Type: Clinical outcome measure (clinician-rated)
Purpose: Quantify disease severity in Progressive Supranuclear Palsy (PSP)
Developer: Dr. Lawrence I. Golbe and colleagues
Original publication: 2004[@golbe2004]
Current use: Primary endpoint in FNP-223 PROSPER trial, LY-3372689 LOTUS trial, and most PSP therapeutic trials
The PSP Rating Scale (PSPRS) is a 0-100 point clinician-administered scale specifically designed for PSP. It assesses six domains of neurological function: daily activities (DAS), behavior (Beh), bulbar (Bul), ocular motor (OM), gait/mobility (Gait), and axial (Ax). The scale has become the standard primary endpoint for PSP clinical trials[1].
The PSPRS contains 28 items across six domains[1:1][2]:
| Domain | Abbrev | Max Points | Items | Content |
|---|---|---|---|---|
| Daily Activities | DAS | 28 | 7 | Dressing, hygiene, feeding, walking, choking, cutting food, |
| Behavior | Beh | 3 | 1 | Neuropsychiatric features |
| Bulbar | Bul | 9 | 6 | Speech, swallowing, eye movements, handwriting |
| Ocular Motor | OM | 16 | 4 | Vertical gaze, horizontal gaze, convergence, eyelid |
| Gait/Mobility | Gait | 12 | 4 | Standing, initiation of gait, walking, falls |
| Axial | Ax | 8 | 2 | Posture, rising from chair |
Total maximum: 100 points (higher = more severe)
| PSPRS Score | Disease Severity | Clinical Context |
|---|---|---|
| 0 | No impairment | Healthy |
| 1-20 | Early PSP | Often still independent |
| 21-40 | Moderate PSP | Progressive functional decline |
| 41-60 | Advanced PSP | Significant disability, wheelchair common |
| 61-80 | Late PSP | Bedridden, feeding tube often needed |
| 81-100 | End-stage PSP | Severe disability, hospice care |
Rate of progression: Untreated PSP patients typically decline 8-12 PSPRS points per year.
PSPRS is the established primary endpoint for PSP therapeutic trials because:
FNP-223 PROSPER Trial (NCT06355531):
LY-3372689 LOTUS Trial (NCT05682807):
Developed by Golbe et al. (2004) through:
Recent work by Cook et al. addresses contemporary trial design[2:1]:
Golbe, L. I., et al. A rating scale for progressive supranuclear palsy. Neurology. 2004. ↩︎ ↩︎ ↩︎
Cook, M. J. C., et al. Clinical outcome assessment in progressive supranuclear palsy trials. Movement Disorders. 2023. ↩︎ ↩︎