Objective: To elucidate the clinical presentation of Progressive Supranuclear Palsy (PSP) in a cohort residing in underserved communities in Buenaventura, Colombia—the country’s primary maritime port

Background: PSP, an atypical parkinsonian syndrome, remains significantly underdiagnosed in developing countries like Colombia. Access to healthcare is a major challenge, particularly in marginalized regions like the Southwestern area, where the ratio of neurologists can be as low as 0.1 per 100,000 inhabitants. Despite the increasing interest in the potential link between environmental pollutants and parkinsonian syndromes in Colombia, few clinical studies have focused on PSP patients, particularly in marginalized communities

Method: This retrospective cohort study aimed to analyze PSP patients in Buenaventura, Colombia. Patients were asessed  wilt the MDS clinical criteria by a movement disorders specialist and evaluated with motor and no n-motor scales  Descriptive statistics and non-parametric tests were utilized for data analysis

Results: The study enrolled 18 PSP patients (50% male, 77 years IQR 72-81) , who underwent their first evaluation by a neurologist after a median delay of 3.5 years (IQR 2-6) from symptom onset. 83.33% had completed only primary school, and 64.71% belonged to the lower socioeconomic stratum. Seven patients  had worked as operators or fishermen at the maritime port.  Half of the patients were diagnosed with PSP Richardson’s variant, and 12 were initially treated with levodopa, but only 5 continued it. Median and IQR scores  were 48 (35-41), 12 (10-14), 30 (27-33), 15 (12-17), 10 (9-11), and 9 (6-11),in the PSPRS, PSP-CDS, HARS, HDRS, MADRS, and NPI-Q  respectively. Interestingly, no correlation was found between disease duration and the PSP-CDS score (p=0.851), and there were no differences by sex (p=0.113) or reported environmental exposures at the port (p=0.139)

Conclusion: Patients with PSP in this cohort faced significant challenges in accessing neurological services for timely diagnosis. The study revealed a substantial burden of motor impairment not correlated with disease duration, alongside high scores for neuropsychiatric symptoms such as depression. Future research should incorporate environmental assessments to investigate potential environmental risk factors

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-clinical-landscape-of-progressive-supranuclear-palsy-in-an-underserved-community-from-southwestern-colombia/