Progressive Supranuclear Palsy Following as Major Depressive Disorder: A Case Report

Öz

Progressive Supranuclear Palsy (PSP) is a rare neurodegenerative disease that is classified among Parkinson plus syndromes, manifesting itself with behavioral, cognitive and emotional symptoms as well as parkinsonian symptoms such as postural instability, ophthalmoplegia, bradykinesia, rigidity affecting the brain stem, basal ganglia and cerebellum. Although there is sufficient information about the pathological process and clinical presentation of PSP, there is no valid biomarker for diagnosis, clinical findings and neuroimaging are very important in diagnosis, patients often get misdiagnosis at their first application. It has been reported that psychiatric symptoms are common in these individuals due to the involvement of the frontal-subcortical circuits, and therefore patients can get psychiatric diagnoses in the early period. We aimed to present a 72-year-old female patient who was followed up with the diagnosis of major depressive disorder in various centers for about 4 years, who did not benefit from psychiatric treatment, and diagnosed with PSP eventually. We also aimed to emphasize that importance of considering neurodegenerative diseases in differential diagnosis in patients whose depressive symptoms begin at an advanced age, are resistant to treatment and have atypical symptoms such as the presence of accompanying neurological findings, and psychiatric symptoms may be the first symptom of neurodegenerative diseases.

Anahtar Kelimeler

• Depression
• neurodegenerative diseases
• Progressive supranuclear palsy

Kaynakça

1. 1-) Morris HR, Wood NW, Lees AJ. Progressive supranuclear palsy (Steele-Richardson-Olszewski disease). Postgrad Med J. 1999;(75):579-584.
2. 2-) Litvan I, Mangone CA, McKee A, et al. Natural history of progressive supranuclear palsy (Steele-Richardson- Olszewski syndrome) and clinical predictors of survival: a clinicopathological study. J Neurol Neurosurg Psychiatry. 1996;(60):615–620.
3. 3-) Grafman J, Litvan I, Gomez C, Thomas NC. Frontal lobe dysfunction in progressive supranuclear palsy. Arch Neurol. 1990;(47):553-558.
4. 4-) Madhusoodanan S, Wilkes V, Campbell RP, Serper M, Essuman EK, Brenner R. Psychiatric symptoms of progressive supranuclear palsy: A case report and brief review. Neuropsychiatry 2014;(4):27–32.
5. 5-) Chiu YW, Lee SH, Yeh TH. Diversified psychiatric presentation in a case of progressive supranuclear palsy. Journal of Clinical Gerontology and Geriatrics 2016;7(4), 164-167.
6. 6-) Cummings JL. Frontal-subcortical circuits and human behavior. Arch Neurol. 1993;(50):873-880.
7. 7-) Erkol G, Karaali Savrun F. Frontotemporal dementia. Cerrahpaşa J Med. 2002; (33): 256-260.
8. 8-)Groschel K, Kastrup A, Litvan I, Schulz JB. Penguins and hummingbirds: midbrain atrophy in progressive supranuclear palsy. Neurology 2006;(66):949-950.

9. 9-)Halliday GM, Hardman CD, Cordato NJ, Hely MA, Morris JG. A role for the substantia nigra pars retriculata in the gaze palsy of progressive supranuclear palsy. Brain 2000;(123):724-732.
10. 10-) Levy ML, Cummings JL, Fairbanks LA, et al. Apathy is not depression. J Neuropsychiatry Clin Neurosci. 1998;(10) 314–319.
11. 11-) Rittman T, Coyle-Gilchrist IT, Rowe JB. Managing cognition in progressive supranuclear palsy. Neurodegenerative Disease Management 2016;(6):499-508.
12. 12-) Litvan I, Bhatia KP, Burn DJ, et al. Movement Disorders Society Scientific Issues Committee. Movement Disorders Society Scientific Issues Committee report: SIC Task Force appraisal of clinical diagnostic criteria for Parkinsonian disorders. Mov Disord. 2003;18(5):467-86.
13. 13-) Walsh CM, Ruoff L, Walker K, et al. Sleepless Night and Day, the Plight of Progressive Supranuclear Palsy. Sleep 2017; (40) 154.
14. 14-) Abe K, Hikita T, Sakoda S. A hypnotic drug for sleep disturbances in patients with Parkinson's disease. No to Shinkei = Brain and Nerve 2005 ;57(4):301-305.
15. 15-) Cotter C, Armytage T, Crimmins D. The use of zolpidem in the treatment of progressive supranuclear palsy. J Clin Neurosci. 2010 Mar;17(3):385-386.