DEPRESSION and anxiety, not motor decline, are the strongest predictors of quality of life in patients with progressive supranuclear palsy (PSP), according to a new study that underscores the pressing need for comprehensive symptom management beyond traditional motor assessments.
In an analysis of 40 patients with probable PSP from the Rossy PSP Centre, researchers examined the relationship between neuropsychiatric symptoms and perceived quality of life using validated scales for motor function, mood, cognition, and disease severity. While PSP is clinically recognized for its hallmark motor and oculomotor features, this study shifts the focus toward psychological wellbeing as a key driver of patient-reported outcomes.
The results revealed that higher levels of depression and anxiety were significantly associated with lower quality of life scores. Specifically, every one-point increase on the depression scale corresponded to a 3.7-point decline in quality of life (95% CI: -6.1 to -1.1). This effect was even more pronounced when accounting for the interaction between anxiety and depression, with quality of life decreasing by 4.3 points per one-point rise on the depression score (95% CI: -7.8 to -0.8).
Interestingly, the study found no meaningful association between quality of life and other commonly measured domains such as motor symptoms, cognition, or overall disease severity in the fully adjusted models. These findings suggest that while motor impairments remain central to PSP diagnosis and progression, they may not be the primary determinant of how patients perceive their daily functioning and well-being.
The authors emphasize that these insights should inform a broader, multidisciplinary approach to PSP care. Integrating routine screening and management of mood disorders could play a pivotal role in improving patient outcomes, especially as neuropsychiatric symptoms often remain under-addressed in clinical settings focused predominantly on motor function.
As the non-motor symptom burden becomes more widely acknowledged in atypical parkinsonian syndromes, this study reinforces the clinical value of looking beyond movement in the holistic care of PSP.
Reference:
Alonso Morales-Rivero et al. The Impact of Neuropsychiatric Symptoms in Perceived Quality of Life in Patients With Progressive Supranuclear Palsy. Eur J Neurol. 2025;32(6):e70248.
