Characterizing behavioral and cognitive dysexecutive changes in progressive supranuclear palsy

Mov Disord. 2006 Feb;21(2):199-207. doi: 10.1002/mds.20707.

Abstract

Frontal lobe dysfunction is a prominent feature of many neurological disorders. Early diagnosis may be enhanced by establishing a profile of cognitive, behavioral, and emotional change. Traditional psychometric assessment focuses on cognitive dysfunction and fails to identify behavioral changes, particularly those associated with orbitofrontal dysfunction. We examined progressive supranuclear palsy (PSP), a prototypical subcortical dementia with frontal features, using commonly available neuropsychological measures and a modification of the Katz Adjustment Scale-Relatives (KAS-R), an instrument first developed to assess dysexecutive changes in head-injured patients. Executive tests identified deficits in reasoning, planning, set shifting, verbal fluency, information processing speed, and response initiation. On the KAS-R, changes in apathy, social withdrawal, and independence were observed, with little change in belligerence, social irresponsibility, uncooperativeness, obstreperousness, anxiety, and depression. The results show the potential utility of this instrument in characterizing behavioral and emotional changes associated with frontal lobe dysfunction in neurodegenerative disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Affective Symptoms / diagnosis
  • Affective Symptoms / physiopathology
  • Affective Symptoms / psychology
  • Aged
  • Attention* / physiology
  • Awareness / physiology
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / physiopathology
  • Cognition Disorders / psychology
  • Female
  • Frontal Lobe / physiopathology
  • Gyrus Cinguli / physiopathology
  • Humans
  • Male
  • Mental Disorders / diagnosis*
  • Mental Disorders / physiopathology
  • Mental Disorders / psychology
  • Middle Aged
  • Neurologic Examination
  • Neuropsychological Tests
  • Personality Assessment
  • Prefrontal Cortex / physiopathology
  • Problem Solving* / physiology
  • Reaction Time / physiology
  • Set, Psychology
  • Supranuclear Palsy, Progressive / diagnosis*
  • Supranuclear Palsy, Progressive / physiopathology
  • Supranuclear Palsy, Progressive / psychology
  • Verbal Behavior / physiology