Progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) are atypical parkinsonian disorders, often associated with a complex symptom burden and unpredictable disease course. Given the variability in illness trajectory, the optimal timing for palliative care services to be introduced is unclear. Robin Bessemer, MD, Western University, Ontario, Canada, shares the findings of a scoping review aiming to better understand the disease course and survival in PSP and MSA. Across the 24 studies reviewed, the use of clinical milestones was prominent. Important disease events that prompted changes in care included frequent falls, cognitive impairment, severe dysarthria, severe dysphagia, and wheelchair dependence. These milestones typically occurred at different timepoints in PSP compared to MSA. Dr Bessemer comments on how clinical milestones can help to map out disease course to better understand its trajectory over time and act as triggers for targeted palliative care interventions. This interview took place at the American Academy of Neurology 2022 Congress in Seattle, WA.
