痉挛也很常见。从出现症状到咨询医疗保健专业人员和 PSP 诊断的平均时间为 5。分别为 2 个月和 15.0 个月。最初最常咨询全科医生或运动障碍专家;98% 的患者被运动障碍专家或普通神经病学家诊断为 PSP。在 PSP 诊断之前,41% 的患者考虑了其他诊断,包括帕金森病 (67%) 和痴呆症 (10%)。非轮椅助行器和轮椅分别有 60% 和 23% 的患者使用,从出现症状到使用的平均时间分别为 20.8 和 39.5 个月。87% 的患者开具了对症药物,最常见的是左旋多巴和抗抑郁药。结论 本研究为来自不同国家的大量 PSP 患者提供了有关病程和治疗的信息。PSP 带来了相当大的临床负担。诊断常常被延误。咨询运动障碍专家可能会加快诊断。目前,只有对症治疗,满意度低,迫切需要改善病情的药物。
更新日期:2021-02-01
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