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Mahadevan J, Sud R, Nadella RK, Vani P, Subramaniam AG, Paul P, Ganapathy A, Mannan AU, Chandru V, Viswanath B, Purushottam M, Jain S. Targeted Sequencing Detects Variants That May Contribute to the Risk of Neuropsychiatric Disorders. Indian J Psychol Med 2022; 44:516-522. [PMID: 36157006 PMCID: PMC9460021 DOI: 10.1177/0253717621993672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Jayant Mahadevan
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Reeteka Sud
- Molecular Genetics Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Ravi Kumar Nadella
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Pulaparambil Vani
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Anand G Subramaniam
- Molecular Genetics Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Pradip Paul
- Molecular Genetics Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Aparna Ganapathy
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bengaluru, Karnataka, India
| | - Ashraf U Mannan
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bengaluru, Karnataka, India
| | - Vijay Chandru
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bengaluru, Karnataka, India.,Centre for Biosystems Science and Engineering, Indian Institute of Science, Bengaluru, Karnataka, India
| | - Biju Viswanath
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India.,Molecular Genetics Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Meera Purushottam
- Molecular Genetics Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Sanjeev Jain
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India.,Molecular Genetics Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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Liu WY, Tung TH, Zhang C, Shi L. Systematic review for the prevention and management of falls and fear of falling in patients with Parkinson's disease. Brain Behav 2022; 12:e2690. [PMID: 35837986 PMCID: PMC9392538 DOI: 10.1002/brb3.2690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/17/2022] [Accepted: 04/24/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE To synthesize recent empirical evidence for the prevention and management of falls and fear of falling in patients with Parkinson's disease (PD). DATA SOURCE Database from PubMed, Cochrane Library, and EMBASE. STUDY DESIGN Systematic review. DATA COLLECTION We searched the PubMed, Cochrane Library, and EMBASE databases for studies published from inception to February 27, 2021. Inclusion criteria were nonreview articles on prevention and management measures related to falls and fall prevention in Parkinson's disease patients. PRINCIPAL FINDINGS We selected 45 articles and conducted in-depth research and discussion. According to the causes of falls in PD patients, they were divided into five directions, namely physical status, pre-existing conditions, environment, medical care, and cognition. In the cognitive domain, we focused on the fear of falling. On the above basis, we constructed a fall prevention model, which is a tertiary prevention health care network, based on The Johns Hopkins Fall Risk Assessment Tool to provide ideas for the prevention and management of falling and fear of falling in PD patients in clinical practice CONCLUSIONS: Falls and fear of falls in patients with Parkinson's disease can be reduced by effective clinical prevention and management. Future studies are needed to explore the efficacy of treatment and prevention of falls and fear of falls.
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Affiliation(s)
- Wen-Yi Liu
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.,Shanghai Bluecross Medical Science Institute, Shanghai, China.,Institute for Hospital Management, Tsing Hua University, Shenzhen Campus, China
| | - Tao-Hsin Tung
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China
| | - Chencheng Zhang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Leiyu Shi
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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53
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Pan Y, Liu J, Ren J, Luo Y, Sun X. Epac: A Promising Therapeutic Target for Vascular Diseases: A Review. Front Pharmacol 2022; 13:929152. [PMID: 35910387 PMCID: PMC9330031 DOI: 10.3389/fphar.2022.929152] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 06/14/2022] [Indexed: 11/13/2022] Open
Abstract
Vascular diseases affect the circulatory system and comprise most human diseases. They cause severe symptoms and affect the quality of life of patients. Recently, since their identification, exchange proteins directly activated by cAMP (Epac) have attracted increasing scientific interest, because of their role in cyclic adenosine monophosphate (cAMP) signaling, a well-known signal transduction pathway. The role of Epac in cardiovascular disease and cancer is extensively studied, whereas their role in kidney disease has not been comprehensively explored yet. In this study, we aimed to review recent studies on the regulatory effects of Epac on various vascular diseases, such as cardiovascular disease, cerebrovascular disease, and cancer. Accumulating evidence has shown that both Epac1 and Epac2 play important roles in vascular diseases under both physiological and pathological conditions. Additionally, there has been an increasing focus on Epac pharmacological modulators. Therefore, we speculated that Epac could serve as a novel therapeutic target for the treatment of vascular diseases.
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Affiliation(s)
- Yunfeng Pan
- Key Laboratory of Bioactive Substances and Resources Utilization of Chinese Herbal Medicine, Ministry of Education, Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Beijing Key Laboratory of Innovative Drug Discovery of Traditional Chinese Medicine (Natural Medicine) and Translational Medicine, Beijing, China
- Key Laboratory of Efficacy Evaluation of Chinese Medicine Against Glycolipid Metabolic Disorders, State Administration of Traditional Chinese Medicine, Beijing, China
| | - Jia Liu
- Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Jiahui Ren
- Key Laboratory of Bioactive Substances and Resources Utilization of Chinese Herbal Medicine, Ministry of Education, Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Beijing Key Laboratory of Innovative Drug Discovery of Traditional Chinese Medicine (Natural Medicine) and Translational Medicine, Beijing, China
- Key Laboratory of Efficacy Evaluation of Chinese Medicine Against Glycolipid Metabolic Disorders, State Administration of Traditional Chinese Medicine, Beijing, China
| | - Yun Luo
- Key Laboratory of Bioactive Substances and Resources Utilization of Chinese Herbal Medicine, Ministry of Education, Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Beijing Key Laboratory of Innovative Drug Discovery of Traditional Chinese Medicine (Natural Medicine) and Translational Medicine, Beijing, China
- Key Laboratory of Efficacy Evaluation of Chinese Medicine Against Glycolipid Metabolic Disorders, State Administration of Traditional Chinese Medicine, Beijing, China
- *Correspondence: Yun Luo, ; Xiaobo Sun,
| | - Xiaobo Sun
- Key Laboratory of Bioactive Substances and Resources Utilization of Chinese Herbal Medicine, Ministry of Education, Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Beijing Key Laboratory of Innovative Drug Discovery of Traditional Chinese Medicine (Natural Medicine) and Translational Medicine, Beijing, China
- Key Laboratory of Efficacy Evaluation of Chinese Medicine Against Glycolipid Metabolic Disorders, State Administration of Traditional Chinese Medicine, Beijing, China
- *Correspondence: Yun Luo, ; Xiaobo Sun,
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Agüera-Ortiz L, Babulal GM, Bruneau MA, Creese B, D'Antonio F, Fischer CE, Gatchel JR, Ismail Z, Kumar S, McGeown WJ, Mortby ME, Nuñez NA, de Oliveira FF, Pereiro AX, Ravona-Springer R, Rouse HJ, Wang H, Lanctôt KL. Psychosis as a Treatment Target in Dementia: A Roadmap for Designing Interventions. J Alzheimers Dis 2022; 88:1203-1228. [PMID: 35786651 PMCID: PMC9484097 DOI: 10.3233/jad-215483] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Psychotic phenomena are among the most severe and disruptive symptoms of dementias and appear in 30% to 50% of patients. They are associated with a worse evolution and great suffering to patients and caregivers. Their current treatments obtain limited results and are not free of adverse effects, which are sometimes serious. It is therefore crucial to develop new treatments that can improve this situation. We review available data that could enlighten the future design of clinical trials with psychosis in dementia as main target. Along with an explanation of its prevalence in the common diseases that cause dementia, we present proposals aimed at improving the definition of symptoms and what should be included and excluded in clinical trials. A review of the available information regarding the neurobiological basis of symptoms, in terms of pathology, neuroimaging, and genomics, is provided as a guide towards new therapeutic targets. The correct evaluation of symptoms is transcendental in any therapeutic trial and these aspects are extensively addressed. Finally, a critical overview of existing pharmacological and non-pharmacological treatments is made, revealing the unmet needs, in terms of efficacy and safety. Our work emphasizes the need for better definition and measurement of psychotic symptoms in dementias in order to highlight their differences with symptoms that appear in non-dementing diseases such as schizophrenia. Advances in neurobiology should illuminate the development of new, more effective and safer molecules for which this review can serve as a roadmap in the design of future clinical trials.
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Affiliation(s)
- Luis Agüera-Ortiz
- Department of Psychiatry, Instituto de Investigación Sanitaria (imas12), Hospital Universitario 12 de Octubre, & Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Ganesh M Babulal
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.,Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.,Department of Psychology, Faculty of Humanities, University of Johannesburg, South Africa
| | - Marie-Andrée Bruneau
- Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal, Quebec, Canada.,Geriatric Institute of Montreal Research Center, Montreal, Quebec, Canada
| | - Byron Creese
- Medical School, College of Medicine and Health, University of Exeter, UK
| | | | - Corinne E Fischer
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Ontario, Canada.,University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada
| | - Jennifer R Gatchel
- Harvard Medical School; Massachusetts General Hospital, Boston MA, USA.,McLean Hospital, Belmont MA, USA
| | - Zahinoor Ismail
- Hotchkiss Brain Institute & O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
| | - Sanjeev Kumar
- Adult Neurodevelopmental and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - William J McGeown
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Moyra E Mortby
- School of Psychology, University of New South Wales, Sydney, Australia & Neuroscience Research Australia, Sydney, Australia
| | - Nicolas A Nuñez
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Fabricio F de Oliveira
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Arturo X Pereiro
- Facultade de Psicoloxía, Universidade de Santiago de Compostela, Spain
| | - Ramit Ravona-Springer
- Sheba Medical Center, Tel Hashomer, Israel & Sackler School of Medicine, Tel Aviv University, Israel
| | - Hillary J Rouse
- School of Aging Studies, University of South Florida, Tampa, FL, USA.,SiteRx, New York, NY, USA
| | - Huali Wang
- Dementia Care and Research Center, Peking University Institute of Mental Health; National & Clinical Research Center for Mental Disorders, Beijing, China
| | - Krista L Lanctôt
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute and Departments of Psychiatry and Pharmacology, University of Toronto, Toronto, Ontario, Canada
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55
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Wal P, Dwivedi J, Wal A, Vig H, Singh Y. Detailed insight into the pathophysiology and the behavioral complications associated with the Parkinson's disease and its medications. FUTURE JOURNAL OF PHARMACEUTICAL SCIENCES 2022. [DOI: 10.1186/s43094-022-00425-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The loss of dopamine neurons in the substantia nigra, as well as other mostly catecholaminergic neurons, causes many of the motor symptoms that define Parkinson's disease. Parkinson's disease is commonly thought of as a movement disorder, the significant prevalence of psychiatric complications such as cognitive impairment, and psychosis suggests it should be considered a neuropsychiatric illness, and all behavioral complications are linked to growing disability and the medication.
Main body
Apart from the disease-induced abnormalities, there are several other side effects of the disease and also from the medication used to prevent the disease. This article focuses on the pathogenesis of Parkinson’s disease and also the behavioral abnormalities caused by the disease and its medication. The study's data were gathered by searching several review articles and research papers from a variety of sources, including Elsevier, PubMed, Research Gate, Journal of Pharmaceutical Science, etc., from the year 1985 to 2021. Parkinson's disease is a neurodegenerative disease caused by a variety of complex processes. It is responsible not just for motor symptoms, but also for a variety of behavioral symptoms that can arise as a result of the disease and/or medication.
Conclusion
Only symptomatic drugs are available; thus, finding treatments that directly address the disease mechanisms causing Parkinson’s disease is essential. To alleviate the disease's burden on patients and their families, better treatments for the neuropsychiatric repercussions of Parkinson's disease are required.
Graphical Abstract
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56
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Okunoye O, Horsfall L, Marston L, Walters K, Schrag A. Rate of Hospitalizations and Underlying Reasons Among People with Parkinson's Disease: Population-Based Cohort Study in UK Primary Care. JOURNAL OF PARKINSON'S DISEASE 2022; 12:411-420. [PMID: 34719512 PMCID: PMC7612266 DOI: 10.3233/jpd-212874] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Hospitalization in Parkinson's disease (PD) is associated with reduced quality of life, caregiver burden and high costs. However, no large-scale studies of rate and causes of hospitalizations in patients with PD have been published. OBJECTIVE To investigate the rate and reasons for hospitalization and factors associated with hospitalization among people with PD compared to the general population. METHODS We examined rate and causes of admission in PD patients and matched controls in The Health Improvement Network from 2006 to 2016. Multivariable Poisson regression was used to explore the effects of age, gender, social deprivation, urbanicity and practice geographic location on hospitalization. RESULTS In the longitudinal data from 9,998 newly diagnosed individuals with PD and 55,554 controls without PD aged ≥50 years, 39% of PD patients and 28% of controls were hospitalised over a median follow-up of 5.1 years. The adjusted incidence rate ratio (IRR) of hospitalization in PD compared to controls was 1.33 (95% CI:1.29-1.37) and rose with increased follow-up duration. Hospitalization rate was overall higher in the older age groups, but the adjusted IRR of hospitalization compared to controls was highest in the youngest age group. PD patients were more often admitted with falls/fractures, infections, gastrointestinal complications, PD, dementia, psychosis/hallucinations, postural hypotension, electrolyte disturbances, stroke and surgical procedures and slightly less often due to hypertension. CONCLUSION People with PD have an increased hospitalization rate compared to controls, particularly in the younger age groups, and it increases with longer disease duration. The complications of motor and non-motor features of PD are amongst the main reasons for admission, some of which could be managed preventatively to avoid admissions.
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Affiliation(s)
- Olaitan Okunoye
- Department of Clinical and Movement Neurosciences, University College London, UK
| | - Laura Horsfall
- Department of Primary Care and Population Health, University College London, UK
| | - Louise Marston
- Department of Primary Care and Population Health, University College London, UK
| | - Kate Walters
- Department of Primary Care and Population Health, University College London, UK
| | - Anette Schrag
- Department of Clinical and Movement Neurosciences, University College London, UK
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57
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Kratter IH, Karp JF, Chang YF, Whiteman AC, Feyder MT, Jorge A, Richardson RM, Henry LC. Association of Preoperative Visual Hallucinations With Cognitive Decline After Deep Brain Stimulation for Parkinson's Disease. J Neuropsychiatry Clin Neurosci 2022; 33:144-151. [PMID: 33203305 DOI: 10.1176/appi.neuropsych.20040077] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Deep brain stimulation (DBS) is effective for the motor symptoms of Parkinson's disease (PD). Although most patients benefit with minimal cognitive side effects, cognitive decline is a risk, and there is little available evidence to guide preoperative risk assessment. Visual illusions or visual hallucinations (VHs) and impulse-control behaviors (ICBs) are relatively common complications of PD and its treatment and may be a marker of more advanced disease, but their relationship with postoperative cognition has not been established. The authors aimed to determine whether any preoperative history of VHs or ICBs is associated with cognitive change after DBS. METHODS Retrospective chart review identified 54 patients with PD who received DBS of the subthalamic nucleus or globus pallidus internus and who completed both pre- and postoperative neuropsychological testing. Linear regression models were used to assess whether any preoperative history of VHs or ICBs was associated with changes in attention, executive function, language, memory, or visuospatial cognitive domains while controlling for surgical target and duration between evaluations. RESULTS The investigators found that a history of VHs was associated with declines in attention (b=-4.04, p=0.041) and executive function (b=-4.24, p=0.021). A history of ICBs was not associated with any significant changes. CONCLUSIONS These results suggest that a history of VHs may increase risk of cognitive decline after DBS; thus, specific preoperative counseling and targeted remediation strategies for these patients may be indicated. In contrast, a history of ICBs does not appear to be associated with increased cognitive risk.
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Affiliation(s)
- Ian H Kratter
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Kratter, Karp); Department of Neurological Surgery, Brain Modulation Laboratory, University of Pittsburgh School of Medicine (Kratter, Chang, Whiteman, Feyder, Jorge, Henry); Department of Neurosurgery, Massachusetts General Hospital, Boston (Richardson); University of Arizona College of Medicine, Department of Psychiatry, Tucson (Karp); and Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, Calif. (Kratter)
| | - Jordan F Karp
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Kratter, Karp); Department of Neurological Surgery, Brain Modulation Laboratory, University of Pittsburgh School of Medicine (Kratter, Chang, Whiteman, Feyder, Jorge, Henry); Department of Neurosurgery, Massachusetts General Hospital, Boston (Richardson); University of Arizona College of Medicine, Department of Psychiatry, Tucson (Karp); and Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, Calif. (Kratter)
| | - Yue-Fang Chang
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Kratter, Karp); Department of Neurological Surgery, Brain Modulation Laboratory, University of Pittsburgh School of Medicine (Kratter, Chang, Whiteman, Feyder, Jorge, Henry); Department of Neurosurgery, Massachusetts General Hospital, Boston (Richardson); University of Arizona College of Medicine, Department of Psychiatry, Tucson (Karp); and Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, Calif. (Kratter)
| | - Ashley C Whiteman
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Kratter, Karp); Department of Neurological Surgery, Brain Modulation Laboratory, University of Pittsburgh School of Medicine (Kratter, Chang, Whiteman, Feyder, Jorge, Henry); Department of Neurosurgery, Massachusetts General Hospital, Boston (Richardson); University of Arizona College of Medicine, Department of Psychiatry, Tucson (Karp); and Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, Calif. (Kratter)
| | - Michael T Feyder
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Kratter, Karp); Department of Neurological Surgery, Brain Modulation Laboratory, University of Pittsburgh School of Medicine (Kratter, Chang, Whiteman, Feyder, Jorge, Henry); Department of Neurosurgery, Massachusetts General Hospital, Boston (Richardson); University of Arizona College of Medicine, Department of Psychiatry, Tucson (Karp); and Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, Calif. (Kratter)
| | - Ahmed Jorge
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Kratter, Karp); Department of Neurological Surgery, Brain Modulation Laboratory, University of Pittsburgh School of Medicine (Kratter, Chang, Whiteman, Feyder, Jorge, Henry); Department of Neurosurgery, Massachusetts General Hospital, Boston (Richardson); University of Arizona College of Medicine, Department of Psychiatry, Tucson (Karp); and Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, Calif. (Kratter)
| | - R Mark Richardson
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Kratter, Karp); Department of Neurological Surgery, Brain Modulation Laboratory, University of Pittsburgh School of Medicine (Kratter, Chang, Whiteman, Feyder, Jorge, Henry); Department of Neurosurgery, Massachusetts General Hospital, Boston (Richardson); University of Arizona College of Medicine, Department of Psychiatry, Tucson (Karp); and Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, Calif. (Kratter)
| | - Luke C Henry
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Kratter, Karp); Department of Neurological Surgery, Brain Modulation Laboratory, University of Pittsburgh School of Medicine (Kratter, Chang, Whiteman, Feyder, Jorge, Henry); Department of Neurosurgery, Massachusetts General Hospital, Boston (Richardson); University of Arizona College of Medicine, Department of Psychiatry, Tucson (Karp); and Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, Calif. (Kratter)
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Sun Y, Cui B, Ye L, Hu Y, Pan Y. Pramipexole Inhibits Neuronal Apoptosis in Rats with Parkinson's Disease. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:7002630. [PMID: 35463692 PMCID: PMC9020956 DOI: 10.1155/2022/7002630] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/12/2022] [Accepted: 03/17/2022] [Indexed: 11/23/2022]
Abstract
To explore the inhibition of pramipexole on the neuronal apoptosis and its influences on the expressions of brain tissue brain-derived neurotrophic factor (BDNF), and serum miR-103a and miR-30b and inflammatory factors in rats with Parkinson's disease. A total of 36 Sprague-Dawley rats were randomly divided into normal group (n = 12), model group (n = 12) and pramipexole group (n = 12). Compared with that in normal group, the positive expression of BDNF was substantially increased in model group and pramipexole group, and its positive expression in pramipexole group was notably higher than that in model group. The WB results revealed that compared with those in normal group, the relative protein expression levels of Bax and Bcl-2 were markedly increased and decreased, respectively, in the other two groups, and that pramipexole group exhibited a remarkable decline in the relative protein expression level of Bax and a considerable increase in that of Bcl-2, compared with model group. The relative expression levels of miR-103a and miR-30b in model and pramipexole groups were markedly higher than those in normal group, and pramipexole group had remarkably higher relative expression levels of miR-103a and miR-30b than model group. It was found through ELISA that model and pramipexole groups had markedly raised IL-1β and IL-18 content compared with normal group, and their content in pramipexole group was remarkably lower than that in model group. Based on the TUNEL results, compared with that in normal group, the apoptosis rate of cells rose substantially in the other two groups, and the apoptosis rate in pramipexole group was notably lower than that in model group. Pramipexole may up-regulate the expressions of BDNF, miR-103a and miR-30b to inhibit the apoptosis and inflammation in Parkinson's disease model rats.
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Affiliation(s)
- Yongqi Sun
- Department of Neurology, Guangdong 999 Brain Hospital, Guangzhou, China
| | - Baohong Cui
- Laboratory Medicine, The Third Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Lin Ye
- Department of Rehabilitation, Xuanwu Hospital Affiliated to Capital Medical University, Beijing, China
| | - Yunxin Hu
- Department of Neurology, Guangdong 999 Brain Hospital, Guangzhou, China
| | - Yujun Pan
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
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Sumi Y, Ubara A, Ozeki Y, Kadotani H. Minor hallucinations in isolated rapid eye movement sleep behavior disorder indicative of early phenoconversion: A preliminary study. Acta Neurol Scand 2022; 145:348-359. [PMID: 34816426 DOI: 10.1111/ane.13555] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 11/01/2021] [Accepted: 11/07/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Minor hallucinations (MH) are psychotic symptoms that can occur anywhere between prodromal to early Parkinson's disease and after onset of motor problems. MH include visual illusions, presence hallucinations, and passage hallucinations. Isolated rapid eye movement sleep behavior disorder (RBD) is a harbinger of neurodegenerative diseases. We conducted a retrospective cohort study to investigate the clinical characteristics of isolated RBD with MH and the risk of phenoconversion. MATERIALS AND METHODS We retrospectively analyzed the data of 36 patients with isolated RBD (four females; median age, 75.0 years). We defined cases reporting at least one minor hallucination as RBD with MH. Demographic data and cognitive function were compared between patients with and without MH, and Cox proportional hazards models estimated the risk of phenoconversion. RESULTS We included 10 (27.8%) patients with MH and 26 (72.2%) without MH. Patients with MH were older, had less dopamine transporter accumulation, more severe autonomic dysfunction, more depressive symptoms, and lower verbal fluency and symbol coding test scores than patients without MH. After follow-up (median, 2.50 years), 13.9% (5/36) of all patients developed phenoconversion (Parkinson's disease, two patients; dementia with Lewy bodies, three patients). The rate of phenoconversion was significantly higher in patients with MH (40.0% vs. 3.8%, p = .005). The Cox proportional hazards model adjusted for age, sex, and disease duration revealed that MH was a significant risk factor for phenoconversion (hazard ratio, 14.72; 95% confidence interval, 1.35-160.5). CONCLUSIONS Minor hallucinations may be utilized as early clinical markers for prodromal estimation of neurodegenerative diseases.
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Affiliation(s)
- Yukiyoshi Sumi
- Department of Psychiatry Shiga University of Medical Science Shiga Japan
| | - Ayaka Ubara
- Department of Psychiatry Shiga University of Medical Science Shiga Japan
- Graduate School of Psychology Doshisha University Kyoto Japan
- Japan Society for the Promotion of Science Research Fellowships Tokyo Japan
| | - Yuji Ozeki
- Department of Psychiatry Shiga University of Medical Science Shiga Japan
| | - Hiroshi Kadotani
- Department of Psychiatry Shiga University of Medical Science Shiga Japan
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Kumfor F, Liang CT, Hazelton JL, Leyton CE, Kaizik C, Devenney E, Connaughton E, Langdon R, Mioshi E, Kwok JB, Dobson‐Stone C, Halliday GM, Piguet O, Hodges JR, Landin‐Romero R. Examining the presence and nature of delusions in Alzheimer's disease and frontotemporal dementia syndromes. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5692. [PMID: 35178786 PMCID: PMC9546395 DOI: 10.1002/gps.5692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/03/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Abnormal beliefs and delusions have been reported in some people with dementia, however, the prevalence of delusions, and their neurocognitive basis has been underexplored. This study aimed to examine the presence, severity, content and neural correlates of delusions in a large, well-characterised cohort of dementia patients using a transdiagnostic, cross-sectional approach. METHODS Four-hundred and eighty-seven people with dementia were recruited: 102 Alzheimer's disease, 136 behavioural-variant frontotemporal dementia, 154 primary progressive aphasia, 29 motor neurone disease, 46 corticobasal syndrome, 20 progressive supranuclear palsy. All patients underwent neuropsychological assessment and brain magnetic resonance imaging, and the Neuropsychiatric Inventory was conducted with an informant, by an experienced clinician. RESULTS In our cohort, 48/487 patients (10.8%) had delusions. A diagnosis of behavioural-variant frontotemporal dementia (18.4%) and Alzheimer's disease (11.8%) were associated with increased risk of delusions. A positive gene mutation was observed in 11/27 people with delusions. Individuals with frequent delusions performed worse on the Addenbrooke's Cognitive Examination (p = 0.035), particularly on the orientation/attention (p = 0.022) and memory (p = 0.013) subtests. Voxel-based morphometry analyses found that increased delusional psychopathology was associated with reduced integrity of the right middle frontal gyrus, right planum temporale and left anterior temporal pole. CONCLUSION Our results demonstrate that delusions are relatively common in dementia and uncover a unique cognitive and neural profile associated with the manifestation of delusions. Clinically, delusions may lead to delayed or misdiagnosis. Our results shed light on how to identify individuals at risk of neuropsychiatric features of dementia, a crucial first step to enable targeted symptom management.
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Affiliation(s)
- Fiona Kumfor
- School of PsychologyThe University of SydneySydneyNew South WalesAustralia
- Brain & Mind CentreThe University of SydneySydneyNew South WalesAustralia
| | - Cheng Tao Liang
- School of PsychologyThe University of SydneySydneyNew South WalesAustralia
- Brain & Mind CentreThe University of SydneySydneyNew South WalesAustralia
| | - Jessica L. Hazelton
- School of PsychologyThe University of SydneySydneyNew South WalesAustralia
- Brain & Mind CentreThe University of SydneySydneyNew South WalesAustralia
| | - Cristian E. Leyton
- Brain & Mind CentreThe University of SydneySydneyNew South WalesAustralia
- Faculty of Health SciencesThe University of SydneySydneyNew South WalesAustralia
| | - Cassandra Kaizik
- Brain & Mind CentreThe University of SydneySydneyNew South WalesAustralia
- Memory and Cognition ClinicRPA HospitalSydneyLocal Health District, New South WalesAustralia
| | - Emma Devenney
- Brain & Mind CentreThe University of SydneySydneyNew South WalesAustralia
- Central Clinical SchoolThe University of SydneySydneyNew South WalesAustralia
| | - Emily Connaughton
- Department of Cognitive SciencesMacquarie UniversitySydneyNew South WalesAustralia
| | - Robyn Langdon
- Department of Cognitive SciencesMacquarie UniversitySydneyNew South WalesAustralia
| | - Eneida Mioshi
- School of Health SciencesUniversity of East AngliaNorwichUK
| | - John B. Kwok
- Brain & Mind CentreThe University of SydneySydneyNew South WalesAustralia
- Central Clinical SchoolThe University of SydneySydneyNew South WalesAustralia
- School of Medical SciencesUniversity of New South WalesSydneyNew South WalesAustralia
| | - Carol Dobson‐Stone
- Brain & Mind CentreThe University of SydneySydneyNew South WalesAustralia
- Central Clinical SchoolThe University of SydneySydneyNew South WalesAustralia
- School of Medical SciencesUniversity of New South WalesSydneyNew South WalesAustralia
| | - Glenda M. Halliday
- Brain & Mind CentreThe University of SydneySydneyNew South WalesAustralia
- Central Clinical SchoolThe University of SydneySydneyNew South WalesAustralia
- School of Medical SciencesUniversity of New South WalesSydneyNew South WalesAustralia
| | - Olivier Piguet
- School of PsychologyThe University of SydneySydneyNew South WalesAustralia
- Brain & Mind CentreThe University of SydneySydneyNew South WalesAustralia
| | - John R. Hodges
- Brain & Mind CentreThe University of SydneySydneyNew South WalesAustralia
- Central Clinical SchoolThe University of SydneySydneyNew South WalesAustralia
| | - Ramon Landin‐Romero
- School of PsychologyThe University of SydneySydneyNew South WalesAustralia
- Brain & Mind CentreThe University of SydneySydneyNew South WalesAustralia
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61
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Visual hallucinations in Lewy body disease: pathophysiological insights from phenomenology. J Neurol 2022; 269:3636-3652. [PMID: 35099586 PMCID: PMC9217885 DOI: 10.1007/s00415-022-10983-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 01/16/2022] [Accepted: 01/19/2022] [Indexed: 11/13/2022]
Abstract
Visual hallucinations (VH) in Lewy body disease (LBD) have a heterogenous phenomenology classified into minor phenomena (MVH) and complex hallucinations (CVH). Mechanisms underpinning VH and their temporal aspects are largely unknown. According to the hodotopic model, we investigated whether changes in distinct cognitive domains and neural networks in the hallucination trait underpin temporal aspects of MVH and CVH in the hallucination state. 35 LBD patients with VH underwent a complete neuropsychological evaluation and resting-state fMRI. North-East-Visual-Hallucinations-Interview was used to assess their typical VH content, duration, and frequency. We found that MVH was not associated with cognitive impairment, while CVH was associated with impairments in visuoperceptual processes, attention and visual abstract reasoning. In seed-to-seed functional connectivity (FC) analysis we identified functional couplings associated with MVH and CVH temporal severity (duration x frequency), duration and frequency. MVH severity was negatively associated with FC between early visual areas (EVA) and ventral-visual-stream regions, and negatively associated with FC between brainstem and EVA, which may be linked to LBD brainstem neuropathology. CVH duration was positively associated with FC between ventral-visual stream and salience network (SN). CVH frequency was negatively associated with FC between DMN and SN. Functional alterations in distinct visual and attentional networks and their dynamic interaction in trait LBD hallucinators are linked to both the phenomenology of state content and its temporal characteristics. Within a network, VH frequency and duration may be linked to different types of functional alterations: increased connectivity leading to sustained activity prolonging VH (duration) and decreased connectivity increasing dysregulated, spontaneous activity (frequency). These findings support the hodotopic hypothesis of VH and may reflect a link between VH phenomenology, LBD neuropathological progression and the involvement of specific neurotransmitter systems.
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62
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Vignando M, Ffytche D, Lewis SJG, Lee PH, Chung SJ, Weil RS, Hu MT, Mackay CE, Griffanti L, Pins D, Dujardin K, Jardri R, Taylor JP, Firbank M, McAlonan G, Mak HKF, Ho SL, Mehta MA. Mapping brain structural differences and neuroreceptor correlates in Parkinson's disease visual hallucinations. Nat Commun 2022; 13:519. [PMID: 35082285 PMCID: PMC8791961 DOI: 10.1038/s41467-022-28087-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 12/14/2021] [Indexed: 12/16/2022] Open
Abstract
Parkinson's psychosis (PDP) describes a spectrum of symptoms that may arise in Parkinson's disease (PD) including visual hallucinations (VH). Imaging studies investigating the neural correlates of PDP have been inconsistent in their findings, due to differences in study design and limitations of scale. Here we use empirical Bayes harmonisation to pool together structural imaging data from multiple research groups into a large-scale mega-analysis, allowing us to identify cortical regions and networks involved in VH and their relation to receptor binding. Differences of morphometrics analysed show a wider cortical involvement underlying VH than previously recognised, including primary visual cortex and surrounding regions, and the hippocampus, independent of its role in cognitive decline. Structural covariance analyses point to the involvement of the attentional control networks in PD-VH, while associations with receptor density maps suggest neurotransmitter loss may be linked to the cortical changes.
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Affiliation(s)
- Miriam Vignando
- Department of Neuroimaging, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
| | - Dominic Ffytche
- Department of Old Age Psychiatry, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK
| | - Simon J G Lewis
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, University of Sydney, Camperdown, NSW, Australia
| | - Phil Hyu Lee
- Yonsei University College of Medicine, Seoul, South Korea
| | | | - Rimona S Weil
- Dementia Research Centre, University College London, 8-11 Queen Square, London, WC1M 3BG, UK
- Wellcome Centre for Neuroimaging, University College London, London, UK
| | - Michele T Hu
- Oxford Parkinson's Disease Centre, Oxford, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Clare E Mackay
- Oxford Parkinson's Disease Centre, Oxford, UK
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Human Brain Activity, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Ludovica Griffanti
- Oxford Parkinson's Disease Centre, Oxford, UK
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Human Brain Activity, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Delphine Pins
- Univ. Lille, Inserm, CHU Lille, U1172 - Centre Lille Neuroscience & Cognition, 59000, Lille, France
| | - Kathy Dujardin
- Univ. Lille, Inserm, CHU Lille, U1172 - Centre Lille Neuroscience & Cognition, 59000, Lille, France
| | - Renaud Jardri
- Univ. Lille, Inserm, CHU Lille, U1172 - Centre Lille Neuroscience & Cognition, 59000, Lille, France
| | - John-Paul Taylor
- Newcastle University, Translational and Clinical Research Institute, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle Upon Tyne, NE4 5PL, UK
| | - Michael Firbank
- Newcastle University, Translational and Clinical Research Institute, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle Upon Tyne, NE4 5PL, UK
| | - Grainne McAlonan
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK
| | - Henry K F Mak
- Division of Neurology, Dept of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Shu Leong Ho
- Division of Neurology, Dept of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Mitul A Mehta
- Department of Neuroimaging, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK
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63
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Potheegadoo J, Dhanis H, Horvath J, Burkhard PR, Blanke O. Presence Hallucinations during Locomotion in Patients with Parkinson's Disease. Mov Disord Clin Pract 2022; 9:127-129. [PMID: 35005079 PMCID: PMC8721837 DOI: 10.1002/mdc3.13367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 10/13/2021] [Accepted: 10/19/2021] [Indexed: 11/22/2022] Open
Affiliation(s)
- Jevita Potheegadoo
- Center for Neuroprosthetics, Faculty of Life Sciences Swiss Federal Institute of Technology (EPFL) Geneva Switzerland.,Brain Mind Institute, Faculty of Life Sciences Swiss Federal Institute of Technology (EPFL) Lausanne Switzerland
| | - Herberto Dhanis
- Center for Neuroprosthetics, Faculty of Life Sciences Swiss Federal Institute of Technology (EPFL) Geneva Switzerland.,Brain Mind Institute, Faculty of Life Sciences Swiss Federal Institute of Technology (EPFL) Lausanne Switzerland
| | - Judit Horvath
- Neurologu Center, La Tour Hospital Meyrin Switzerland.,Department of Clinical Neurosciences Geneva University Hospital Geneva Switzerland
| | - Pierre R Burkhard
- Department of Clinical Neurosciences Geneva University Hospital Geneva Switzerland
| | - Olaf Blanke
- Center for Neuroprosthetics, Faculty of Life Sciences Swiss Federal Institute of Technology (EPFL) Geneva Switzerland.,Brain Mind Institute, Faculty of Life Sciences Swiss Federal Institute of Technology (EPFL) Lausanne Switzerland.,Department of Clinical Neurosciences Geneva University Hospital Geneva Switzerland
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64
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Digiovanni A, Ajdinaj P, Russo M, Sensi SL, Onofrj M, Thomas A. Bipolar spectrum disorders in neurologic disorders. Front Psychiatry 2022; 13:1046471. [PMID: 36620667 PMCID: PMC9811836 DOI: 10.3389/fpsyt.2022.1046471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Psychiatric symptoms frequently predate or complicate neurological disorders, such as neurodegenerative diseases. Symptoms of bipolar spectrum disorders (BSD), like mood, behavioral, and psychotic alterations, are known to occur - individually or as a syndromic cluster - in Parkinson's disease and in the behavioral variant of frontotemporal dementia (FTD). Nonetheless, due to shared pathophysiological mechanisms, or genetic predisposition, several other neurological disorders show significant, yet neglected, clinical and biological overlaps with BSD like neuroinflammation, ion channel dysfunctions, neurotransmission imbalance, or neurodegeneration. BSD pathophysiology is still largely unclear, but large-scale network dysfunctions are known to participate in the onset of mood disorders and psychotic symptoms. Thus, functional alterations can unleash BSD symptoms years before the evidence of an organic disease of the central nervous system. The aim of our narrative review was to illustrate the numerous intersections between BSD and neurological disorders from a clinical-biological point of view and the underlying predisposing factors, to guide future diagnostic and therapeutical research in the field.
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Affiliation(s)
- Anna Digiovanni
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Paola Ajdinaj
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Mirella Russo
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Stefano L Sensi
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Marco Onofrj
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Astrid Thomas
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
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65
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Weintraub D, Aarsland D, Chaudhuri KR, Dobkin RD, Leentjens AF, Rodriguez-Violante M, Schrag A. The neuropsychiatry of Parkinson's disease: advances and challenges. Lancet Neurol 2022; 21:89-102. [PMID: 34942142 PMCID: PMC8800169 DOI: 10.1016/s1474-4422(21)00330-6] [Citation(s) in RCA: 136] [Impact Index Per Article: 68.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 08/21/2021] [Accepted: 09/20/2021] [Indexed: 01/03/2023]
Abstract
In people with Parkinson's disease, neuropsychiatric signs and symptoms are common throughout the disease course. These symptoms can be disabling and as clinically relevant as motor symptoms, and their presentation can be similar to, or distinct from, their counterparts in the general population. Correlates and risk factors for developing neuropsychiatric signs and symptoms include demographic, clinical, and psychosocial characteristics. The underlying neurobiology of these presentations is complex and not well understood, with the strongest evidence for neuropathological changes associated with Parkinson's disease, mechanisms linked to dopaminergic therapy, and effects not specific to Parkinson's disease. Assessment instruments and formal diagnostic criteria exist, but there is little routine screening of these signs and symptoms in clinical practice. Mounting evidence supports a range of pharmacological and non-pharmacological interventions, but relatively few efficacious treatment options exist. Optimising the management of neuropsychiatric presentations in people with Parkinson's disease will require additional research, raised awareness, specialised training, and development of innovative models of care.
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Affiliation(s)
- Daniel Weintraub
- Departments of Psychiatry and Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Parkinson's Disease Research, Education and Clinical Center, Corporal Michael J Crescenz Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA.
| | - Dag Aarsland
- Department of Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Centre for Age-Related Disease, Stavanger University Hospital, Stavanger, Norway
| | - Kallol Ray Chaudhuri
- Department of Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Parkinson's Foundation Centre of Excellence, King's College Hospital, King's College London, London, UK
| | - Roseanne D Dobkin
- Department of Psychiatry, Rutgers University, Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | - Albert Fg Leentjens
- Department of Psychiatry, and School for Mental Health and Neuroscience, Maastricht University Hospital, Maastricht, Netherlands
| | - Mayela Rodriguez-Violante
- Clinical Neurodegenerative Diseases Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - Anette Schrag
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, UCL, London, UK
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66
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Abstract
Advanced Parkinson's disease (PD) often brings a set of motor and non-motor features that are particularly challenging to manage. Medication options can be limited by side-effects and quality of life can be severely affected by an accumulating burden of nonmotor symptoms. Here, we reviewed the literature and our clinical experience with the aim of providing a practical approach to the management of advanced PD. We provide guidelines for treatment of physical and neurobehavioral concerns, that occur in advanced PD.
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67
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Spinosa V, Brattico E, Campo F, Logroscino G. A systematic review on resting state functional connectivity in patients with neurodegenerative disease and hallucinations. NEUROIMAGE: CLINICAL 2022; 35:103112. [PMID: 35853345 PMCID: PMC9421441 DOI: 10.1016/j.nicl.2022.103112] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/17/2022] [Accepted: 07/10/2022] [Indexed: 11/25/2022] Open
Abstract
Our review produced ten resting functional magnetic resonance imaging studies. Most of the included studies focused on synucleinopathies and visual hallucinations. Disrupted Default Mode and attentional networks can be involved in hallucinations. The intrusion of predictive processes can be responsible for hallucination phenomena. Studies on hallucinations in tauopathies and different sensory modality are needed.
Hallucinations are a complex and multidimensional phenomenon which can differ based on the involved pathology, typology and sensory modality. Hallucinations are common in patients with neurodegenerative diseases. Recent sparse evidence from resting state functional magnetic resonance imaging (rs-fMRI) studies has identified altered functional connectivity in those patients within several brain networks, such as the default mode, attentional and sensory ones, without, however, providing an organized picture of the mechanisms involved. This systematic review, following PRISMA guidelines, aims at critically analyzing the current literature on the brain networks associated with the phenomenon of hallucinations in patients with neurodegenerative diseases. Ten rs-fMRI studies fulfilled our selection criteria. All these studies focused on synucleinopathies, and most of them focused on visual hallucinations and were characterized by a heterogeneous methodology. Thus, instead of offering a definite picture of the mechanisms underlying hallucinations in neurodegeneration, this systematic review encourages further research especially concerning tauopathies. Notwithstanding, the findings overall suggest a disruption in the top-down (associated with memory intrusion and difficulty of inhibition) and in the bottom-up processes (associated with the sensory areas involved in the hallucinations). Further investigations are needed in order to disentangle the brain mechanisms involved in hallucinations and to overcome possible limitations characterizing the current literature.
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68
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Cognitive and visual processing performance in Parkinson's disease patients with vs without visual hallucinations: A meta-analysis. Cortex 2022; 146:161-172. [PMID: 34864505 DOI: 10.1016/j.cortex.2021.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/27/2021] [Accepted: 11/02/2021] [Indexed: 12/17/2022]
Abstract
IMPORTANCE Cognitive and visual impairments in Parkinson's Disease Psychosis (PDP) raise the question of whether a specific profile of impaired cognition and visual function is linked to vulnerability to visual hallucinations (VHs). Previous studies have limited sample sizes and only included a sub-sample of tests. This is the first meta-analysis quantifying visuo-cognitive impairments in PDP patients across a spectrum of tests and taking into account potential confounding factors such as levodopa medication, illness duration and general cognitive ability. OBJECTIVE Compare visual processing and cognitive performance between PD patients with and without VHs (PDVH and PDnoVH). METHODS Four databases (PubMed, PsychINFO, Scopus, WebOfScience) were searched for studies on visual and/or cognitive performance of PDnoVH and PDVH published up to 02/2020. For each task, means and SDs were extracted and standardized-mean-differences (SMDs) between-groups calculated. Effect-sizes (Hedges' g) were calculated for all comparisons and synthesized in random-effects meta-analyses with robust-variance-estimation (accounting for multiple correlated measures within each study per cognitive/visual domain). Publication bias was assessed with funnel plots and Egger intercept. RESULTS N = 99 studies including 2508 PDVH patients (mean age 68.4 years) and 5318 PDnoVH (mean age 66.4 years) were included in the seven meta-analyses. PDVH patients performed worse than PDnoVH across all measures of cognition and visual processing, with the greatest between-group effect-sizes in executive functions, attention, episodic memory and visual processing. Study characteristics were not significantly associated with between-group differences in the domains investigated. Age-differences were significantly associated with performance differences in general cognition, working memory and executive functions. CONCLUSION Models of PDVH need to incorporate a wider range of cognitive and processing domains than currently included. There is a need for studies disentangling the temporal relationship between cognitive/visual deficits and VHs as early identification of risk before the onset of VHs could mitigate later outcomes such as progression to dementia.
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69
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Matar E, Brooks D, Lewis SJ, Halliday GM. Limbic thalamus atrophy is associated with visual hallucinations in Lewy body disorders. Neurobiol Aging 2022; 112:122-128. [DOI: 10.1016/j.neurobiolaging.2022.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 12/04/2021] [Accepted: 01/03/2022] [Indexed: 01/22/2023]
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Gibson LL, Pollak TA, Heslegrave A, Hye A, Batzu L, Rota S, Trivedi D, Nicholson TR, Ffytche D, Zetterberg H, Chaudhuri KR, Aarsland D. Plasma Neurofilament Light and p-tau181 and Risk of Psychosis in Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2022; 12:1527-1538. [PMID: 35466956 DOI: 10.3233/jpd-223182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Neuropsychiatric symptoms are common and important to people with Parkinson's disease (PD), but their etiology is poorly understood. Plasma neurofilament light (NfL) and p-tau181 are biomarkers of neuro-axonal degeneration and tau pathology respectively, which have yet to be explored in association with the affective and psychotic symptoms in PD. OBJECTIVE To investigate the relationship between plasma NfL and p-tau181 with the affective and psychotic symptoms in PD. METHODS We assessed the baseline concentration of plasma NfL and p-tau181 in a cohort of 108 patients with PD and 38 healthy controls. A subgroup of patients (n = 63) were assessed annually with clinical measures for up to 7 years. Psychotic symptoms were assessed using the Non-Motor Symptom Scale and affective symptoms were measured in the Hospital Anxiety and Depression Scale. RESULTS Baseline plasma NfL was a significant predictor of psychotic symptoms longitudinally across the study adjusted for age, Hoehn and Yahr stage, duration of follow up, duration of disease, baseline levodopa and dopamine agonist medication, and baseline cognition: (OR 8.15 [95% CI 1.40-47.4], p = 0.020). There was no association between NfL concentration and the cumulative prevalence of affective symptoms. Plasma p-tau181 concentration was not associated with psychotic or affective symptoms. CONCLUSION These findings suggest psychotic symptoms are associated with greater neurodegeneration in PD. Further studies are needed to explore NfL as a potential biomarker for psychosis in PD.
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Affiliation(s)
- Lucy L Gibson
- Old Age Psychiatry Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Thomas A Pollak
- Neuropsychiatry Research and Education Group, Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Amanda Heslegrave
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
| | - Abdul Hye
- Old Age Psychiatry Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lucia Batzu
- Department of Basic and Clinical Neuroscience, Parkinson Foundation International Centre of Excellence, Kings College Hospital and Kings College London, London, UK
| | - Silvia Rota
- Department of Basic and Clinical Neuroscience, Parkinson Foundation International Centre of Excellence, Kings College Hospital and Kings College London, London, UK
| | - Dhaval Trivedi
- Department of Basic and Clinical Neuroscience, Parkinson Foundation International Centre of Excellence, Kings College Hospital and Kings College London, London, UK
| | - Timothy R Nicholson
- Neuropsychiatry Research and Education Group, Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Dominic Ffytche
- Old Age Psychiatry Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Henrik Zetterberg
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Salhgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - K Ray Chaudhuri
- Department of Basic and Clinical Neuroscience, Parkinson Foundation International Centre of Excellence, Kings College Hospital and Kings College London, London, UK
| | - Dag Aarsland
- Old Age Psychiatry Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Centre for Age-Related Disease, Stavanger University Hospital, Stavanger, Norway
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71
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Diederich NJ. [Causes of visual hallucinations in Parkinson's disease]. DER NERVENARZT 2022; 93:392-401. [PMID: 34342675 PMCID: PMC9010390 DOI: 10.1007/s00115-021-01165-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/17/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Visual hallucinations (VH) have mainly been considered as late symptoms of Parkinson's disease (PD); however, minor forms of VH also occur in early stages of the disease. Initially dopaminergic overstimulation was discussed as the cause and later on VH have been considered as an early red flag of dementia in PD. OBJECTIVE The present study analyzed whether the pathophysiological concept of VH has been enlarged in recent years. MATERIAL AND METHODS Clinical, pharmacological, neuropathological as well as functional magnetic resonance imaging studies dealing with VH were reviewed. A systematic classification in monomodal and multimodal models of VH is proposed. The applicability to various forms of VH and various triggering situations is critically examined. RESULTS Reduction of the visual information input, erroneous visual processing, attention deficits, and dysfunctional connectivity between various cerebral networks have been shown. There is partial overlapping with the Lhermitte syndrome and the Charles Bonnet syndrome. No model is able to fully explain all VH variants. Not all VH have the same pathogenesis and the same poor prognosis. CONCLUSION The chain of causes underlying VH is complex and can vary from patient to patient. So far the therapeutic applications are largely unexplored; however, there is preliminary evidence that beside adjustment of the medication, improvement of visual acuity, active involvement of the partner, and possibly, individually adaptable coping strategies could be successfully implemented.
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Affiliation(s)
- Nico J. Diederich
- Abteilung für Neurologie, Centre Hospitalier de Luxembourg, 4, rue Barblé, 1210 Luxemburg-Stadt, Luxemburg
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Sivanandy P, Leey TC, Xiang TC, Ling TC, Wey Han SA, Semilan SLA, Hong PK. Systematic Review on Parkinson's Disease Medications, Emphasizing on Three Recently Approved Drugs to Control Parkinson's Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:364. [PMID: 35010624 PMCID: PMC8744877 DOI: 10.3390/ijerph19010364] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 12/20/2022]
Abstract
Parkinson's Disease (PD) is a disease that involves neurodegeneration and is characterised by the motor symptoms which include muscle rigidity, tremor, and bradykinesia. Other non-motor symptoms include pain, depression, anxiety, and psychosis. This disease affects up to ten million people worldwide. The pathophysiology behind PD is due to the neurodegeneration of the nigrostriatal pathway. There are many conventional drugs used in the treatment of PD. However, there are limitations associated with conventional drugs. For instance, levodopa is associated with the on-off phenomenon, and it may induce wearing off as time progresses. Therefore, this review aimed to analyze the newly approved drugs by the United States-Food and Drug Administration (US-FDA) from 2016-2019 as the adjuvant therapy for the treatment of PD symptoms in terms of efficacy and safety. The new drugs include safinamide, istradefylline and pimavanserin. From this review, safinamide is considered to be more efficacious and safer as the adjunct therapy to levodopa as compared to istradefylline in controlling the motor symptoms. In Study 016, both safinamide 50 mg (p = 0.0138) and 100 mg (p = 0.0006) have improved the Unified Parkinson's Disease Rating Scale (UPDRS) part III score as compared to placebo. Improvement in Clinical Global Impression-Change (CGI-C), Clinical Global Impression-Severity of Illness (CGI-S) and off time were also seen in both groups of patients following the morning levodopa dose. Pimavanserin also showed favorable effects in ameliorating the symptoms of Parkinson's Disease Psychosis (PDP). A combination of conventional therapy and non-pharmacological treatment is warranted to enhance the well-being of PD patients.
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Affiliation(s)
- Palanisamy Sivanandy
- Department of Pharmacy Practice, School of Pharmacy, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia
- School of Postgraduate Studies, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia
| | - Tan Choo Leey
- Bachelor of Pharmacy (Hons) Programme, School of Pharmacy, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia; (T.C.L.); (T.C.X.); (T.C.L.); (S.A.W.H.); (S.L.A.S.); (P.K.H.)
| | - Tan Chi Xiang
- Bachelor of Pharmacy (Hons) Programme, School of Pharmacy, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia; (T.C.L.); (T.C.X.); (T.C.L.); (S.A.W.H.); (S.L.A.S.); (P.K.H.)
| | - Tan Chi Ling
- Bachelor of Pharmacy (Hons) Programme, School of Pharmacy, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia; (T.C.L.); (T.C.X.); (T.C.L.); (S.A.W.H.); (S.L.A.S.); (P.K.H.)
| | - Sean Ang Wey Han
- Bachelor of Pharmacy (Hons) Programme, School of Pharmacy, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia; (T.C.L.); (T.C.X.); (T.C.L.); (S.A.W.H.); (S.L.A.S.); (P.K.H.)
| | - Samantha Lia Anak Semilan
- Bachelor of Pharmacy (Hons) Programme, School of Pharmacy, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia; (T.C.L.); (T.C.X.); (T.C.L.); (S.A.W.H.); (S.L.A.S.); (P.K.H.)
| | - Phoon Kok Hong
- Bachelor of Pharmacy (Hons) Programme, School of Pharmacy, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia; (T.C.L.); (T.C.X.); (T.C.L.); (S.A.W.H.); (S.L.A.S.); (P.K.H.)
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73
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Robotically-induced hallucination triggers subtle changes in brain network transitions. Neuroimage 2021; 248:118862. [PMID: 34971766 DOI: 10.1016/j.neuroimage.2021.118862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 11/19/2021] [Accepted: 12/23/2021] [Indexed: 01/20/2023] Open
Abstract
The perception that someone is nearby, although nobody can be seen or heard, is called presence hallucination (PH). Being a frequent hallucination in patients with Parkinson's disease, it has been argued to be indicative of a more severe and rapidly advancing form of the disease, associated with psychosis and cognitive decline. PH may also occur in healthy individuals and has recently been experimentally induced, in a controlled manner during fMRI, using MR-compatible robotics and sensorimotor stimulation. Previous neuroimaging correlates of such robot-induced PH, based on conventional time-averaged fMRI analysis, identified altered activity in the posterior superior temporal sulcus and inferior frontal gyrus in healthy individuals. However, no link with the strength of the robot-induced PH was observed, and such activations were also associated with other sensations induced by robotic stimulation. Here we leverage recent advances in dynamic functional connectivity, which have been applied to different psychiatric conditions, to decompose fMRI data during PH-induction into a set of co-activation patterns that are tracked over time, as to characterize their occupancies, durations, and transitions. Our results reveal that, when PH is induced, the identified brain patterns significantly and selectively increase their transition probabilities towards a specific brain pattern, centred on the posterior superior temporal sulcus, angular gyrus, dorso-lateral prefrontal cortex, and middle prefrontal cortex. This change is not observed in any other control conditions, nor is it observed in association with other sensations induced by robotic stimulation. The present findings describe the neural mechanisms of PH in healthy individuals and identify a specific disruption of the dynamics of network interactions, extending previously reported network dysfunctions in psychotic patients with hallucinations to an induced robot-controlled specific hallucination in healthy individuals.
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Abstract
INTRODUCTION Psychosis is one of the incapacitating nonmotor symptoms of Parkinson's disease (PD). Although several risk factors that include older age, rapid eye movement sleep behavior disorder, depression, and cognitive dysfunction have been identified, the exact neural correlates remain elusive. As cognitive impairment has a close association with psychosis in PD, it is useful to know the spectrum of cognitive impairment in PD patients with psychosis (PD-P). METHODS This cross-sectional study compared various cognitive parameters of PD-P (visual/minor hallucinations) and PD patients with no psychosis (PD-NP). A neuropsychological battery encapsulating several cognitive domains (executive, visuospatial, learning, and memory) was used for the cognitive assessment of 37 PD-P and 51 PD-NP patients who were matched for age, gender, education, and disease duration. RESULTS The two groups were comparable in terms of disease severity and stage. Although the groups had a comparable mean score on Montreal cognitive assessment, the PD-P group performed poorly in tests focused on executive function (color trail test, forward digit span), verbal learning and memory (Rey auditory and verbal learning test), and visuospatial functions (complex figure test, corsi block tapping test). Those with complex visual hallucinations performed poorly in the color trial test (part A) compared to those with minor hallucinations. CONCLUSION Psychosis is associated with a multidomain cognitive dysfunction in PD. All PD patients should undergo detailed cognitive assessment as cognitive dysfunction may be a marker of psychosis in the future. Additional longitudinal studies are warranted to obtain detailed insights into this issue.
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Rodriguez-Sanchez F, Rodriguez-Blazquez C, Bielza C, Larrañaga P, Weintraub D, Martinez-Martin P, Rizos A, Schrag A, Chaudhuri KR. Identifying Parkinson's disease subtypes with motor and non-motor symptoms via model-based multi-partition clustering. Sci Rep 2021; 11:23645. [PMID: 34880345 PMCID: PMC8654994 DOI: 10.1038/s41598-021-03118-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 11/29/2021] [Indexed: 12/27/2022] Open
Abstract
Identification of Parkinson's disease subtypes may help understand underlying disease mechanisms and provide personalized management. Although clustering methods have been previously used for subtyping, they have reported generic subtypes of limited relevance in real life practice because patients do not always fit into a single category. The aim of this study was to identify new subtypes assuming that patients could be grouped differently according to certain sets of related symptoms. To this purpose, a novel model-based multi-partition clustering method was applied on data from an international, multi-center, cross-sectional study of 402 Parkinson's disease patients. Both motor and non-motor symptoms were considered. As a result, eight sets of related symptoms were identified. Each of them provided a different way to group patients: impulse control issues, overall non-motor symptoms, presence of dyskinesias and pyschosis, fatigue, axial symptoms and motor fluctuations, autonomic dysfunction, depression, and excessive sweating. Each of these groups could be seen as a subtype of the disease. Significant differences between subtypes (P< 0.01) were found in sex, age, age of onset, disease duration, Hoehn & Yahr stage, and treatment. Independent confirmation of these results could have implications for the clinical management of Parkinson's disease patients.
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Affiliation(s)
| | - Carmen Rodriguez-Blazquez
- National Center of Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Concha Bielza
- Computational Intelligence Group, Universidad Politécnica de Madrid, Madrid, Spain
| | - Pedro Larrañaga
- Computational Intelligence Group, Universidad Politécnica de Madrid, Madrid, Spain
| | - Daniel Weintraub
- Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
| | - Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Alexandra Rizos
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience and Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK
| | - Anette Schrag
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - K Ray Chaudhuri
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience and Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK
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Weiss D, Höglinger G, Klostermann F, Weise D, Zeuner KE, Reichmann H. [Hallucinations in Patients with Idiopathic Parkinson's Disease]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2021; 90:456-464. [PMID: 34844278 DOI: 10.1055/a-1670-7111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Patients with idiopathic Parkinson's disease develop symptoms of the hallucination-psychosis spectrum in more than 20%. Most common are visual hallucinations. The pathogenesis of hallucinations mainly depends on disease duration, the distribution and extent of alpha-synuclein pathology, and modulating effects of the dopaminergic therapy. When managing PD hallucinations both anti-delirogenic actions and medication management are important. However, decrease in dopaminergic medication may lead to critical worsening of akinesia. If appropriate neuroleptic medication - essentially quetiapin or clozapin - can be considered. Instead, anti-dopaminergic neuroleptics should not be used owing to their pro-akinetic side-effects. Here, we provide therapy recommendations to manage PD hallucinations based on an up-to-date targeted review of the literature and expert-based empirical evidence.
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Affiliation(s)
- Daniel Weiss
- Neurologische Klinik mit Schwerpunkt Neurodegenerative Erkrankungen und Hertie-Institut für Klinische Hirnforschung, Universitätsklinikum Tübingen, Deutschland
| | - Günter Höglinger
- Klinik für Neurologie mit Klinischer Neurophysiologie, Medizinisch Hochschule Hannover, Deutschland
| | - Fabian Klostermann
- Klinik für Neurologie mit Experimenteller Neurologie, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Deutschland
| | - David Weise
- Klinik für Neurologie, Schmerztherapie und Schlafmedizin, Asklepios Fachklinikum Stadtroda, Deutschland
| | - Kirsten E Zeuner
- Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Deutschland
| | - Heinz Reichmann
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Carl Gustav Carus Dresden, Deutschland
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McLaughlin J, Young T. Neurology in the psychiatric patient: how to think about differentials in altered mental status and diagnoses not to miss. BJPSYCH ADVANCES 2021. [DOI: 10.1192/bja.2021.67] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
SUMMARY
A wide variety of neurological conditions may present first to a psychiatrist and it is important to be aware of these in differential diagnosis. A careful history, examination and a broad differential diagnosis can help set up an appropriate management plan – with room to change if things change in unexpected ways. In this article we explore common ground shared by psychiatry and neurology and show how incorporation of neurological knowledge can improve the practice of psychiatry. Using four fictional case vignettes of altered mental status we explore important neurological differential diagnoses which could present to the Psychiatrist.
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78
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Marques A, Taylor NL, Roquet D, Beze S, Chassain C, Pereira B, O'Callaghan C, Lewis SJG, Durif F. Structural and Functional Correlates of Hallucinations and Illusions in Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2021; 12:397-409. [PMID: 34744050 DOI: 10.3233/jpd-212838] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Visual illusions (VI) in Parkinson's disease (PD) are generally considered as an early feature of the psychosis spectrum leading to fully formed visual hallucinations (VH), although this sequential relationship has not been clearly demonstrated. OBJECTIVE We aimed to determine whether there are any overlapping, potentially graded patterns of structural and functional connectivity abnormalities in PD with VI and with VH. Such a finding would argue for a continuum between these entities, whereas distinct imaging features would suggest different neural underpinnings for the phenomena. METHODS In this case control study, we compared structural and resting state functional MRI brain patterns of PD patients with VH (PD-H, n = 20), with VI (PD-I, n = 19), and without VH or VI (PD-C, n = 23). RESULTS 1) PD-H had hypo-connectivity between the ILO and anterior cingulate precuneus and parahippocampal gyrus compared to PD-C and PD-I; 2) In contrast, PD-I had hyper-connectivity between the inferior frontal gyrus and the postcentral gyrus compared to PD-C and PD-H. Moreover, PD-I had higher levels of functional connectivity between the amygdala, hippocampus, insula, and fronto-temporal regions compared to PD-H, together with divergent patterns toward the cingulate. 3) Both PD-I and PD-H had functional hypo-connectivity between the lingual gyrus and the parahippocampal region vs. PD-C, and no significant grey matter volume differences was observed between PD-I and PD-H. CONCLUSION Distinct patterns of functional connectivity characterized VI and VH in PD, suggesting that these two perceptual experiences, while probably linked and driven by at least some similar mechanisms, could reflect differing neural dysfunction.
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Affiliation(s)
- Ana Marques
- Forefront Parkinson's Disease Research Clinic, Brain and Mind Center, School of Medical Sciences, University ofSydney, Camperdown, Sydney, Australia.,Université Clermont Auvergne, IGCNC, InstitutPascal, Clermont-Ferrand University Hospital, Neurology Department, Clermont-Ferrand, France
| | - Natasha L Taylor
- Forefront Parkinson's Disease Research Clinic, Brain and Mind Center, School of Medical Sciences, University ofSydney, Camperdown, Sydney, Australia
| | - Daniel Roquet
- Frontiers, Brain andMind Center, University of Sydney, Camperdown, Sydney, Australia
| | - Steven Beze
- Université Clermont Auvergne, IGCNC, InstitutPascal, Clermont-Ferrand University Hospital, Neurology Department, Clermont-Ferrand, France
| | - Carine Chassain
- Université Clermont Auvergne, IGCNC, InstitutPascal, Clermont-Ferrand University Hospital, NeuroradiologyDepartment, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Bruno Pereira
- Clermont-Ferrand University Hospital, Biostatistics Department, Clermont-Ferrand, France
| | - Claire O'Callaghan
- Forefront Parkinson's Disease Research Clinic, Brain and Mind Center, School of Medical Sciences, University ofSydney, Camperdown, Sydney, Australia
| | - Simon J G Lewis
- Forefront Parkinson's Disease Research Clinic, Brain and Mind Center, School of Medical Sciences, University ofSydney, Camperdown, Sydney, Australia
| | - Franck Durif
- Université Clermont Auvergne, IGCNC, InstitutPascal, Clermont-Ferrand University Hospital, Neurology Department, Clermont-Ferrand, France
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Bashkatova V. Metabotropic glutamate receptors and nitric oxide in dopaminergic neurotoxicity. World J Psychiatry 2021; 11:830-840. [PMID: 34733645 PMCID: PMC8546773 DOI: 10.5498/wjp.v11.i10.830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/11/2021] [Accepted: 08/03/2021] [Indexed: 02/06/2023] Open
Abstract
Dopaminergic neurotoxicity is characterized by damage and death of dopaminergic neurons. Parkinson's disease (PD) is a neurodegenerative disorder that primarily involves the loss of dopaminergic neurons in the substantia nigra. Therefore, the study of the mechanisms, as well as the search for new targets for the prevention and treatment of neurodegenerative diseases, is an important focus of modern neuroscience. PD is primarily caused by dysfunction of dopaminergic neurons; however, other neurotransmitter systems are also involved. Research reports have indicated that the glutamatergic system is involved in different pathological conditions, including dopaminergic neurotoxicity. Over the last two decades, the important functional interplay between dopaminergic and glutamatergic systems has stimulated interest in the possible role of metabotropic glutamate receptors (mGluRs) in the development of extrapyramidal disorders. However, the specific mechanisms driving these processes are presently unclear. The participation of the universal neuronal messenger nitric oxide (NO) in the mechanisms of dopaminergic neurotoxicity has attracted increased attention. The current paper aims to review the involvement of mGluRs and the contribution of NO to dopaminergic neurotoxicity. More precisely, we focused on studies conducted on the rotenone-induced PD model. This review is also an outline of our own results obtained using the method of electron paramagnetic resonance, which allows quantitation of NO radicals in brain structures.
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Affiliation(s)
- Valentina Bashkatova
- Laboratory of Physiology Reinforcements, Anokhin Institute of Normal Physiology, Moscow 125315, Russia
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80
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Prevalence and Risk Factors for Minor Hallucinations in Patients with Parkinson's Disease. Behav Neurol 2021; 2021:3469706. [PMID: 34646400 PMCID: PMC8505047 DOI: 10.1155/2021/3469706] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/20/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose As the most frequent and earliest type of psychotic phenomenon in Parkinson's disease (PD), minor hallucination (MH) can occur before the onset of motor symptoms. This sensation may be an early predictor of severe psychotic and cognitive states and is often overlooked in clinics. This study was aimed at providing a comprehensive and in-depth understanding of MHs. Patients and Methods. Demographic information was obtained from 262 patients with PD, and a series of clinical assessment questionnaires were provided. According to the result of the Movement Disorders Society Unified Parkinson's Disease Rating Scale Part I, the patients were classified into the MH and nonhallucination (NH) groups. Results MHs were the most common psychotic symptom with 38.9% prevalence. The most frequent MH was visual illusion, especially object misidentification. Three minor phenomena were somewhat consistent in terms of external factors, temporal factors, and content. Disease duration, daily levodopa equivalent dose, and percentage of levodopa and dopamine-receptor agonist use were remarkably greater in the MH group than in the NH group. After covariate control, the MH group had worse life quality and more severe nonmotor symptoms, including poor sleep quality and rapid eye movement sleep behavior disorder (RBD), than the NH group. The binary logistic regression model showed that RBD, sleep quality, and health-related life quality were associated with MHs. Conclusion A high prevalence of MHs was observed in patients with PD. Further studies are needed to confirm and expand the identified clinical factors related to MH, which have potential prognostic and therapeutic implication.
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Onofrj M, Russo M, Carrarini C, Delli Pizzi S, Thomas A, Bonanni L, Espay AJ, Sensi SL. Functional neurological disorder and somatic symptom disorder in Parkinson's disease. J Neurol Sci 2021; 433:120017. [PMID: 34629180 DOI: 10.1016/j.jns.2021.120017] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/02/2021] [Accepted: 09/29/2021] [Indexed: 11/15/2022]
Abstract
The occurrence of Functional Neurological Disorder (FND) and Somatic Symptom Disorder (SSD) in PD was not commonly accepted until recently, despite some evidence that emerged in the pre and early L-Dopa era. More recently, the recognition of FND and SSD were noted to be relevant for the management of PD. FND and SSD appear early in the course of PD, often preceding motor symptoms, may interfere with treatment outcomes, often acquire psychotic features during progression, and are mixed with and often concealed by the progressive cognitive decline. We review the related features from the range of the available reports and discuss theoretical models conceived to explain the potential pathophysiological background of these disorders. Finally, we suggest that FND and SSD should be included among the non-motor symptoms of PD and be considered a prodromal feature in a subset of patients. This article is part of the Special Issue "Parkinsonism across the spectrum of movement disorders and beyond" edited by Joseph Jankovic, Daniel D. Truong and Matteo Bologna.
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Affiliation(s)
- Marco Onofrj
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Mirella Russo
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Claudia Carrarini
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Stefano Delli Pizzi
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Molecular Neurology and Behavioral Neurology Units, Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Astrid Thomas
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Molecular Neurology and Behavioral Neurology Units, Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Laura Bonanni
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Alberto J Espay
- James J. and Joan A. Gardner Family Center for Parkinson's disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, United States
| | - Stefano L Sensi
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Molecular Neurology and Behavioral Neurology Units, Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Institute for Mind Impairments and Neurological Disorders-iMIND, University of California, Irvine, Irvine, CA, United States.
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Koros C, Stefanis L, Scarmeas N. Parkinsonism and dementia. J Neurol Sci 2021; 433:120015. [PMID: 34642023 DOI: 10.1016/j.jns.2021.120015] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/01/2021] [Accepted: 09/29/2021] [Indexed: 12/13/2022]
Abstract
The aim of the present review is to summarize literature data on dementia in parkinsonian disorders. Cognitive decline and the gradual development of dementia are considered to be key features in the majority of parkinsonian conditions. The burden of dementia in everyday life of parkinsonian patients and their caregivers is vast and can be even more challenging to handle than the motor component of the disease. Common pathogenetic mechanisms involve the aggregation and spreading of abnormal proteins like alpha-synuclein, tau or amyloid in cortical and subcortical regions with subsequent dysregulation of multiple neurotransmitter systems. The degree of cognitive deterioration in these disorders is variable and ranges from mild cognitive impairment to severe cognitive dysfunction. There is also variation in the number and type of affected cognitive domains which can involve either a single domain like executive or visuospatial function or multiple ones. Novel genetic, biological fluid or imaging biomarkers appear promising in facilitating the diagnosis and staging of dementia in parkinsonian conditions. A significant part of current research in Parkinson's disease and other parkinsonian syndromes is targeted towards the cognitive aspects of these disorders. Stabilization or amelioration of cognitive outcomes represents a primary endpoint in many ongoing clinical trials for novel disease modifying treatments in this field. This article is part of the Special Issue "Parkinsonism across the spectrum of movement disorders and beyond" edited by Joseph Jankovic, Daniel D. Truong and Matteo Bologna.
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Affiliation(s)
- Christos Koros
- 1st Department of Neurology, Aeginition University, Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Leonidas Stefanis
- 1st Department of Neurology, Aeginition University, Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece; Center of Clinical Research, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aeginition University, Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece; The Gertrude H. Sergievsky Center, Department of Neurology, Taub Institute for Research in Alzheimer's, Disease and the Aging Brain, Columbia University, New York, USA.
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Naumann W, Gogarten J, Schönfeld S, Klostermann F, Marzinzik F, Schindlbeck KA. Diplopia in Parkinson's disease: Indication of a cortical phenotype with cognitive dysfunction? Acta Neurol Scand 2021; 144:440-449. [PMID: 34096617 DOI: 10.1111/ane.13479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 04/18/2021] [Accepted: 05/14/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND Visual disturbances are increasingly recognized as common non-motor symptoms in Parkinson's disease (PD). In PD patients, intermittent diplopia has been found to be associated with the presence of visual hallucinations and the Parkinson's psychosis spectrum. Here, we investigated whether diplopia in PD is associated with other non-motor traits and cognitive impairment. METHODS We investigated 50 non-demented PD patients with and without intermittent diplopia and 24 healthy controls for visual disturbances, as well as motor and non-motor symptoms. All participants underwent a neuropsychological test battery; visuospatial abilities were further evaluated with subtests of the Visual Object and Space Perception Battery (VOSP). The two PD patient groups did not differ significantly in age, symptom duration, motor symptom severity, frequency of visual hallucinations, or visual sensory efficiency. RESULTS PD patients with diplopia reported more frequent non-motor symptoms including more subjective cognitive problems and apathy without changes in global cognition measures compared to those without diplopia. PD patients with diplopia had greater impairment in several tests of visuospatial function (pentagon copying p = .002; number location p = .001; cube analysis p < .02) and object perception (p < .001) compared to PD patients without diplopia and healthy controls. By contrast, no consistent group differences were observed in executive function, memory, or language. CONCLUSIONS PD patients with diplopia have a greater non-motor symptom burden and deficits in visuospatial function compared to PD patients without diplopia. PD patients with diplopia might be prone to a cortical phenotype with cognitive decline and apathy associated with worse prognosis.
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Affiliation(s)
- Wanda Naumann
- Department of Neurology Charité–Universitätsmedizin Berlin Berlin Germany
| | - Jacob Gogarten
- Department of Neurology Charité–Universitätsmedizin Berlin Berlin Germany
| | - Shideh Schönfeld
- Department of Ophthalmology Charité–Universitätsmedizin Berlin Berlin Germany
| | - Fabian Klostermann
- Department of Neurology Charité–Universitätsmedizin Berlin Berlin Germany
| | - Frank Marzinzik
- Department of Neurology Charité–Universitätsmedizin Berlin Berlin Germany
| | - Katharina A. Schindlbeck
- Department of Neurology Charité–Universitätsmedizin Berlin Berlin Germany
- Center for Neurosciences The Feinstein Institute for Medical Research Manhasset NY USA
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84
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Moriyama TS, Drukker M, Guloksuz S, Ten Have M, de Graaf R, van Dorsselaer S, Gunther N, Bak M, van Os J. Evidence for an interrelated cluster of Hallucinatory experiences in the general population: an incidence study. Psychol Med 2021; 51:2034-2043. [PMID: 32317030 DOI: 10.1017/s0033291720000793] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although hallucinations have been studied in terms of prevalence and its associations with psychopathology and functional impairment, very little is known about sensory modalities other than auditory (i.e. haptic, visual and olfactory), as well the incidence of hallucinations, factors predicting incidence and subsequent course. METHODS We examined the incidence, course and risk factors of hallucinatory experiences across different modalities in two unique prospective general population cohorts in the same country using similar methodology and with three interview waves, one over the period 1996-1999 (NEMESIS) and one over the period 2007-2015 (NEMESIS-2). RESULTS In NEMESIS-2, the yearly incidence of self-reported visual hallucinations was highest (0.33%), followed by haptic hallucinations (0.31%), auditory hallucinations (0.26%) and olfactory hallucinations (0.23%). Rates in NEMESIS-1 were similar (respectively: 0.35%, 0.26%, 0.23%, 0.22%). The incidence of clinician-confirmed hallucinations was approximately 60% of the self-reported rate. The persistence rate of incident hallucinations was around 20-30%, increasing to 40-50% for prevalent hallucinations. Incident hallucinations in one modality were very strongly associated with occurrence in another modality (median OR = 59) and all modalities were strongly associated with delusional ideation (median OR = 21). Modalities were approximately equally strongly associated with the presence of any mental disorder (median OR = 4), functioning, indicators of help-seeking and established environmental risk factors for psychotic disorder. CONCLUSIONS Hallucinations across different modalities are a clinically relevant feature of non-psychotic disorders and need to be studied in relation to each other and in relation to delusional ideation, as all appear to have a common underlying mechanism.
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Affiliation(s)
- Tais S Moriyama
- Instituto Bairral, Itapira, Brazil
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Marjan Drukker
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Sinan Guloksuz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Magreet Ten Have
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Ron de Graaf
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Saskia van Dorsselaer
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Nicole Gunther
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- School of Psychology, Open University, Heerlen, The Netherlands
| | - Maarten Bak
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, London, UK
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85
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The Importance of Cross-Disciplinary Research: A Commentary on "Brainstem Pathologies Correlate With Depression and Psychosis in Parkinson's Disease". Am J Geriatr Psychiatry 2021; 29:969-971. [PMID: 33526370 DOI: 10.1016/j.jagp.2021.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 11/20/2022]
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86
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Fischer NM, Hinkle JT, Perepezko K, Bakker CC, Morris M, Broen MP, Butala A, Dawson TM, Leentjens AF, Mari Z, Marvel CL, Mills KA, Rosenthal LS, Shepard MD, Pantelyat A, Bakker A, Pletnikova O, Troncoso JC, Wang J, Pontone GM. Brainstem Pathologies Correlate With Depression and Psychosis in Parkinson's Disease. Am J Geriatr Psychiatry 2021; 29:958-968. [PMID: 33455856 PMCID: PMC8277871 DOI: 10.1016/j.jagp.2020.12.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 11/30/2020] [Accepted: 12/12/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND The pathological hallmarks of Parkinson's disease include intraneuronal Lewy bodies, neuronal loss, and gliosis. We aim to correlate Parkinson's disease neuropsychiatric symptoms, (e.g., depression, psychosis, and anxiety) with the severity of neuropathology in the substantia nigra and locus coeruleus. METHODS The brains of 175 participants with a primary pathologic diagnosis of Parkinson's disease were analyzed semi-quantitatively to ascertain the burden of neuronal loss and gliosis and Lewy body pathology within the locus coeruleus and substantia nigra. Participants' history of anxiety, depression, and psychosis were determined using a chart-extracted medical history or record of formal psychiatric evaluation. RESULTS Of the sample, 56% (n = 98), 50% (n = 88), and 31.25% (n = 55) of subjects had a diagnosis of psychosis, depression, and anxiety, respectively. Psychosis (χ2 = 7.1, p = 0.008, df = 1) and depression (χ2 = 7.2, p = 0.007, df = 1) were associated with severe neuronal loss and gliosis in the substantia nigra but not in the locus coeruleus. No association was observed between anxiety and neuronal loss and gliosis in either region. No neuropsychiatric symptoms were associated with Lewy body score. After controlling for disease duration and dementia, psychosis (odds ratio [OR]: 3.1, 95% confidence interval [CI]: 1.5-6.4, χ2 = 9.4, p = 0.012, df = 1) and depression (OR: 2.6, 95% CI: 1.3-5.0, χ2 = 7.9, p = 0.005, df = 1) remained associated with severe neuronal loss and gliosis in the substantia nigra. CONCLUSION These results suggest that psychosis and depression in Parkinson's disease are associated with the underlying neurodegenerative process and demonstrate that cell loss and gliosis may be a better marker of neuropsychiatric symptoms than Lewy body pathology.
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Affiliation(s)
- Nicole Mercado Fischer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Jared T. Hinkle
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States,Medical Scientist Training Program, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Kate Perepezko
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Catherine C. Bakker
- Morris K. Udall Parkinson’s Disease Research Center of Excellence, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Meaghan Morris
- Clinical and Neuropathology Core, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Martinus P.G. Broen
- Department of Neurology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Ankur Butala
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore MD, United States
| | - Ted M. Dawson
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore MD, United States,Neuroregeneration and Stem Cell Programs, Institute for Cell Engineering, Johns Hopkins School of Medicine, Baltimore, MD, United States,Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD, United States,Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Albert F.G. Leentjens
- Department of Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Zoltan Mari
- Morris K. Udall Parkinson’s Disease Research Center of Excellence, Johns Hopkins School of Medicine, Baltimore, MD, United States,Lou Ruvo Center for Brain Health, Cleveland Clinic, Las Vegas, NV, United States
| | - Cherie L. Marvel
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore MD, United States
| | - Kelly A. Mills
- Morris K. Udall Parkinson’s Disease Research Center of Excellence, Johns Hopkins School of Medicine, Baltimore, MD, United States,Department of Neurology, Johns Hopkins School of Medicine, Baltimore MD, United States
| | - Liana S. Rosenthal
- Morris K. Udall Parkinson’s Disease Research Center of Excellence, Johns Hopkins School of Medicine, Baltimore, MD, United States,Department of Neurology, Johns Hopkins School of Medicine, Baltimore MD, United States
| | - Melissa D. Shepard
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Alexander Pantelyat
- Morris K. Udall Parkinson’s Disease Research Center of Excellence, Johns Hopkins School of Medicine, Baltimore, MD, United States,Department of Neurology, Johns Hopkins School of Medicine, Baltimore MD, United States
| | - Arnold Bakker
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Olga Pletnikova
- Morris K. Udall Parkinson’s Disease Research Center of Excellence, Johns Hopkins School of Medicine, Baltimore, MD, United States,Clinical and Neuropathology Core, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Juan C. Troncoso
- Morris K. Udall Parkinson’s Disease Research Center of Excellence, Johns Hopkins School of Medicine, Baltimore, MD, United States,Clinical and Neuropathology Core, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Jiangxia Wang
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Gregory M. Pontone
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States,Morris K. Udall Parkinson’s Disease Research Center of Excellence, Johns Hopkins School of Medicine, Baltimore, MD, United States,Department of Neurology, Johns Hopkins School of Medicine, Baltimore MD, United States
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87
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Zarotti N, Eccles FJR, Foley JA, Paget A, Gunn S, Leroi I, Simpson J. Psychological interventions for people with Parkinson's disease in the early 2020s: Where do we stand? Psychol Psychother 2021; 94:760-797. [PMID: 33174688 DOI: 10.1111/papt.12321] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/27/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE To explore the heterogeneity of the literature on psychological interventions for psychological difficulties in people with Parkinson's disease (PD). METHODS A scoping review was performed across five major databases (MEDLINE Complete, PsycINFO, CINAHL, Academic Search Ultimate, and Cochrane Library) up to June 2020. RESULTS From an initial return of 4911 citations, 56 studies were included, of which 21 were RCTs. A relatively wide range of therapeutic models have been adopted with people with PD, from common therapies such as cognitive behavioural therapy (CBT) and mindfulness, to less frequent approaches, for example, acceptance and commitment therapy (ACT) and psychodrama. The clinical implications of the findings are discussed, and suggestions are provided for future research on intervention studies and key psychological outcomes. CONCLUSIONS CBT appears to be effective in treating depression and sleep disorders in people with PD, while psychoeducation programmes alone should be avoided. The use of CBT to improve anxiety, quality of life, and impulse control, as well mindfulness-based interventions, should be undertaken with some caution because of insufficient research and inconsistent results. As we enter the new decade, more high-quality evidence is required for psychological interventions in people with PD in general and to corroborate preliminary positive findings on the adoption of less frequent approaches such as ACT. PRACTITIONER POINTS Parkinson's disease is a progressive neurodegenerative condition associated with several psychological difficulties which be targeted by psychological interventions. Currently, cognitive behavioural therapy (CBT) can be recommended to treat depression and sleep disorders in people with Parkinson's, while psychoeducation alone should be avoided. Caution is advised regarding the use of CBT and mindfulness-based interventions to improve anxiety, quality of life, and impulse control. Further evidence is required for less common approaches, such as acceptance and commitment therapy, psychodrama, and EMDR.
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Affiliation(s)
- Nicolò Zarotti
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, UK
| | - Fiona J R Eccles
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, UK
| | - Jennifer A Foley
- Department of Neuropsychology, National Hospital of Neurology & Neurosurgery, London, UK.,UCL Queen Square Insitute of Neurology, Queen Square, London, UK
| | - Andrew Paget
- Department of Neuropsychology, National Hospital of Neurology & Neurosurgery, London, UK.,UCL Queen Square Insitute of Neurology, Queen Square, London, UK
| | - Sarah Gunn
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, UK
| | - Iracema Leroi
- Global Brain Health Institute, Trinity College Dublin, Ireland
| | - Jane Simpson
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, UK
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88
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Onofrj M, Di Iorio A, Carrarini C, Russo M, Franciotti R, Espay AJ, Boylan LS, Taylor JP, Di Giannantonio M, Martinotti G, Valente EM, Thomas A, Bonanni L, Delli Pizzi S, Dono F, Sensi S. Preexisting Bipolar Disorder Influences the Subsequent Phenotype of Parkinson's Disease. Mov Disord 2021; 36:2840-2852. [PMID: 34427338 PMCID: PMC9292484 DOI: 10.1002/mds.28745] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 12/13/2022] Open
Abstract
Background Patients with bipolar spectrum disorders (BSDs) exhibit an increased risk of Parkinson's disease (PD). Objective The aim is to investigate whether a previous diagnosis of BSDs influences the phenotype of PD. Methods Of 2660 PD patients followed for at least 6 years (6–27), 250 (BSD‐PD) had BSDs, 6–20 years before PD diagnosis; 48%–43% had a PD or BSD family history, and 34 carried glucocerebrosidase (GBA) and Parkin (PRKN) mutations. The cohort was split into a subset of 213 BSD‐PD patients, compared with 426 matched PD patients without BSDs, and a subset of 34 BSD‐PD and 79 PD patients carrying GBA or PRKN mutations. Carriers of mutations absent in BSD‐PD patients and of synuclein triplication were excluded. Structured clinical interviews and mood disorder questionnaires assessed BSDs. Linear mixed models evaluated the assessment scales over time. Thirteen BSD‐PD patients underwent subthalamic nucleus deep brain stimulation (STN‐DBS) and were compared with 27 matched STN‐DBS‐treated PD patients. Results Compared to PD patients, BSD‐PD showed (1) higher frequency of family history of PD (odds ratio [OR] 3.31; 2.32–4.71) and BSDs (OR 6.20; 4.11–9.35) 5); (2) higher incidence of impulse control disorders (hazard ratio [HR] 5.95, 3.89–9.09); (3) higher frequency of functional disorders occurring before PD therapy (HR, 5.67, 3.95–8.15); (4) earlier occurrence of delusions or mild dementia (HR, 7.70, 5.55–10.69; HR, 1.43, 1.16–1.75); and (5) earlier mortality (1.48; 1.11–1.97). Genetic BSD‐PD subjects exhibited clinical features indistinguishable from nongenetic BSD‐PD subjects. STN‐DBS‐treated BSD‐PD patients showed no improvements in quality of life compared to the control group. Conclusions BSDs as a prodrome to PD unfavorably shape their course and are associated with detrimental neuropsychiatric features and treatment outcomes. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
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Affiliation(s)
- Marco Onofrj
- Department of Neuroscience, Imaging, and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center of Advanced Studies and Technology, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.,YDA Foundation, Institute of Immune Therapy and Advanced Biological Treatments, Pescara, Italy
| | - Angelo Di Iorio
- Department of Aging Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Claudia Carrarini
- Department of Neuroscience, Imaging, and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Mirella Russo
- Department of Neuroscience, Imaging, and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Raffaella Franciotti
- Department of Neuroscience, Imaging, and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Alberto J Espay
- Department of Neurology, James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA
| | - Laura S Boylan
- Department of Neurology, Bellevue Hospital, New York University School of Medicine, New York, New York, USA
| | - John-Paul Taylor
- Translational and Clinical Research Institute, Biomedical Research Building, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging, and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging, and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Enza M Valente
- IRCCS Mondino Foundation and Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Astrid Thomas
- Department of Neuroscience, Imaging, and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Laura Bonanni
- Department of Neuroscience, Imaging, and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Stefano Delli Pizzi
- Department of Neuroscience, Imaging, and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Fedele Dono
- Department of Neuroscience, Imaging, and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - StefanoL Sensi
- Department of Neuroscience, Imaging, and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center of Advanced Studies and Technology, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Institute for Mind Impairments and Neurological Disorders (IMIND), University of California-Irvine, Irvine, California, USA
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89
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Revankar GS, Kajiyama Y, Hattori N, Shimokawa T, Nakano T, Mihara M, Mori E, Mochizuki H. Prestimulus Low-Alpha Frontal Networks Are Associated with Pareidolias in Parkinson's Disease. Brain Connect 2021; 11:772-782. [PMID: 33858200 DOI: 10.1089/brain.2020.0992] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Pareidolias are visual phenomena wherein ambiguous, abstract forms or shapes appear meaningful due to incorrect perception. In Parkinson's disease (PD), patients susceptible to visual hallucinations experience visuo-perceptual deficits in the form of pareidolias. Although pareidolias necessitate top-down modulation of visual processing, the cortical dynamics of internally generated perceptual priors on these visual misperceptions is unknown. Objectives: To study prestimulus-related electroencephalography (EEG) spectral and network abnormalities in PD patients experiencing pareidolias. Methods: Twenty-one PD in-patients and 10 age-matched controls were evaluated. Neuropsychological assessments included tests for cognition, attention, and executive functions. Pareidolias were quantified by using the "noise pareidolia test" with simultaneous EEG recording. The PD patients were subdivided into two groups-those with high pareidolia counts (n = 10) and those without (n = 11). The EEG was analyzed 1000 msec before stimulus presentation in the spectral domain (theta, low-alpha, and high-alpha frequencies) with corresponding graph networks to evaluate network properties. Statistical analysis included analysis of variance and multiple regression to evaluate the differences. Results: The PD patients with high pareidolia counts were older with lower scores on neuropsychological tests. Their prestimulus EEG low-alpha band showed a tendency toward higher frontal activity (p = 0.07). Graph networks showed increased normalized clustering coefficient (p = 0.05) and lower frontal degree centrality (p = 0.005). These network indices correlated positively to patients' pareidolia scores. Discussion: We suggest that pareidolias in PD are a consequence of an abnormal top-down modulation of visual processing; they are defined by their frontal low-alpha spectral and network alterations in the prestimulus phase due to a dissonance between patients' internally generated mental processing with external stimuli. Impact statement Pareidolias in Parkinson's disease (PD) are considered to be promising early markers of visual hallucinations and an indicator of PD prognosis. In certain susceptible PD patients, pareidolias can be evoked and studied. Here, via electroencephalography, we aimed at understanding this visual phenomenon by studying how neural information is processed before stimulus presentation in such patients. Using spectral and graph network measures, we revealed how top-down modulated internally generated processes affect visual perception in patients with pareidolias. Our findings highlight how prestimulus network alterations in the frontal cortex shape poststimulus pareidolic manifestations in PD.
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Affiliation(s)
- Gajanan S Revankar
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yuta Kajiyama
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Noriaki Hattori
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka, Japan.,Department of Rehabilitation, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Tetsuya Shimokawa
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology (NICT), Osaka, Japan
| | - Tomohito Nakano
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Masahito Mihara
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka, Japan.,Department of Neurology, Kawasaki Medical College, Okayama, Japan
| | - Etsuro Mori
- Department of Behavioral Neurology and Neuropsychiatry, Osaka University, Osaka, Japan
| | - Hideki Mochizuki
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka, Japan
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90
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Zhong M, Wu Z, Jiang X, Shen B, Zhu J, Zhang L. Knowledge domain and emerging trends in visual hallucination research: A scientometric analysis. World J Psychiatry 2021; 11:491-506. [PMID: 34513610 PMCID: PMC8394690 DOI: 10.5498/wjp.v11.i8.491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/29/2021] [Accepted: 07/05/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Visual hallucination (VH) refers to a spontaneous visual perception without corresponding external stimuli and often occurs in ophthalmological and neuropsychiatric disorders. It is associated with poor quality of life, and increased patient hospitalization and nursing home admission. To date, a scientometric analysis of research on VH is lacking.
AIM To objectively summarize the features of VH research and gain insights into the emerging trends in research on VH.
METHODS CiteSpace V was used in this article. Publication outputs, document types, geographic distributions, co-authorship status, research hotspots, and co-citation status were analyzed. A total of 2176 original articles and 465 reviews were included in the database downloaded from the Web of Science Core Collection. We selected the top 50 most cited or occurring articles or items to create a visualized network with a 1-year interval. In the document co-citation analysis stage, we performed clustering analysis on co-cited references, and log likelihood tests were used to name the clusters.
RESULTS The results showed that most publications can be classified into neurology, sports, and ophthalmology studies. In addition, North America, Europe, Asia and Australia published the most documents. Some well-known authors have always had a leading role in this field; meanwhile, new authors keep emerging. A relatively stable cooperation has been formed among many authors. Furthermore, neuropsychiatric symptom and functional connectivity are the top hotspots. Research on VH in dementia with Lewy bodies and Parkinson’s disease (PD) have received much attention. Studies on VH in PD are likely to be the new emerging trends in the future, especially the mechanisms of VH.
CONCLUSION Research on VH has formed a complete system. More large-scale clinical and in-depth basic research are required to better understand the mechanisms underlying VH, which will contribute to our understanding of the pathophysiology and therapeutic options for VH.
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Affiliation(s)
- Min Zhong
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Zhuang Wu
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Xu Jiang
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Bo Shen
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Jun Zhu
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Li Zhang
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
- Institute of Neuropsychiatric Diseases, Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
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91
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Powell A, Ireland C, Lewis SJG. Visual Hallucinations and the Role of Medications in Parkinson's Disease: Triggers, Pathophysiology, and Management. J Neuropsychiatry Clin Neurosci 2021; 32:334-343. [PMID: 32374649 DOI: 10.1176/appi.neuropsych.19110316] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Visual hallucinations, which are part of the syndrome of Parkinson's disease (PD) psychosis, affect patients' quality of life and increase the likelihood of residential aged-care placement. The association between visual hallucinations and dopaminergic and other medications that are necessary for the symptomatic management of motor and other symptoms of PD is a common clinical dilemma. While dopaminergic medications have long been associated with PD psychosis, a clear causal link has not been established, and other neurotransmitter systems, particularly noradrenaline, serotonin, and acetylcholine, are implicated and important. A diverse range of demographic and disease-related risk factors, some being modifiable, highlight the complexity of potential underlying pathophysiological processes but also broaden practical options for prevention and treatment that can be multifaceted and individualized. The investigators reviewed the clinical features and epidemiology of visual hallucinations and PD, explored the pathological evidence for dysfunction of multiple neurotransmitter systems that may be relevant to these phenomena, and addressed the potential of medications commonly used in PD to either trigger or treat these symptoms.
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Affiliation(s)
- Alice Powell
- Parkinson's Disease Research Clinic, Brain and Mind Centre (Powell, Lewis), and Healthy Brain Ageing Program (Ireland), University of Sydney, Camperdown, New South Wales, Australia
| | - Catriona Ireland
- Parkinson's Disease Research Clinic, Brain and Mind Centre (Powell, Lewis), and Healthy Brain Ageing Program (Ireland), University of Sydney, Camperdown, New South Wales, Australia
| | - Simon J G Lewis
- Parkinson's Disease Research Clinic, Brain and Mind Centre (Powell, Lewis), and Healthy Brain Ageing Program (Ireland), University of Sydney, Camperdown, New South Wales, Australia
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92
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Ali F. Pimavanserin: A Friend or Foe in Parkinson Disease Psychosis. Neurology 2021; 97:613-614. [PMID: 34389650 DOI: 10.1212/wnl.0000000000012656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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93
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Kim K, Kim S, Myung W, Shim I, Lee H, Kim B, Cho SK, Yoon J, Kim DK, Won HH. Shared Genetic Background between Parkinson's Disease and Schizophrenia: A Two-Sample Mendelian Randomization Study. Brain Sci 2021; 11:1042. [PMID: 34439661 PMCID: PMC8393703 DOI: 10.3390/brainsci11081042] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/27/2021] [Accepted: 07/30/2021] [Indexed: 12/25/2022] Open
Abstract
Background and objectives: Parkinson's disease (PD) and schizophrenia often share symptomatology. Psychotic symptoms are prevalent in patients with PD, and similar motor symptoms with extrapyramidal signs are frequently observed in antipsychotic-naïve patients with schizophrenia as well as premorbid families. However, few studies have examined the relationship between PD and schizophrenia. We performed this study to evaluate whether genetic variants which increase PD risk influence the risk of developing schizophrenia, and vice versa. Materials and Methods: Two-sample Mendelian randomization (TSMR) with summary statistics from large-scale genome-wide association studies (GWAS) was applied. Summary statistics were extracted for these instruments from GWAS of PD and schizophrenia; Results: We found an increase in the risk of schizophrenia per one-standard deviation (SD) increase in the genetically-predicted PD risk (inverse-variance weighted method, odds ratio = 1.10; 95% confidence interval, 1.05-1.15; p = 3.49 × 10-5). The association was consistent in sensitivity analyses, including multiple TSMR methods, analysis after removing outlier variants with potential pleiotropic effects, and analysis after applying multiple GWAS subthresholds. No relationships were evident between PD and smoking or other psychiatric disorders, including attention deficit hyperactivity disorder, autism spectrum disorder, bipolar affective disorder, major depressive disorder, Alzheimer's disease, or alcohol dependence. However, we did not find a reverse relationship; genetic variants increasing schizophrenia risk did not alter the risk of PD; Conclusions: Overall, our findings suggest that increased genetic risk of PD can be associated with increased risk of schizophrenia. This association supports the intrinsic nature of the psychotic symptom in PD rather than medication or environmental effects. Future studies for possible comorbidities and shared genetic structure between the two diseases are warranted.
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Affiliation(s)
- Kiwon Kim
- Department of Psychiatry, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Sungan-ro, Kangdong-gu, Seoul 05355, Korea;
| | - Soyeon Kim
- Samsung Medical Center, Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul 06351, Korea; (S.K.); (I.S.); (B.K.)
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam 13620, Korea;
| | - Injeong Shim
- Samsung Medical Center, Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul 06351, Korea; (S.K.); (I.S.); (B.K.)
| | - Hyewon Lee
- Department of Health Administration and Management, College of Medical Sciences, Soonchunhyang University, Asan 31538, Korea;
- Department of Software Convergence, Graduate School, Soonchunhyang University, Asan 31538, Korea
| | - Beomsu Kim
- Samsung Medical Center, Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul 06351, Korea; (S.K.); (I.S.); (B.K.)
| | - Sung Kweon Cho
- Department of Pharmacology, School of Medicine, Ajou University, Worldcup-ro, Yeongtong-gu, Suwon 16499, Korea;
| | - Joohyun Yoon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam 13620, Korea;
| | - Doh Kwan Kim
- Samsung Medical Center, Department of Psychiatry, School of Medicine, Sungkyunkwan University, Seoul 06351, Korea;
| | - Hong-Hee Won
- Samsung Medical Center, Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul 06351, Korea; (S.K.); (I.S.); (B.K.)
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94
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Schedlich-Teufer C, Jost ST, Krack P, Witt K, Weintraub D, Baldermann JC, Sommerauer M, Amstutz D, van Eimeren T, Dafsari HS, Kalbe E, Visser-Vandewalle V, Fink GR, Kessler J, Barbe MT. Assessment of Affective-Behavioral States in Parkinson's Disease Patients: Towards a New Screening Tool. JOURNAL OF PARKINSONS DISEASE 2021; 11:1417-1430. [PMID: 33967055 DOI: 10.3233/jpd-202375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Assessment of affective-behavioral states in patients with Parkinson's disease (PD) undergoing deep brain stimulation (DBS) is essential. OBJECTIVE To analyze well-established questionnaires as a pilot-study with the long term aim to develop a screening tool evaluating affective-behavioral dysfunction, including depression, anxiety, apathy, mania, and impulse control disorders, in PD patients screened for DBS. METHODS Two hundred ninety-seven inpatients with PD underwent standardized neuropsychiatric testing including German versions of Beck Depression Inventory-II, Hospital Anxiety and Depression Scale, Apathy Evaluation Scale, Self-Report Manic Inventory, and Questionnaire for Impulsive-Compulsive Disorders in PD-Rating Scale, to assess appropriateness for DBS. Statistical item reduction was based on exploratory factor analysis, Cronbach's alpha, item-total correlations, item difficulty, and inter-item correlations. Confirmatory factor analysis was conducted to assess factorial validity. An expert rating was performed to identify clinically relevant items in the context of PD and DBS, to maintain content validity. We compared the shortened subscales with the original questionnaires using correlations. To determine cutoff points, receiver operating characteristics analysis was performed. RESULTS The items of the initial questionnaires were reduced from 129 to 38 items. Results of confirmatory factor analyses supported the validity of the shortened pool. It demonstrated high internal consistency (Cronbach's alpha = 0.72-0.83 across subscales), and the individual subscales were correlated with the corresponding original scales (rs = 0.84-0.95). Sensitivities and specificities exceeded 0.7. CONCLUSION The shortened item pool, including 38 items, provides a good basis for the development of a screening tool, capturing affective-behavioral symptoms in PD patients before DBS implantation. Confirmation of the validity of such a screening tool in an independent sample of PD patients is warranted.
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Affiliation(s)
- Charlotte Schedlich-Teufer
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Stefanie Theresa Jost
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Paul Krack
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Karsten Witt
- Department of Neurology, School of Medicine and Health Sciences, University of Oldenburg, Oldenburg, Germany.,Research Center Neurosensory Science, University of Oldenburg, Oldenburg, Germany
| | - Daniel Weintraub
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Parkinson's Disease Research, Education and Clinical Center, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - Juan Carlos Baldermann
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Michael Sommerauer
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Deborah Amstutz
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Thilo van Eimeren
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn-Cologne, Germany
| | - Haidar Salimi Dafsari
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Elke Kalbe
- Department of Medical Psychology, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Veerle Visser-Vandewalle
- Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Gereon Rudolf Fink
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany
| | - Josef Kessler
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Michael Thomas Barbe
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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95
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Alenikova OA. [Visual hallucinations in Parkinson's disease]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:106-113. [PMID: 34283539 DOI: 10.17116/jnevro2021121061106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Visual hallucinations have a negative effect on the course of Parkinson's disease (PD), being a source of stress for the patients themselves and caregivers. The article discusses the basic theories and pathogenetic mechanisms of the development of visual hallucinations in PD consisting of the following components: impairment of the visual information received from the retina with subsequent disruption of its processing in the central parts of the visual system; lack of suppression of internally generated images through the ponto-geniculo-occipital system; the invasion of REM sleep patterns in wakefulness; decreased ability of the brain stem structures to implement appropriate information filtering as well as excessive drug-induced activation of the mesolimbic system. Particular attention is paid to visual impairment and changes in the transmission of information along the retino-hypothalamic tract. In this connection, dysfunction in the «retina - hypothalamus» system can also be considered as one of the factors that determines the time and rhythm of occurrence or exacerbation of visual hallucinations in PD. Attracting attention to this aspect opens new therapeutic possibilities where the circadian system can be positioned as a target of additional exposure in the treatment of visual hallucinations in PD.
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Affiliation(s)
- O A Alenikova
- Republican Scientific and Practical Center of Neurology and Neurosurgery, Minsk, Republic of Belarus
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96
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Bernasconi F, Blondiaux E, Potheegadoo J, Stripeikyte G, Pagonabarraga J, Bejr-Kasem H, Bassolino M, Akselrod M, Martinez-Horta S, Sampedro F, Hara M, Horvath J, Franza M, Konik S, Bereau M, Ghika JA, Burkhard PR, Van De Ville D, Faivre N, Rognini G, Krack P, Kulisevsky J, Blanke O. Robot-induced hallucinations in Parkinson's disease depend on altered sensorimotor processing in fronto-temporal network. Sci Transl Med 2021; 13:13/591/eabc8362. [PMID: 33910980 DOI: 10.1126/scitranslmed.abc8362] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 08/18/2020] [Accepted: 01/23/2021] [Indexed: 01/23/2023]
Abstract
Hallucinations in Parkinson's disease (PD) are disturbing and frequent non-motor symptoms and constitute a major risk factor for psychosis and dementia. We report a robotics-based approach applying conflicting sensorimotor stimulation, enabling the induction of presence hallucinations (PHs) and the characterization of a subgroup of patients with PD with enhanced sensitivity for conflicting sensorimotor stimulation and robot-induced PH. We next identify the fronto-temporal network of PH by combining MR-compatible robotics (and sensorimotor stimulation in healthy participants) and lesion network mapping (neurological patients without PD). This PH-network was selectively disrupted in an additional and independent cohort of patients with PD, predicted the presence of symptomatic PH, and associated with cognitive decline. These robotics-neuroimaging findings extend existing sensorimotor hallucination models to PD and reveal the pathological cortical sensorimotor processes of PH in PD, potentially indicating a more severe form of PD that has been associated with psychosis and cognitive decline.
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Affiliation(s)
- Fosco Bernasconi
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics & Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
| | - Eva Blondiaux
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics & Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
| | - Jevita Potheegadoo
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics & Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
| | - Giedre Stripeikyte
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics & Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
| | - Javier Pagonabarraga
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, 08041 Barcelona, Spain.,Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), 28031 Madrid, Spain.,Biomedical Research Institute (IIB-Sant Pau), 08041 Barcelona, Spain
| | - Helena Bejr-Kasem
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, 08041 Barcelona, Spain.,Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), 28031 Madrid, Spain.,Biomedical Research Institute (IIB-Sant Pau), 08041 Barcelona, Spain
| | - Michela Bassolino
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics & Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
| | - Michel Akselrod
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics & Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland.,MySpace Lab, Lausanne University UNIL and University Hospital of Lausanne, CHUV, 1011 Lausanne, Switzerland
| | - Saul Martinez-Horta
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, 08041 Barcelona, Spain.,Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), 28031 Madrid, Spain.,Biomedical Research Institute (IIB-Sant Pau), 08041 Barcelona, Spain
| | - Frederic Sampedro
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, 08041 Barcelona, Spain.,Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), 28031 Madrid, Spain.,Biomedical Research Institute (IIB-Sant Pau), 08041 Barcelona, Spain
| | - Masayuki Hara
- Graduate School of Science and Engineering, Saitama University, 338-8570 Saitama, Japan
| | - Judit Horvath
- Department of Neurology, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Matteo Franza
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics & Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
| | - Stéphanie Konik
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics & Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland.,MySpace Lab, Lausanne University UNIL and University Hospital of Lausanne, CHUV, 1011 Lausanne, Switzerland
| | - Matthieu Bereau
- Department of Neurology, Geneva University Hospitals, 1205 Geneva, Switzerland.,Department of Neurology, Besançon University Hospital, 25056 Besançon, France
| | | | - Pierre R Burkhard
- Department of Neurology, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Dimitri Van De Ville
- Medical Image Processing Laboratory, Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland.,Department of Radiology and Medical Informatics, University of Geneva, 1206 Geneva, Switzerland
| | - Nathan Faivre
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics & Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland.,Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000 Grenoble, France
| | - Giulio Rognini
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics & Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
| | - Paul Krack
- Department of Neurology, Inselspital, University Hospital and University of Bern, 3010 Bern, Switzerland
| | - Jaime Kulisevsky
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, 08041 Barcelona, Spain. .,Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), 28031 Madrid, Spain.,Biomedical Research Institute (IIB-Sant Pau), 08041 Barcelona, Spain
| | - Olaf Blanke
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics & Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland. .,Department of Neurology, Geneva University Hospitals, 1205 Geneva, Switzerland
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97
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Fénelon G, Parant J, Cleret de Langavant L. Victor Parant (1848-1924) and the first report of psychosis in the course of Parkinson's disease with dementia. Rev Neurol (Paris) 2021; 177:1221-1227. [PMID: 34247848 DOI: 10.1016/j.neurol.2021.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 10/20/2022]
Abstract
Until the beginning of the twentieth century, neurologists considered that mental disorders in the course of Parkinson's disease (PD) occurred in the terminal phases of the disease or were due to coincidental pathologies. Benjamin Ball (1834-1893), in 1881 and 1882, drew attention to the frequency of cognitive and depressive disorders in PD. In 1883, Victor Parant (1848-1924), referring to Ball's work, published the first detailed observation of a PD patient with dementia and psychotic symptoms. Parant was an alienist running a private clinic for mental diseases in Toulouse, France. One of his main interests was the question of the responsibility of the insane, and he was called upon as a forensic expert in several cases. In this context, Parant examined a man who had been suffering from PD for several years, and later developed concurrently severe cognitive impairment and psychotic disorders. The patient would meet modern criteria for PD-associated psychosis: he had multimodal hallucinations (visual, auditory and somatic), visual illusions, and paranoid delusions. He also reported unusual symptoms: supernumerary limbs and Alice in Wonderland syndrome. Parant forwarded the far-sighted hypothesis that cognitive and psychotic disorders were due to the extension of PD lesions within the brain. The unheralded work of Victor Parant should be recognized in the history of neuropsychiatry.
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Affiliation(s)
- G Fénelon
- Service de Neurologie, hôpitaux universitaires Henri Mondor-Albert Chenevier, AP-HP, 94000 Créteil, France; Équipe neuropsychologie interventionnelle, Institut Mondor de Recherche Biomédicale, Université Paris-Est Créteil, INSERM, 94000 Créteil, France; Département d'études cognitives, École normale supérieure, Université PSL, 75005 Paris, France.
| | - J Parant
- Psychiatrist, private practice, 31300 Toulouse, France.
| | - L Cleret de Langavant
- Service de Neurologie, hôpitaux universitaires Henri Mondor-Albert Chenevier, AP-HP, 94000 Créteil, France; Équipe neuropsychologie interventionnelle, Institut Mondor de Recherche Biomédicale, Université Paris-Est Créteil, INSERM, 94000 Créteil, France; Département d'études cognitives, École normale supérieure, Université PSL, 75005 Paris, France.
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98
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Marques A, Beze S, Lambert C, Bonamy L, de Chazeron I, Rieu I, Chiambaretta F, Durif F. Psycho-sensory modalities of visual hallucinations and illusions in Parkinson's disease. Rev Neurol (Paris) 2021; 177:1228-1236. [PMID: 34238577 DOI: 10.1016/j.neurol.2021.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/10/2021] [Accepted: 04/16/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Visual illusions (VI) in Parkinson's disease (PD) are generally considered part of the prodrome towards fully formed visual hallucinations (VH), and classified as minor hallucinations. However, this sequential relationship has not been clearly demonstrated and very little is known about the specific phenomenology of VI in regards to VH. We aimed to describe and compare psycho-sensory modalities associated with VI and VH in PD patients. METHODS PD patients with VI (PD-I, n=26) and VH (PD-H, n=28) were included in this case-controlled study. We compared qualitative and quantitative psycho-sensory modalities of VI and VH using the PsychoSensory hAllucinations Scale (PSAS), and demographical and clinical features of each group. RESULTS PD-I perceptions were more often colored blots (P=0.05) or objects (P=0.005) compared to PD-H. Conversely, PD-H perceptions were more often described as animals (P<0.001), occurring at night (P=0.03) compared to PD-I. The experienced phenomena were more frequent in PD-H (P=0.02), and lasted longer (P=0.02) than for PD-I, but no between-group difference was observed for other repercussion factors including negative aspect, conviction, impact, controllable nature of the perception. Passage hallucinations and sense of presence were observed in both groups with similar frequencies (respectively P=0.60 and P=0.70). Multivariate analysis adjusting for disease severity or duration confirmed these results. CONCLUSION VI and VH in PD have different qualitative sensory modalities, with similar quantitative repercussion for patients, and similar association with modalities such as "sense of presence and passage hallucinations", in contrast to the generally accepted classification of VI as minor VH. REGISTRATION NUMBER: clinicaltrials.gov number NCT03454269.
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Affiliation(s)
- A Marques
- Université Clermont-Auvergne, EA7280, neurology department, Clermont-Ferrand university hospital, Clermont-Ferrand, France.
| | - S Beze
- Université Clermont-Auvergne, EA7280, neurology department, Clermont-Ferrand university hospital, Clermont-Ferrand, France; Ophtalmology department, Clermont-Ferrand university hospital, Clermont-Ferrand, France
| | - C Lambert
- Biostatistics department, Clermont-Ferrand university hospital, Clermont-Ferrand, France
| | - L Bonamy
- Université Clermont-Auvergne, EA7280, neurology department, Clermont-Ferrand university hospital, Clermont-Ferrand, France
| | - I de Chazeron
- Université Clermont-Auvergne, EA7280, psychiatry department, Clermont-Ferrand university hospital, Clermont-Ferrand, France
| | - I Rieu
- Université Clermont-Auvergne, EA7280, neurology department, Clermont-Ferrand university hospital, Clermont-Ferrand, France
| | - F Chiambaretta
- Ophtalmology department, Clermont-Ferrand university hospital, Clermont-Ferrand, France
| | - F Durif
- Université Clermont-Auvergne, EA7280, neurology department, Clermont-Ferrand university hospital, Clermont-Ferrand, France
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99
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De Michele G, Palmieri GR, Pane C, Dello Iacovo CDP, Perillo S, Saccà F, De Michele G, De Rosa A. Othello syndrome in Parkinson's disease: a systematic review and report of a case series. Neurol Sci 2021; 42:2721-2729. [PMID: 33978871 PMCID: PMC8263449 DOI: 10.1007/s10072-021-05249-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 04/10/2021] [Indexed: 11/02/2022]
Abstract
INTRODUCTION Psychosis in Parkinson's disease (PD) is common and consists of hallucinations, illusions, and delusions. Among the latter, delusional jealousy, also named Othello syndrome (OS), might impair the quality of life of both patients and their partners. We aimed to perform a systematic review and report a series of PD patients presenting with OS. METHODS A systematic review research was performed in PubMed database, excluding non-English articles, single case reports, reviews and neuropathology articles, comments, and articles concerning OS associated with deep brain stimulation (DBS) and levodopa-carbidopa intestinal gel infusion. We also described eleven PD patients (9 M and 2 F) with OS, identified in a cohort of consecutive 153 patients, comparing them with eleven matched no OS (nOS) PD subjects taken from the same cohort. RESULTS We included eight articles (four case series and four cross-sectional studies). OS resulted more common among males than females. We did not find higher levodopa dose and levodopa equivalent dose for dopamine agonists and for all anti-parkinsonian drugs in our OS group. In our case series, OS patients showed visual hallucinations (p=0.001) and a trend to have depression (p=0.080) more frequently than nOS ones. CONCLUSIONS OS is not a rare disorder in PD, probably due not only to abnormal dopaminergic stimulation but also to serotonergic dysfunction in biologically predisposed subjects. Visual hallucinations and other concomitant psychiatric diseases, in particular depression, might represent a risk factor for the OS development.
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Affiliation(s)
- Giovanna De Michele
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Via Pansini 5, 80131, Naples, Italy
| | - Gianluigi Rosario Palmieri
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Via Pansini 5, 80131, Naples, Italy
| | - Chiara Pane
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Via Pansini 5, 80131, Naples, Italy
| | - Carmen Diletta Paola Dello Iacovo
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Via Pansini 5, 80131, Naples, Italy
| | - Sandra Perillo
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Via Pansini 5, 80131, Naples, Italy
| | - Francesco Saccà
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Via Pansini 5, 80131, Naples, Italy
| | - Giuseppe De Michele
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Via Pansini 5, 80131, Naples, Italy
| | - Anna De Rosa
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Via Pansini 5, 80131, Naples, Italy.
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Milán-Tomás Á, Fernández-Matarrubia M, Rodríguez-Oroz MC. Lewy Body Dementias: A Coin with Two Sides? Behav Sci (Basel) 2021; 11:94. [PMID: 34206456 PMCID: PMC8301188 DOI: 10.3390/bs11070094] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/12/2021] [Accepted: 06/15/2021] [Indexed: 02/07/2023] Open
Abstract
Lewy body dementias (LBDs) consist of dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), which are clinically similar syndromes that share neuropathological findings with widespread cortical Lewy body deposition, often with a variable degree of concomitant Alzheimer pathology. The objective of this article is to provide an overview of the neuropathological and clinical features, current diagnostic criteria, biomarkers, and management of LBD. Literature research was performed using the PubMed database, and the most pertinent articles were read and are discussed in this paper. The diagnostic criteria for DLB have recently been updated, with the addition of indicative and supportive biomarker information. The time interval of dementia onset relative to parkinsonism remains the major distinction between DLB and PDD, underpinning controversy about whether they are the same illness in a different spectrum of the disease or two separate neurodegenerative disorders. The treatment for LBD is only symptomatic, but the expected progression and prognosis differ between the two entities. Diagnosis in prodromal stages should be of the utmost importance, because implementing early treatment might change the course of the illness if disease-modifying therapies are developed in the future. Thus, the identification of novel biomarkers constitutes an area of active research, with a special focus on α-synuclein markers.
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Affiliation(s)
- Ángela Milán-Tomás
- Department of Neurology, Clínica Universidad de Navarra, 28027 Madrid, Spain;
| | - Marta Fernández-Matarrubia
- Department of Neurology, Clínica Universidad de Navarra, 31008 Pamplona, Spain;
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - María Cruz Rodríguez-Oroz
- Department of Neurology, Clínica Universidad de Navarra, 28027 Madrid, Spain;
- Department of Neurology, Clínica Universidad de Navarra, 31008 Pamplona, Spain;
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
- CIMA, Center of Applied Medical Research, Universidad de Navarra, Neurosciences Program, 31008 Pamplona, Spain
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