The PSP Association were kind enough to publish a short article about our new Dunhill Medical Trust project exploring “Can tests of cognitive function help diagnose PSP?”. You can also read the article with a nice picture here (page 15)
I first heard about PSP as a graduate student when I read a paper describing an unusual and devastating disease characterised by paralysis of the eyes. The paper reported a striking result: people with PSP had a problem moving attention that was not experienced by people with Parkinson’s disease. At the time I was doing my doctoral research and the result seemed to have profound implications for our theoretical understanding of attention. I didn’t realise at this time was that it might also be important for the purposes of diagnosis. I was keen to explore how PSP affected attention further, but unfortunately due to the rarity of the condition we had no luck finding participants. At this point end I moved on to working with stroke survivors. However, as my career progressed I often thought about the condition, and one day happened to mention it to Dr Neil Archibald, consultant neurologist at James Cook University Hospital. He had a particular interest in PSP and was keen to collaborate. He put me in touch with the PSP Association, and together we ran a workshop with patients, carers, clinicians and academics to generate research ideas.
One issue that was important to everyone was diagnosis. Because PSP is rare and shares many symptoms with Parkinson’s disease, a great many PSP patients are misdiagnosed. This is distressing to patients and carers and can lead to unnecessary prescription of medications with potentially harmful side effects. Out of the workshop emerged an idea for a pilot study comparing mental functions such as attention and memory in people with PSP and Parkinson’s disease, with the long- term aim of evaluating whether such tests could be useful for diagnosis. Over the next 2 years we recruited a group people with PSP and another group of people with Parkinson’s disease. We asked them to do computer tasks that tested their eye-movements, attention and short-term memory. The results of the pilot study were clear: People with PSP could not make any up or down eye-movements, and their left and right eye-movements were also affected. Importantly, we found impairments in attention and memory that seemed to correlate with the eye-movement problems. These results were very promising, and the Dunhill Medical Trust subsequently agreed to fund a 3-year project designed to develop a more complete understanding of how PSP affects visual cognition. This project will begin next year, and we hope it will bring us a step closer to finding a cheap, effective and reliable tool for the early diagnosis of PSP.