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Ovlyakulov B, Hu BL, Kan HY, Guo Q, Li XF, Fan HH, Wu HM, Wang JY, Zhang X, Zhu JH. Escitalopram moderately outperforms citalopram towards anti-neuroinflammation and neuroprotection in 6-hydroxydopamine-induced mouse model of Parkinson's disease. Int Immunopharmacol 2024; 139:112715. [PMID: 39032471 DOI: 10.1016/j.intimp.2024.112715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 07/02/2024] [Accepted: 07/15/2024] [Indexed: 07/23/2024]
Abstract
Citalopram and escitalopram are structurally close-related antidepressants and both forms are widely used in the world. We aimed to comparatively evaluate the anti-neuroinflammatory and neuroprotective effects of escitalopram and citalopram in Parkinson's disease (PD) mouse model. Mice were randomly divided into six groups and received 6-hydroxydopamine (6-OHDA) or vehicle administration. The mice were then treated with escitalopram, citalopram or saline for consecutive 7 days. Behaviors, neuroinflammation, neurotransmitters, and neurotoxicity were assessed. Results showed that citalopram but not escitalopram worsened body weight loss and increased freezing time in the PD mice. Both drugs had no impact on the anxiety-like behaviors but ameliorated the depressive-like behaviors as in elevated plus maze and sucrose splash tests. Escitalopram but not citalopram ameliorated motor discoordination in the PD mice as in rotarod test. In accordance, escitalopram but not citalopram attenuated the 6-OHDA-induced nigrostriatal dopaminergic loss. Further mechanistic investigations showed that both drugs mitigated activations of microglia and astrocytes and/or levels of pro-inflammatory cytokines in the PD mice, but escitalopram showed appreciably better effects in the substantia nigra. Neurotransmitter examination in the prefrontal cortex suggested that the two drugs had comparable effects on the disturbed neurotransmitters in the PD mice, but citalopram was prone to disrupt certain normal homeostasis. In conclusion, escitalopram is moderately superior than citalopram to suppress neuroinflammation and to protect against dopaminergic neuronal death and motor discoordination in the 6-OHDA-induced PD mice. Our findings imply that escitalopram shall be prescribed with priority over citalopram to treat PD patients with depression as escitalopram may meanwhile provide greater additional benefits to the patients.
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Affiliation(s)
- Begench Ovlyakulov
- Department of Preventive Medicine and Institute of Nutrition and Diseases, School of Public Health, Wenzhou Medical University, Wenzhou, Zhejiang, China; Department of Neurology and Institute of Geriatric Neurology, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Bei-Lei Hu
- Department of Neurology and Institute of Geriatric Neurology, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hong-Yang Kan
- Department of Neurology and Institute of Geriatric Neurology, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qing Guo
- Department of Preventive Medicine and Institute of Nutrition and Diseases, School of Public Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiao-Fen Li
- Department of Preventive Medicine and Institute of Nutrition and Diseases, School of Public Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hui-Hui Fan
- Department of Preventive Medicine and Institute of Nutrition and Diseases, School of Public Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hong-Mei Wu
- Department of Preventive Medicine and Institute of Nutrition and Diseases, School of Public Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jian-Yong Wang
- Department of Neurology and Institute of Geriatric Neurology, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiong Zhang
- Department of Neurology and Institute of Geriatric Neurology, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Jian-Hong Zhu
- Department of Preventive Medicine and Institute of Nutrition and Diseases, School of Public Health, Wenzhou Medical University, Wenzhou, Zhejiang, China; Department of Neurology and Institute of Geriatric Neurology, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
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Deng Q, Parker E, Wu C, Zhu L, Liu TCY, Duan R, Yang L. Repurposing Ketamine in the Therapy of Depression and Depression-Related Disorders: Recent Advances and Future Potential. Aging Dis 2024:AD.2024.0239. [PMID: 38916735 DOI: 10.14336/ad.2024.0239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 04/29/2024] [Indexed: 06/26/2024] Open
Abstract
Depression represents a prevalent and enduring mental disorder of significant concern within the clinical domain. Extensive research indicates that depression is very complex, with many interconnected pathways involved. Most research related to depression focuses on monoamines, neurotrophic factors, the hypothalamic-pituitary-adrenal axis, tryptophan metabolism, energy metabolism, mitochondrial function, the gut-brain axis, glial cell-mediated inflammation, myelination, homeostasis, and brain neural networks. However, recently, Ketamine, an ionotropic N-methyl-D-aspartate (NMDA) receptor antagonist, has been discovered to have rapid antidepressant effects in patients, leading to novel and successful treatment approaches for mood disorders. This review aims to summarize the latest findings and insights into various signaling pathways and systems observed in depression patients and animal models, providing a more comprehensive view of the neurobiology of anxious-depressive-like behavior. Specifically, it highlights the key mechanisms of ketamine as a rapid-acting antidepressant, aiming to enhance the treatment of neuropsychiatric disorders. Moreover, we discuss the potential of ketamine as a prophylactic or therapeutic intervention for stress-related psychiatric disorders.
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Affiliation(s)
- Qianting Deng
- College of Physical Education and Sport Science, South China Normal University, Guangzhou, China
| | - Emily Parker
- Medical College of Georgia at Augusta University, Augusta, GA 30912, USA
| | - Chongyun Wu
- College of Physical Education and Sport Science, South China Normal University, Guangzhou, China
| | - Ling Zhu
- College of Physical Education and Sport Science, South China Normal University, Guangzhou, China
| | - Timon Cheng-Yi Liu
- College of Physical Education and Sport Science, South China Normal University, Guangzhou, China
| | - Rui Duan
- College of Physical Education and Sport Science, South China Normal University, Guangzhou, China
| | - Luodan Yang
- College of Physical Education and Sport Science, South China Normal University, Guangzhou, China
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Batzu L, Podlewska A, Gibson L, Chaudhuri KR, Aarsland D. A general clinical overview of the non-motor symptoms in Parkinson's disease: Neuropsychiatric symptoms. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2024; 174:59-97. [PMID: 38341232 DOI: 10.1016/bs.irn.2023.11.001] [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: 02/12/2024]
Abstract
The heterogeneity of non-motor features observed in people with Parkinson's disease (PD) is often dominated by one or more symptoms belonging to the neuropsychiatric spectrum, such as cognitive impairment, psychosis, depression, anxiety, and apathy. Due to their high prevalence in people with PD (PwP) and their occurrence in every stage of the disease, from the prodromal to the advanced stage, it is not surprising that PD can be conceptualised as a complex neuropsychiatric disorder. Despite progress in understanding the pathophysiological mechanisms underlying the neuropsychiatric signs and symptoms in PD, and better identification and diagnosis of these symptoms, effective treatments are still a major unmet need. The impact of these symptoms on the quality of life of PwP and caregivers, as well as their contribution to the overall non-motor symptom burden can be greater than that of motor symptoms and require a personalised, holistic approach. In this chapter, we provide a general clinical overview of the major neuropsychiatric symptoms of PD.
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Affiliation(s)
- Lucia Batzu
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom
| | - Aleksandra Podlewska
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom
| | - Lucy Gibson
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - K Ray Chaudhuri
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom
| | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Centre for Age-Related Diseases, Stavanger University Hospital, Stavanger, Norway.
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Angelopoulou E, Stanitsa E, Karpodini CC, Bougea A, Kontaxopoulou D, Fragkiadaki S, Koros C, Georgakopoulou VE, Fotakopoulos G, Koutedakis Y, Piperi C, Papageorgiou SG. Pharmacological and Non-Pharmacological Treatments for Depression in Parkinson's Disease: An Updated Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1454. [PMID: 37629744 PMCID: PMC10456434 DOI: 10.3390/medicina59081454] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/19/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023]
Abstract
Depression represents one of the most common non-motor disorders in Parkinson's disease (PD) and it has been related to worse life quality, higher levels of disability, and cognitive impairment, thereby majorly affecting not only the patients but also their caregivers. Available pharmacological therapeutic options for depression in PD mainly include selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, and tricyclic antidepressants; meanwhile, agents acting on dopaminergic pathways used for motor symptoms, such as levodopa, dopaminergic agonists, and monoamine oxidase B (MAO-B) inhibitors, may also provide beneficial antidepressant effects. Recently, there is a growing interest in non-pharmacological interventions, including cognitive behavioral therapy; physical exercise, including dance and mind-body exercises, such as yoga, tai chi, and qigong; acupuncture; therapeutic massage; music therapy; active therapy; repetitive transcranial magnetic stimulation (rTMS); and electroconvulsive therapy (ECT) for refractory cases. However, the optimal treatment approach for PD depression is uncertain, its management may be challenging, and definite guidelines are also lacking. It is still unclear which of these interventions is the most appropriate and for which PD stage under which circumstances. Herein, we aim to provide an updated comprehensive review of both pharmacological and non-pharmacological treatments for depression in PD, focusing on recent clinical trials, systematic reviews, and meta-analyses. Finally, we discuss the pharmacological agents that are currently under investigation at a clinical level, as well as future approaches based on the pathophysiological mechanisms underlying the onset of depression in PD.
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Affiliation(s)
- Efthalia Angelopoulou
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (E.A.); (E.S.); (A.B.); (D.K.); (S.F.); (C.K.)
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Evangelia Stanitsa
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (E.A.); (E.S.); (A.B.); (D.K.); (S.F.); (C.K.)
| | - Claire Chrysanthi Karpodini
- Sport and Physical Activity Research Centre, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton WV1 1LY, UK;
| | - Anastasia Bougea
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (E.A.); (E.S.); (A.B.); (D.K.); (S.F.); (C.K.)
| | - Dionysia Kontaxopoulou
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (E.A.); (E.S.); (A.B.); (D.K.); (S.F.); (C.K.)
| | - Stella Fragkiadaki
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (E.A.); (E.S.); (A.B.); (D.K.); (S.F.); (C.K.)
| | - Christos Koros
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (E.A.); (E.S.); (A.B.); (D.K.); (S.F.); (C.K.)
| | | | - George Fotakopoulos
- Department of Neurosurgery, General University Hospital of Larissa, 41221 Larissa, Greece;
| | - Yiannis Koutedakis
- Functional Architecture of Mammals in Their Environment Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 38221 Volos, Greece;
| | - Christina Piperi
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Sokratis G. Papageorgiou
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (E.A.); (E.S.); (A.B.); (D.K.); (S.F.); (C.K.)
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Usnich T, Hauptmann B, Hanssen H, Prasuhn J, Balck A, Borsche M, Tadic V, Klee A, Noblejas-Sanchez G, Vollstedt EJ, Klein C, Brüggemann N, Kasten M. Depressive symptoms in Parkinson's disease are insufficiently but more often treated than in other chronic conditions. NPJ Parkinsons Dis 2023; 9:113. [PMID: 37452071 PMCID: PMC10349053 DOI: 10.1038/s41531-023-00551-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 06/26/2023] [Indexed: 07/18/2023] Open
Abstract
Depressive symptoms in Parkinson's disease (PD) are multifactorial and are partly linked to the underlying dopaminergic deficit. However, at least a subset of PD patients may exhibit an unspecific depressive reaction to chronic illness. Here, we compared the prevalence and severity of depressive symptoms in PD patients and disease controls (DC). PD patients reported depressive symptoms at similar frequencies as DC but were on antidepressants, especially Mirtazapine, more frequently. Still, in both groups, a high proportion of patients with clinically significant depressive symptoms was not receiving medication. Diagnosis and treatment of depressive symptoms both in PD and DC should be improved.
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Affiliation(s)
- Tatiana Usnich
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Björn Hauptmann
- Neurologisches Zentrum, Segeberger Kliniken Gruppe, Bad Segeberg, Schleswig-Holstein, Germany
| | - Henrike Hanssen
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Jannik Prasuhn
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Alexander Balck
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Max Borsche
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Vera Tadic
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Annika Klee
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | | | | | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Norbert Brüggemann
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Meike Kasten
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany.
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Hämäläinen I, Tiihonen M, Hartikainen S, Tolppanen AM. Recent hospitalization and risk of antidepressant initiation in people with Parkinson's disease. BMC Geriatr 2022; 22:974. [PMID: 36528563 PMCID: PMC9758789 DOI: 10.1186/s12877-022-03698-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND People with Parkinson's disease (PD) are more likely to be hospitalized and initiate antidepressant use compared to people without PD. It is not known if hospitalization increases the risk of antidepressant initiation. We studied whether a recent hospitalization associates with antidepressant initiation in people with PD. METHODS A nested case-control study within the nationwide register-based FINPARK cohort which includes community-dwelling Finnish residents diagnosed with PD between years 1996 and 2015 (N = 22,189) was conducted. Initiation of antidepressant use after PD diagnosis was identified from Prescription Register with 1-year washout period (cases). One matched non-initiator control for each case was identified (N = 5492 age, sex, and time since PD diagnosis-matched case-control pairs). Hospitalizations within the 14 day-period preceding the antidepressant initiation were identified from the Care Register for Health Care. RESULTS The mean age at antidepressant initiation was 73.5 years with median time since PD diagnosis 2.9 years. Selective serotonin reuptake inhibitors (48.1%) and mirtazapine (35.7%) were the most commonly initiated antidepressants. Recent hospitalization was more common among antidepressant initiators than non-initiators (48.3 and 14.3%, respectively) and was associated with antidepressant initiation also after adjusting for comorbidities and use of medications during the washout (adjusted OR, 95% CI 5.85, 5.20-6.59). The initiators also had longer hospitalizations than non-initiators. PD was the most common main discharge diagnosis among both initiators (54.6%) and non-initiators (28.8%). Discharge diagnoses of mental and behavioral disorders and dementia were more common among initiators. CONCLUSIONS Hospitalisation is an opportunity to identify and assess depressive symptoms, sleep disorders and pain, which may partially explain the association. Alternatively, the indication for antidepressant initiation may have led to hospitalisation, or hospitalisation to aggravation of, e.g., neuropsychiatric symptoms leading to antidepressant initiation.
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Affiliation(s)
- Iida Hämäläinen
- grid.9668.10000 0001 0726 2490Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland ,grid.9668.10000 0001 0726 2490School of Pharmacy, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Miia Tiihonen
- grid.9668.10000 0001 0726 2490Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland ,grid.9668.10000 0001 0726 2490School of Pharmacy, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Sirpa Hartikainen
- grid.9668.10000 0001 0726 2490Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland ,grid.9668.10000 0001 0726 2490School of Pharmacy, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Anna-Maija Tolppanen
- grid.9668.10000 0001 0726 2490Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland ,grid.9668.10000 0001 0726 2490School of Pharmacy, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
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Prange S, Klinger H, Laurencin C, Danaila T, Thobois S. Depression in Patients with Parkinson's Disease: Current Understanding of its Neurobiology and Implications for Treatment. Drugs Aging 2022; 39:417-439. [PMID: 35705848 PMCID: PMC9200562 DOI: 10.1007/s40266-022-00942-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2022] [Indexed: 12/11/2022]
Abstract
Depression is one of the most frequent and burdensome non-motor symptoms in Parkinson’s disease (PD), across all stages. Even when its severity is mild, PD depression has a great impact on quality of life for these patients and their caregivers. Accordingly, accurate diagnosis, supported by validated scales, identification of risk factors, and recognition of motor and non-motor symptoms comorbid to depression are critical to understanding the neurobiology of depression, which in turn determines the effectiveness of dopaminergic drugs, antidepressants and non-pharmacological interventions. Recent advances using in vivo functional and structural imaging demonstrate that PD depression is underpinned by dysfunction of limbic networks and monoaminergic systems, depending on the stage of PD and its associated symptoms, including apathy, anxiety, rapid eye movement sleep behavior disorder (RBD), cognitive impairment and dementia. In particular, the evolution of serotonergic, noradrenergic, and dopaminergic dysfunction and abnormalities of limbic circuits across time, involving the anterior cingulate and orbitofrontal cortices, amygdala, thalamus and ventral striatum, help to delineate the variable expression of depression in patients with prodromal, early and advanced PD. Evidence is accumulating to support the use of dual serotonin and noradrenaline reuptake inhibitors (desipramine, nortriptyline, venlafaxine) in patients with PD and moderate to severe depression, while selective serotonin reuptake inhibitors, repetitive transcranial magnetic stimulation and cognitive behavioral therapy may also be considered. In all patients, recent findings advocate that optimization of dopamine replacement therapy and evaluation of deep brain stimulation of the subthalamic nucleus to improve motor symptoms represents an important first step, in addition to physical activity. Overall, this review indicates that increasing understanding of neurobiological changes help to implement a roadmap of tailored interventions for patients with PD and depression, depending on the stage and comorbid symptoms underlying PD subtypes and their prognosis.
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Affiliation(s)
- Stéphane Prange
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, NS-PARK/FCRIN Network, 59 Boulevard Pinel, 69500, Bron, France. .,Physiopathology of the Basal Ganglia Team, Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, 67 Boulevard Pinel, 69675, Bron, France. .,Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - Hélène Klinger
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, NS-PARK/FCRIN Network, 59 Boulevard Pinel, 69500, Bron, France
| | - Chloé Laurencin
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, NS-PARK/FCRIN Network, 59 Boulevard Pinel, 69500, Bron, France.,Physiopathology of the Basal Ganglia Team, Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, 67 Boulevard Pinel, 69675, Bron, France
| | - Teodor Danaila
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, NS-PARK/FCRIN Network, 59 Boulevard Pinel, 69500, Bron, France.,Physiopathology of the Basal Ganglia Team, Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, 67 Boulevard Pinel, 69675, Bron, France
| | - Stéphane Thobois
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, NS-PARK/FCRIN Network, 59 Boulevard Pinel, 69500, Bron, France. .,Physiopathology of the Basal Ganglia Team, Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, 67 Boulevard Pinel, 69675, Bron, France. .,Faculté de Médecine et de Maïeutique Lyon Sud Charles Mérieux, Univ Lyon, Université Claude Bernard Lyon 1, Oullins, France.
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Jellinger KA. The pathobiological basis of depression in Parkinson disease: challenges and outlooks. J Neural Transm (Vienna) 2022; 129:1397-1418. [PMID: 36322206 PMCID: PMC9628588 DOI: 10.1007/s00702-022-02559-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022]
Abstract
Depression, with an estimated prevalence of about 40% is a most common neuropsychiatric disorder in Parkinson disease (PD), with a negative impact on quality of life, cognitive impairment and functional disability, yet the underlying neurobiology is poorly understood. Depression in PD (DPD), one of its most common non-motor symptoms, can precede the onset of motor symptoms but can occur at any stage of the disease. Although its diagnosis is based on standard criteria, due to overlap with other symptoms related to PD or to side effects of treatment, depression is frequently underdiagnosed and undertreated. DPD has been related to a variety of pathogenic mechanisms associated with the underlying neurodegenerative process, in particular dysfunction of neurotransmitter systems (dopaminergic, serotonergic and noradrenergic), as well as to disturbances of cortico-limbic, striato-thalamic-prefrontal, mediotemporal-limbic networks, with disruption in the topological organization of functional mood-related, motor and other essential brain network connections due to alterations in the blood-oxygen-level-dependent (BOLD) fluctuations in multiple brain areas. Other hypothetic mechanisms involve neuroinflammation, neuroimmune dysregulation, stress hormones, neurotrophic, toxic or metabolic factors. The pathophysiology and pathogenesis of DPD are multifactorial and complex, and its interactions with genetic factors, age-related changes, cognitive disposition and other co-morbidities awaits further elucidation.
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Affiliation(s)
- Kurt A. Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, 1150 Vienna, Austria
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Orayj K, Almeleebia T, Vigneshwaran E, Alshahrani S, Alavudeen SS, Alghamdi W. Trend of recognizing depression symptoms and antidepressants use in newly diagnosed Parkinson's disease: Population-based study. Brain Behav 2021; 11:e2228. [PMID: 34124851 PMCID: PMC8413829 DOI: 10.1002/brb3.2228] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/12/2021] [Accepted: 05/19/2021] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Although depression symptoms are common among patients with Parkinson's disease (PD), the medical literature still reports underrecognition of depression in patients with PD. Our main objective is to examine the trend of depression recognition during the first year of PD diagnosis using large population data. METHODS We conducted a population-based study of residents in Wales, using the Secure Anonymized Information Linkage (SAIL) Databank. We included newly diagnosed patients with PD aged 40 years or older with a first PD diagnosis between 2000 and 2015. Depression and antidepressants related data were extracted from SAIL. A series of multilevel logistic regressions were run to determine the factors affecting depression recognition. The results were presented using odds ratios (ORs) with 95% confidence intervals (CI). RESULTS The study included 6596 patients with PD. About 38% of patients had a recorded code of antidepressants, depression diagnosis, or both within the first year of PD diagnosis. There was a significant association of depression diagnosis, antidepressant use, or both with the year of PD diagnosis (OR 0.972, 95% CI 0.962-0.983). We also found that patients who used monoamine oxidase inhibitors (MAO-B inhibitors) were associated with a lower depression diagnosis, use antidepressants, or both, compared to those who did not use MAO-B inhibitors (OR 0.769, 95% CI 0.627-0.943). CONCLUSION There is a slight decrease in depression recognition in PD patients between 2000 and 2015, which could be due to an increase in depression recognition during the prodromal phase of PD.
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Affiliation(s)
- Khalid Orayj
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Tahani Almeleebia
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Easwaran Vigneshwaran
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Sultan Alshahrani
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Sirajudeen S Alavudeen
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Wael Alghamdi
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
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