The Depression Impact on Progressive Muscular Atrophy: A Rare Case Report of Motor Neuron Disease

Abstract

Progressive muscular atrophy (PMA) is a rare subtype of motor neuron disease (MND), accounting for approximately 2.5% of cases worldwide. It is characterized by progressive degeneration of lower motor neurons, leading to muscle atrophy, fasciculations, and weakness without early upper motor neuron involvement. Depression is a frequently reported psychiatric comorbidity in MND, yet may be difficult to recognize in PMA due to overlapping somatic symptoms and communication limitations in advanced disease. In this study, a 41-year-old man with progressive limb weakness initially attributed to cervical pathology, who was subsequently diagnosed with PMA and developed severe depressive symptoms during the advanced stage of illness with ventilator dependence, is reported. Psychiatric management included antidepressant therapy, supportive psychotherapy adapted to profound physical disability, and multidisciplinary care planning. This case highlights the diagnostic challenges of identifying depression in advanced PMA and illustrates the importance of integrated psychiatric care to address psychological distress, facilitate communication, and support decision-making. The report does not establish causal relationships but aims to contribute to the limited literature on psychiatric management in this rare condition.