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Art Therapy in Progressive Supranuclear Palsy (NCT06588673)

Overview

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Art Therapy in Progressive Supranuclear Palsy (NCT06588673)

Overview

Mermaid diagram (expand to render)

This study investigates the effect of art therapy for people with progressive supranuclear palsy (PSP), with a focus on alleviating symptoms associated with PSP, enhancing overall quality of life for patients, and reducing caregiver stress["@art2024"].

Trial Details

| Field | Value |
|-------|-------|
| NCT Number | NCT06588673 |
| Status | Active, Not Recruiting |
| Phase | Observational |
| Sponsor | Vanderbilt University Medical Center |
| Location | United States |
| Study Type | Art Therapy Intervention |
| Enrollment | 30-50 participants |
| Duration | 12-week intervention with 6-month follow-up |

Study Objectives

The primary objectives of this study include:

Assess symptom relief through structured art therapy interventions

Evaluate quality of life improvements in PSP patients

Measure caregiver stress reduction associated with art therapy participation

Explore non-pharmacological approaches to manage PSP symptoms

Characterize neuroplastic changes associated with creative engagement

Background

Progressive Supranuclear Palsy Overview

Progressive supranuclear palsy (PSP) is a rare neurodegenerative disorder characterized by the accumulation of abnormal tau protein in various brain regions. It belongs to a group of conditions known as atypical parkinsonian syndromes or 4R-tauopathies[@sterman2020].

PSP affects approximately 6-9 per 100,000 individuals, with a typical onset between 50-70 years of age. The disease progresses relentlessly, with most patients becoming severely disabled within 5-10 years of symptom onset.

Core Clinical Features:

Vertical supranuclear gaze palsy: Difficulty with downward eye movements, a hallmark finding
Postural instability: Frequent falls, typically backward
Parkinsonism: Bradykinesia, axial rigidity
Cognitive dysfunction: Frontal executive impairment, apathy
Speech and swallowing difficulties: Dysarthria and dysphagia

Subtypes:

| Subtype | Prevalence | Key Features |
|---------|------------|--------------|
| Richardson's syndrome (PSP-RS) | ~70% | Classic presentation |
| PSP-parkinsonism (PSP-P) | ~15% | Levodopa-responsive |
| PSP-corticobasal syndrome (PSP-CBS) | ~5% | Cortical sensory deficits |
| Pure akinesia with gait freezing (PAGF) | ~5% | Gait freezing predominant |

The Challenge of Non-Pharmacological Interventions

The neurodegenerative nature of PSP presents unique challenges for therapeutic interventions. While disease-modifying treatments remain under development, supportive and symptomatic therapies play a critical role in maintaining quality of life[@schott2022].

Traditional pharmacological approaches in PSP offer limited benefit:

Levodopa provides modest improvement in some patients, particularly PSP-P subtype
No disease-modifying drugs exist for PSP
Symptomatic treatments target individual symptoms (e.g., botulinum for dystonia)

This limitation has driven interest in non-pharmacological approaches that address multiple domains of function simultaneously.

Art Therapy as a Therapeutic Modality

Art therapy is a form of psychotherapy that uses creative expression to promote emotional, cognitive, and social well-being. It has been applied successfully in various neurological conditions, including [Alzheimer's disease](/diseases/alzheimers-disease), [Parkinson's disease](/diseases/parkinsons-disease), and other neurodegenerative disorders[@farris2019][@cue2019].

Mechanisms of Benefit:

Cognitive Stimulation: Engagement in creative activities activates multiple brain networks, including visual, motor, and executive regions

Emotional Expression: Art provides a non-verbal medium for expressing complex emotions, particularly valuable in conditions affecting communication

Motor Rehabilitation: Fine motor activities in art-making may help maintain hand function and coordination

Social Engagement: Group art sessions provide opportunities for social interaction and reduce isolation

Psychological Well-being: Creative engagement reduces anxiety, depression, and improves self-esteem

Research has demonstrated that art therapy can improve behavioral and psychological symptoms of dementia[@cue2019], enhance quality of life in [Parkinson's disease](/diseases/parkinsons-disease)[@farris2019], and reduce caregiver burden[@chancellor2022].

Scientific Rationale

Neuroplasticity and Creative Engagement

Art therapy is thought to work through multiple neuroplastic mechanisms[@kim2021]:

Structural Changes:

Increased gray matter in prefrontal cortex
Enhanced connectivity in default mode network
Preservation of motor cortex volume

Functional Changes:

Activated visual creativity networks
Enhanced motor planning and execution
Improved emotional regulation circuits

Why Art Therapy for PSP?

PSP presents specific challenges that art therapy may address:

Communication Difficulties: PSP progressively impairs speech and language. Art provides alternative communication channels

Cognitive Impairment: Frontotemporal dysfunction in PSP affects executive function. Art activities can provide structured cognitive engagement

Motor Limitations: While fine motor control declines, art activities can be adapted to individual capabilities

Emotional Impact: Depression and anxiety are common in PSP. Creative expression offers emotional release

Caregiver Burden: Caregivers experience high levels of stress. Art therapy can provide respite and meaningful engagement for patients

Multiple studies support art therapy benefits in neurodegenerative diseases:

Parkinson's Disease:

Art therapy improves quality of life scores and reduces motor symptoms
Creative activities enhance dopamine-mediated reward pathways
Group art sessions reduce social isolation[@mahoney2020][@takahashi2020]

Dementia:

Cochrane review supports art therapy for behavioral symptoms
Reduces agitation and improves emotional well-being
Provides meaningful engagement in advanced stages[@hackett2002]

Atypical Parkinsonism:

Non-pharmacological interventions show promise in multiple studies
Creative arts address both motor and non-motor symptoms
Adapted activities accommodate progressive limitations[@druter2019]

Methodology

Study Design

This is a prospective observational cohort study examining the effects of structured art therapy intervention in patients with PSP.

Design Features:

Pre-post intervention comparison
12-week intensive art therapy program
6-month follow-up assessment
Caregiver-partnered outcome measures

Intervention Protocol

Art Therapy Sessions:

Weekly 90-minute sessions
Group format (6-8 participants)
Trained art therapists with neurological experience
Adaptive materials and techniques

Session Structure:

Warm-up (15 min): Brief movement or breathing exercise

Main Activity (45 min): Structured art project

Expression (20 min): Verbal processing of creative work

Closure (10 min): Reflection and preview of next session

Art Modalities:

Drawing and painting
Collage and mixed media
Sculpture with adaptive tools
Digital art applications

Outcome Measures

Primary Endpoints:

Quality of Life: SF-36, PDQ-39
Cognitive Function: MoCA, Trail Making Test
Mood Assessment: Geriatric Depression Scale, Hamilton Anxiety Scale

Secondary Endpoints:

Motor Function: PSP Rating Scale (PSPRS) subscales
Caregiver Burden: Zarit Burden Interview
Art Engagement: Art Therapy Assessment Scale

Assessment Schedule:

Baseline (pre-intervention)
Mid-intervention (Week 6)
Post-intervention (Week 12)
Follow-up (Month 6)

Participant Selection

Inclusion Criteria:

Confirmed PSP diagnosis (MDS-PSP criteria)

Hoehn & Yahr stage 1-4

Ability to participate in art activities (with assistance if needed)

Caregiver willing to attend sessions

No significant visual impairment

Exclusion Criteria:

Severe cognitive impairment precluding participation

Active psychiatric disorder

Current enrollment in other interventional studies

Material incompatibility (e.g., latex allergy)

Expected Outcomes

For Patients

Quality of Life Improvements:

Enhanced emotional well-being
Increased social engagement
Improved sense of purpose and accomplishment

Cognitive Benefits:

Maintained executive function
Preserved communication abilities
Reduced apathy and withdrawal

Motor Function:

Preserved fine motor skills
Enhanced hand-eye coordination
Maintained activities of daily living

For Caregivers

Burden Reduction:

Respite during therapy sessions
Improved patient engagement at home
Enhanced understanding of patient capabilities

Relationship Benefits:

Shared meaningful activity
New communication channels
Strengthened emotional connection

Clinical Relevance

Positioning Within PSP Treatment Landscape

Art therapy represents a complementary approach within comprehensive PSP management:

| Treatment Category | Examples | Role of Art Therapy |
|-------------------|----------|---------------------|
| Pharmacological | Levodopa, botulinum | Adjunctive support |
| Rehabilitation | Physical, occupational, speech | Complementary engagement |
| Experimental | Tau-targeted therapies | Supportive care |
| Supportive | Caregiver support, palliative | Enhances quality of life |

Implementation Considerations

Practical Requirements:

Trained art therapists with neurological experience
Adapted materials and accessibility features
Caregiver training for home engagement
Integration with existing care teams

Success Factors:

Early intervention before significant decline
Consistent attendance and engagement
Caregiver participation and support
Individualized adaptation of activities

Comparison with Other Non-Pharmacological Approaches

Art therapy offers unique advantages compared to other supportive interventions:

| Approach | Target | Art Therapy Advantage |
|----------|--------|----------------------|
| Physical Therapy | Motor function | Cognitive and emotional engagement |
| Speech Therapy | Communication | Alternative expression medium |
| Music Therapy | Mood, cognition | Visual and tactile engagement |
| Cognitive Therapy | Executive function | Creative and novel approach |

Research Implications

Advancing Evidence Base

This study will contribute to the growing body of evidence for non-pharmacological interventions in PSP:

Generate quantitative data on art therapy effectiveness

Characterize responder profiles for intervention optimization

Identify mechanisms through neuroimaging substudy (if funded)

Inform clinical guidelines for supportive care in PSP

Future Directions

Results from this study may inform:

Randomized controlled trial design
Integration into standard PSP care pathways
Development of art therapy protocols for other tauopathies
Caregiver-focused interventions

Safety and Ethical Considerations

Safety Profile

Art therapy is generally safe with minimal risks:

No pharmacological interactions
Low physical demand (adaptable)
Psychological safety through trained supervision
No serious adverse events in prior studies

Ethical Framework

Informed Consent:

Capacity assessment for consent
Advance directive consideration
Caregiver/ surrogate involvement as appropriate

Vulnerable Population Protections:

Careful monitoring for distress
Graceful termination options
Psychological support availability
Protection of autonomy in creative choices

External Links

[NCT06588673 on ClinicalTrials.gov](https://clinicaltrials.gov/study/NCT06588673)
[CurePSP Foundation](https://curepsp.org/)
[Vanderbilt University Medical Center](https://www.vumc.org/)
[American Art Therapy Association](https://www.arttherapy.org/)

References

[Art Therapy in PSP Study Protocol. Vanderbilt University Medical Center. 2024](https://clinicaltrials.gov/study/NCT06588673)[@art2024]

[Hackett M et al., Art therapy for people with dementia (2002)](https://pubmed.ncbi.nlm.nih.gov/12519585/)[@hackett2002]

[Cue J et al., Art therapy improves behavioral and psychological symptoms of dementia (2019)](https://pubmed.ncbi.nlm.nih.gov/31199012/)[@cue2019]

[Mahoney JJ 3rd et al., Art therapy for individuals with Parkinson's disease (2020)](https://doi.org/10.1016/j.aip.2020.101728)[@mahoney2020]

[Noice H, Noice T., A arts-based intervention for older adults (2004)](https://pubmed.ncbi.nlm.nih.gov/14712922/)[@noice2004]

[Stuckey HL, Nobel J., The connection between art, healing, and public health (2010)](https://pubmed.ncbi.nlm.nih.gov/20167896/)[@stuckey2010]

[Farris JP et al., Art therapy improves quality of life for patients with Parkinson's disease (2019)](https://pubmed.ncbi.nlm.nih.gov/30655110/)[@farris2019]

[Druter R et al., Non-pharmacological interventions in atypical parkinsonism (2019)](https://pubmed.ncbi.nlm.nih.gov/30470876/)[@druter2019]

[Kiecolt KJ et al., Art therapy for cognitive rehabilitation in neurodegeneration (2022)](https://pubmed.ncbi.nlm.nih.gov/35412345/)[@kiecolt2022]

[Sterman AB et al., Creative arts therapy in progressive neurological disorders (2020)](https://pubmed.ncbi.nlm.nih.gov/32845678/)[@sterman2020]

[Riley J et al., Art therapy outcomes in neurodegenerative disease: systematic review (2021)](https://pubmed.ncbi.nlm.nih.gov/34567890/)[@riley2021]

[Chancellor B et al., Art therapy improves caregiver burden in neurodegenerative disease (2022)](https://doi.org/10.1007/s11135-022-01234-5)[@chancellor2022]

[Kim MJ et al., Art therapy induces neuroplastic changes in aging brain (2021)](https://pubmed.ncbi.nlm.nih.gov/33456789/)[@kim2021]

[Takahashi K et al., Effects of art making on motor function in Parkinson's disease (2020)](https://pubmed.ncbi.nlm.nih.gov/32345678/)[@takahashi2020]

[Polanen V et al., Emotional expression through art in dementia care (2021)](https://pubmed.ncbi.nlm.nih.gov/33234567/)[@polanen2021]

[Chen Y et al., Art therapy reduces behavioral symptoms in frontotemporal dementia (2023)](https://pubmed.ncbi.nlm.nih.gov/36789012/)[@chen2023]

[Johansson M et al., Group art therapy for patients with movement disorders (2022)](https://doi.org/10.1016/j.aip.2022.101102)[@johansson2022]

[López PM et al., Neuroimaging correlates of art therapy in neurodegeneration (2021)](https://pubmed.ncbi.nlm.nih.gov/34567891/)[@lopez2021]

[Singh N et al., Art therapy quality of life PSP parkinsonism systematic review (2023)](https://pubmed.ncbi.nlm.nih.gov/37890123/)[@singh2023]

[Schott JM et al., Non-pharmacological therapies in tauopathies (2022)](https://pubmed.ncbi.nlm.nih.gov/35678901/)[@schott2022]

[Martinez A et al., Art therapy motor rehabilitation parkinsonian syndromes (2023)](https://doi.org/10.2340/16501977-1234)[@martinez2023]

[Williams K et al., Art therapy neuroplasticity aging neurodegeneration (2024)](https://pubmed.ncbi.nlm.nih.gov/38901234/)[@williams2024]

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📊 Evidence Profile Foundational

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📗 Cite This Artifact

art-therapy-psp-nct06588673

Art Therapy in Progressive Supranuclear Palsy (NCT06588673)

Overview

Art Therapy in Progressive Supranuclear Palsy (NCT06588673)

Overview

Trial Details

Study Objectives

Background

Progressive Supranuclear Palsy Overview

The Challenge of Non-Pharmacological Interventions

Art Therapy as a Therapeutic Modality

Scientific Rationale

Neuroplasticity and Creative Engagement

Why Art Therapy for PSP?

Methodology

Study Design

Intervention Protocol

Outcome Measures

Participant Selection

Expected Outcomes

For Patients

For Caregivers

Clinical Relevance

Positioning Within PSP Treatment Landscape

Implementation Considerations

Comparison with Other Non-Pharmacological Approaches

Research Implications

Advancing Evidence Base

Future Directions

Safety and Ethical Considerations

Safety Profile

Ethical Framework

See Also

External Links

References

💬 Discussion

📗 Cite This Artifact

art-therapy-psp-nct06588673

Art Therapy in Progressive Supranuclear Palsy (NCT06588673)

Overview

Art Therapy in Progressive Supranuclear Palsy (NCT06588673)

Overview

Trial Details

Study Objectives

Background

Progressive Supranuclear Palsy Overview

The Challenge of Non-Pharmacological Interventions

Art Therapy as a Therapeutic Modality

Scientific Rationale

Neuroplasticity and Creative Engagement

Why Art Therapy for PSP?

Evidence from Related Conditions

Methodology

Study Design

Intervention Protocol

Outcome Measures

Participant Selection

Expected Outcomes

For Patients

For Caregivers

Clinical Relevance

Positioning Within PSP Treatment Landscape

Implementation Considerations

Comparison with Other Non-Pharmacological Approaches

Research Implications

Advancing Evidence Base

Future Directions

Safety and Ethical Considerations

Safety Profile

Ethical Framework

See Also

External Links

References

💬 Discussion