Objective: To characterize the prevalence, symptoms, and severity of light sensitivity in Progressive Supranuclear palsy (PSP)).

Background: Photophobia is a commonly encountered clinical symptom in PSP [1] and previous studies have noted high rates of these symptoms in these patients. The clinical impact of photophobia has not been explored. Here, we assessed photophobia using standardized measures designed for migraine patients and previous PSP literature.

Method: Participants (n=26, 12 PSP (4 males, 8 females, average age = 71.83, SD = 6.69), 14 PD (9 males, 5 females, average age = 64.14, SD=5.8)) participated in this survey study in the Movement Disorders Clinic at Vanderbilt University Medical Center. The questionnaire was based on standardized photophobia questionnaires for assessment of migraine severity [2] and previous photophobia literature [1][3]. One-sided Wilcoxin tests were used to determine severity of light sensitivity. Frequency tables and Fisher exact tests were used to determine how often symptoms were reported. Fisher exact tests were FDR corrected (0.05).

Results: The majority (11/12) of PSP patients indicated that bright light was bothersome, but this symptom was only noted in 29% (4/14) of PD patients. Most in PSP patients noted light sensitivity, at a significantly greater frequency as compared to PD patients (60.3% vs 23.0%, p<0.001). Photophobia resulted in a reduced willingness to leave the house during the day (42% vs 0%, p<0.05), an increased need for wearing sunglasses outside the house (83% vs 29%, p<0.05), and negative impact on the ability to complete daily tasks (50% vs 0%, p<0.05).

Conclusion: PSP patients experience photophobia, which manifests as light sensitivity. This symptom is a strong contributor to reduced quality of life. Further work is needed to understand the biological basis of this symptom and therapeutic options for patients.

References: [1] Wu, Yiwen, and Mark Hallett. “Photophobia in neurologic disorders.” Translational neurodegeneration 6, no. 1 (2017): 26. [2] Choi, Jeong Yoon, Kyungmi Oh, Byung Jo Kim, C. S. Chung, Seong Beom Koh, and Kun Woo Park. “Usefulness of a photophobia questionnaire in patients with migraine.” Cephalalgia 29, no. 9 (2009): 953-959. [3] Digre, Kathleen B., and K. C. Brennan. “Shedding light on photophobia.” Journal of neuro-ophthalmology: the official journal of the North American Neuro-Ophthalmology Society 32, no. 1 (2012): 68.

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