Progressive supranuclear palsy treatment—A systematic review

Progressive supranuclear palsy (PSP) is an uncommon neurodegenerative disease associated with postural instability, falling, and memory loss. Different therapeutic approaches have been suggested for PSP, but their efficacy is unclear. With our growing understanding of Parkinson’s-related syndromes, it is likely that PSP will be increasingly diagnosed, so it is even more important now to know the usefulness of the possible therapies. To our knowledge, no systematic review of PSP therapy has been published.ObjectiveTo determine the effectiveness of published PSP treatments.Evidence reviewA systematic review of published literature was completed. We searched using PubMed, Scopus, EMBASE, PsychInfo, Cochrane and CINAHL for related articles. To maximize sensitivity, we also searched “gray” literature.Standard exclusion criteria were used: no comparison group; no clear, defined interventions; outcome(s) that were not objective; and outcome assessors not blinded to the intervention.FindingsThe initial search obtained 1073 publications. Of these studies, 24 were relevant to the question of therapy efficacy. Fifteen dealt with medications, 4 with intra- or transcranial procedures, 2 with physical therapy, 1 dealt with ophthalmic treatment, and 2 dealt with two simultaneous types of interventions, ophthalmic and physical rehabilitation. Of these studies, 13 remained after application of our exclusion criteria.In this final group, all either showed no benefit, or found changes that were not reflected in any benefit to the subject’s quality of life or longevity.ConclusionAt the patient level, effectiveness has not been established for any treatment for PSP.