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This study investigates whether cognitive deficits predict disease progression in PSP\u2010RS.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n A total of 146 PSP\u2010RS from the Tilavonemab trial were evaluated at baseline and over 52\u00a0weeks using the PSP\u2010Rating Scale (PSPRS), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and the Unified Parkinson's Disease Rating Scale Part\u2010II (UPDRS\u2010II). Multiple linear regression analyses were performed between the RBANS, UPDRS\u2010II, and the PSPRS change. Clinical scores, gray matter volumes, and neurofilament\u2010light chain (NfL) were compared using analyses of covariance (ANCOVAs) and linear mixed models between language score\u2010groups.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Lower RBANS\u2010language at baseline predicted greater PSPRS worsening over time. The low language\u2010score group showed poorer cognitive performance, elevated NfL, and reduced gray matter volume in language\u2010related areas.<\/jats:p>\n <\/jats:sec>\n \n DISCUSSION<\/jats:title>\n Speech\/language deficits predict worse prognosis in PSP\u2010RS, emphasizing the value of including language scores in clinical trials.<\/jats:p>\n <\/jats:sec>\n \n Highlights<\/jats:title>\n \n \n \n Speech and language deficits predict a worse prognosis in progressive supranuclear palsy\u2010Richardson syndrome (PSP\u2010RS).<\/jats:p>\n <\/jats:list-item>\n \n Lower language scores are associated with worse cognitive performance over time.<\/jats:p>\n <\/jats:list-item>\n \n Lower language scores related to higher neurofilament\u2010light chain (NfL) at baseline.<\/jats:p>\n <\/jats:list-item>\n \n The low language\u2010score group presented greater atrophy in language\u2010related brain areas.<\/jats:p>\n <\/jats:list-item>\n \n Stratifying PSP\u2010RS cases using language scores may improve clinical trials.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/alz.70485","type":"journal-article","created":{"date-parts":[[2025,7,20]],"date-time":"2025-07-20T03:38:45Z","timestamp":1752982725000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Language impairment is associated with faster progression in progressive supranuclear palsy\u2010Richardson syndrome"],"prefix":"10.1002","volume":"21","author":[{"given":"Indira","family":"Garcia\u2010Cordero","sequence":"first","affiliation":[{"name":"Tanz Centre for Research in Neurodegenerative Diseases University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Camilo","family":"Vargas\u2010Gonzalez","sequence":"additional","affiliation":[{"name":"Tanz Centre for Research in Neurodegenerative Diseases University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohsen","family":"Hadian","sequence":"additional","affiliation":[{"name":"Tanz Centre for Research in Neurodegenerative Diseases University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ece","family":"Bayram","sequence":"additional","affiliation":[{"name":"Movement Disorders Center Department of Neurology University of Colorado Anschutz Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Rodriguez\u2010Porcel","sequence":"additional","affiliation":[{"name":"Department of Neurology Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blas","family":"Couto","sequence":"additional","affiliation":[{"name":"Institute of Cognitive and Translational Neuroscience (INCyT\u2010INECO\u2010CONICET) Favaloro University Hospital Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Iyer","sequence":"additional","affiliation":[{"name":"Departments of Molecular and Cellular Biology and Statistics Harvard University Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence I.","family":"Golbe","sequence":"additional","affiliation":[{"name":"Rutgers Robert Wood Johnson Medical School New Brunswick New Jersey USA"},{"name":"CurePSP, Inc. 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