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D'Iorio A, Maggi G, Guida P, Aiello EN, Poletti B, Silani V, Ticozzi N, Santangelo G, Obeso I. Early Detection of Depression in Parkinson's Disease: Psychometrics and Diagnostics of the Spanish Version of the Beck Depression Inventory. Arch Clin Neuropsychol 2024; 39:418-422. [PMID: 37974300 DOI: 10.1093/arclin/acad087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/20/2023] [Accepted: 10/10/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE Depression is one of the most disabling non-motor symptoms in Parkinson's disease (PD) and requires proper diagnosis as it negatively impacts patients' and their relatives quality of life. The present study aimed to examine the psychometric and diagnostic properties of the Beck Depression Inventory-I (BDI-I) in a Spanish PD cohort. METHOD Consecutive PD outpatients completed the Spanish version of the BDI-I and other questionnaires assessing anxiety and apathy. Patients' caregivers completed the depression/dysphoria domain of the Neuropsychiatric Inventory (NPI-D). The internal consistency, convergent and divergent validity and the factorial structure of BDI-I were evaluated, and an optimal cut-off was defined by means of the Youden index. RESULTS The BDI-I proved to have a good internal consistency and was underpinned by a mono-component structure. Regarding construct validity, the BDI-I was substantially related to anxiety and apathy measures in PD. Furthermore, the BDI-I overall showed good accuracy with adequate sensitivity and specificity. The optimal cut-off point was defined at 10. CONCLUSIONS We provided evidence of the psychometric and diagnostic properties of the Spanish version of the BDI-I as a screening tool for depression in Spanish speaking PD patients, suggesting its usefulness in clinical research and practice.
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Affiliation(s)
- Alfonsina D'Iorio
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Gianpaolo Maggi
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Pasqualina Guida
- Control and Habit Laboratory, HM CINAC (Centro Integral en Neurociencias), University Hospital HM Puerta del Sur; CEU San Pablo University, Madrid, Spain
- Control and Habit Laboratory, Network Center for Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid, Spain
| | - Edoardo Nicolò Aiello
- Department of Neurology and Laboratory of Neuroscience, IRCCS, Istituto Auxologico Italiano, Milano, Italy
| | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience, IRCCS, Istituto Auxologico Italiano, Milano, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS, Istituto Auxologico Italiano, Milano, Italy
- Department of Pathophysiology and Transplantation, "Dino Ferrari Center", Università degli Studi di Milano, Milano, Italy
| | - Nicola Ticozzi
- Department of Neurology and Laboratory of Neuroscience, IRCCS, Istituto Auxologico Italiano, Milano, Italy
- Department of Pathophysiology and Transplantation, "Dino Ferrari Center", Università degli Studi di Milano, Milano, Italy
| | - Gabriella Santangelo
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Ignacio Obeso
- Control and Habit Laboratory, HM CINAC (Centro Integral en Neurociencias), University Hospital HM Puerta del Sur; CEU San Pablo University, Madrid, Spain
- Department of Psychobiology, Universidad Complutense de Madrid, Madrid, Spain
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Interian A, Miller RB, Hill LMS, Latorre M, King AR, Rodriguez KM, Mann SL, Kashan RS, Dissanayaka NN, Dobkin RD. A Pilot Study of Telehealth Mindfulness-Based Cognitive Therapy for Depression in Parkinson's Disease. J Geriatr Psychiatry Neurol 2023; 36:143-154. [PMID: 35603772 DOI: 10.1177/08919887221103579] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Parkinson's disease (PD) is characterized by high-rates of depression with limited evidence-based treatment options to improve mood. Objective: To expand therapeutic options, we evaluated the feasibility and effect of a telehealth mindfulness-based cognitive therapy intervention adapted for PD (MBCT-PD) in a sample of participants with DSM-5 depressive disorders. Methods: Fifteen participants with PD and clinically-significant depression completed 9 sessions of MBCT-PD. Depression, anxiety, and quality of life were evaluated at baseline, endpoint, and 1-month follow-up. Results: Telehealth MBCT-PD was feasible and beneficial. Completion rates exceeded 85% and treatment satisfaction rates were high. Notable improvements were observed for depression, anxiety, and quality of life over the course of the trial. Conclusion: Telehealth MBCT-PD shows promise and warrants further evaluation via randomized clinical trial with more diverse participants. Such research holds the potential to expand the range of therapeutic options for depression in PD, thereby setting the stage for personalized care.
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Affiliation(s)
- Alejandro Interian
- 20063VA New Jersey Healthcare System, Lyons, NJ, USA.,20061Rutgers-Robert Wood Johnson Medical School, Department of Psychiatry, Piscataway, NJ, USA
| | | | | | | | - Arlene R King
- 20063VA New Jersey Healthcare System, Lyons, NJ, USA
| | | | - Sarah L Mann
- 20063VA New Jersey Healthcare System, Lyons, NJ, USA
| | - Rachel S Kashan
- 20061Rutgers-Robert Wood Johnson Medical School, Department of Psychiatry, Piscataway, NJ, USA
| | - Nadeeka N Dissanayaka
- UQ Centre for Clinical Research, Faculty of Medicine, 25056The University of Queensland, Brisbane, AU-QLD, Australia.,School of Psychology, 12287University of Queensland, Brisbane, AU-QLD, Australia.,Department of Neurology, 303224Royal Brisbane & Women's Hospital, Brisbane, AU-QLD, Australia
| | - Roseanne D Dobkin
- 20061Rutgers-Robert Wood Johnson Medical School, Department of Psychiatry, Piscataway, NJ, USA
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Patel V, Ts J, Kamble N, Yadav R, K T, Pal PK, Reddy Yc J. Prevalence and Correlates of Psychiatric Comorbidity and Multimorbidity in Parkinson's Disease and Atypical Parkinsonian Syndromes. J Geriatr Psychiatry Neurol 2023; 36:155-163. [PMID: 35579346 DOI: 10.1177/08919887221103575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE Psychiatric comorbidity in Parkinson's disease (PD) and atypical parkinsonian syndromes (APS) has been consistently associated with poor outcomes. However, the co-occurrence of multiple psychiatric disorders has been sparsely studied. This study examines the prevalence, patterns, and correlates of psychiatric comorbidity and multimorbidity among in-patients hospitalised with PD/APS. METHODS Patients (N-110 [PD-71, APS-39]) underwent a single cross-sectional assessment. Psychiatric comorbidity was examined using the Mini International Neuropsychiatric Interview. Other domains assessed include sleep disorders, quality of life, and caregiver burden. STATISTICAL ANALYSIS In addition to descriptive statistics, multinomial logistic regression was used to examine the effect of sociodemographic and clinical factors on comorbidities. RESULTS The prevalence of psychiatric comorbidity in patients with PD and APS was 77.00% and 71.79%, with approximately half of those having co-occurrence of multiple psychiatric disorders. In both disorders, depression was the most common, followed by anxiety disorder. The two commonest patterns of multimorbidity reported in PD were the combination of depression and anxiety disorder, followed by the combination of psychosis, depression, and anxiety, with the order being reversed in APS. When compared to those without, those with single psychiatric comorbidity had higher odds of having REM sleep behaviour disorder and caregiver stress. Those with multiple psychiatric comorbidities had higher odds of being female, higher UPDRS part-1 scores, REM sleep behaviour disorder, poor sleep quality, and caregiver stress. CONCLUSION Psychiatric illness is highly comorbid among patients with PD/APS, with most having multiple co-occurring psychiatric illnesses. Clinicians must be aware to ensure early detection and intervention.
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Affiliation(s)
- Vinit Patel
- Department of Psychiatry, Ringgold: 29148National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Jaisoorya Ts
- Department of Psychiatry, Ringgold: 29148National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Nitish Kamble
- Department of Neurology, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Ravi Yadav
- Department of Neurology, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Thennarassu K
- Department of Biostatistics, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Janardhan Reddy Yc
- Department of Psychiatry, Ringgold: 29148National Institute of Mental Health and Neurosciences, Bangalore, India
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Sharma V, Singh TG, Kaur A, Mannan A, Dhiman S. Brain-Derived Neurotrophic Factor: A Novel Dynamically Regulated Therapeutic Modulator in Neurological Disorders. Neurochem Res 2023; 48:317-339. [PMID: 36308619 DOI: 10.1007/s11064-022-03755-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 09/02/2022] [Accepted: 09/03/2022] [Indexed: 02/04/2023]
Abstract
The growth factor brain-derived neurotrophic factor (BDNF), and its receptor tropomyosin-related kinase receptor type B (TrkB) play an active role in numerous areas of the adult brain, where they regulate the neuronal activity, function, and survival. Upregulation and downregulation of BDNF expression are critical for the physiology of neuronal circuits and functioning in the brain. Loss of BDNF function has been reported in the brains of patients with neurodegenerative or psychiatric disorders. This article reviews the BDNF gene structure, transport, secretion, expression and functions in the brain. This article also implicates BDNF in several brain-related disorders, including Alzheimer's disease, Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis, major depressive disorder, schizophrenia, epilepsy and bipolar disorder.
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Affiliation(s)
- Veerta Sharma
- Chitkara College of Pharmacy, Chitkara University, 140401, Rajpura, Punjab, India
| | - Thakur Gurjeet Singh
- Chitkara College of Pharmacy, Chitkara University, 140401, Rajpura, Punjab, India.
| | - Amarjot Kaur
- Chitkara College of Pharmacy, Chitkara University, 140401, Rajpura, Punjab, India
| | - Ashi Mannan
- Chitkara College of Pharmacy, Chitkara University, 140401, Rajpura, Punjab, India
| | - Sonia Dhiman
- Chitkara College of Pharmacy, Chitkara University, 140401, Rajpura, Punjab, India
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Jola C, Sundström M, McLeod J. Benefits of dance for Parkinson's: The music, the moves, and the company. PLoS One 2022; 17:e0265921. [PMID: 36409733 PMCID: PMC9678293 DOI: 10.1371/journal.pone.0265921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 11/03/2022] [Indexed: 11/22/2022] Open
Abstract
Dance classes designed for people with Parkinson's are very popular and associated not only with increasing individuals' motor control abilities but also their mood; not least by providing a social network and the enjoyment of the music. However, quantitative evidence of the benefits is inconsistent and often lacks in power. For a better understanding of the contradictory findings between participants' felt experiences and existing quantitative findings in response to dance classes, we employed a mixed method approach that focussed on the effects of music. Participant experience of the dance class was explored by means of semi-structured interviews and gait changes were measured in a within-subjects design through the Timed Up and Go (TUG) test before and after class, with and without music. We chose the TUG test for its ecological validity, as it is a simple test that resembles movements done in class. We hypothesised that the music and the dance class would have a facilitating effect on the TUG performance. In line with existing research, we found that before class, the gait of 26 participants was significantly improved when accompanied by a soundtrack. However, after class, music did not have a significantly facilitating effect, yet gait without music significantly improved after class compared to before. We suggest that whilst the music acts as an external stimulator for movement before the dance class, after the dance class, participants have an internalised music or rhythm that supports their motor control. Thus, externally played music is of less relevance. The importance of music was further emphasised in the qualitative data alongside social themes. A better understanding of how music and dance affects Parkinson's symptoms and what aspects make individuals 'feel better' will help in the design of future interventions.
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Affiliation(s)
- Corinne Jola
- Division of Psychology and Forensic Science, School of Applied Sciences, Abertay University, Dundee, United Kingdom
- * E-mail:
| | - Moa Sundström
- Division of Psychology and Forensic Science, School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | - Julia McLeod
- Division of Nursing and Mental Health, School of Applied Sciences, Abertay University, Dundee, United Kingdom
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Liu Y, Ding L, Xianyu Y, Nie S, Yang J. Research on depression in Parkinson disease: A bibliometric and visual analysis of studies published during 2012-2021. Medicine (Baltimore) 2022; 101:e29931. [PMID: 35945720 PMCID: PMC9351875 DOI: 10.1097/md.0000000000029931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The diagnosis and treatment rate of Parkinson disease (PD) with depression has a low diagnostic rate, and there is no consensus on the choice of treatment mode. This study evaluates the global research trends of scientific outputs related to depression in PD from multiple perspectives, using a bibliometric analysis and visualization tool to scientifically analyze the knowledge from the literature. METHODS Literature related to depression in PD published from 2012 to 2021 was included and selected from the Web of Science Core Collection database in October 2021. CiteSpace software was used to visualize and analyze co-occurrence analyses for countries, institutions, authors, and keywords. RESULTS A total of 4533 articles from the Web of Science database were included. The United States made the largest contribution with the majority of publications (1215; 29.40%). Toronto University was the most productive institution. PD, depression, quality of life, dementia, nonmotor symptom, prevalence, anxiety, Alzheimer disease, symptom, and disorder would be significantly correlated with depression in PD. The current hot spots in this field focus on the following: risk factors for depression in PD, assessment scale of depression in PD, and rehabilitation of depression in PD. CONCLUSIONS This analysis not only reveals the current research trends and hotspots but also provides some instructive suggestions on the development of depression in PD.
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Affiliation(s)
- Yan Liu
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, China
- *Correspondence: Yan Liu, Department of Nursing, Renmin Hospital of Wuhan University, Jiefang Road 238, Wuhan 430060, China (e-mail: )
| | - Linlin Ding
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Yunyan Xianyu
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, China
| | - Shuke Nie
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jiying Yang
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
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Predictive Model of Quality of Life in Patients with Parkinson's Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020672. [PMID: 35055498 PMCID: PMC8775752 DOI: 10.3390/ijerph19020672] [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] [Received: 11/27/2021] [Revised: 12/28/2021] [Accepted: 01/05/2022] [Indexed: 01/27/2023]
Abstract
Parkinson's disease is a chronic, progressive, and disabling neurodegenerative disease which evolves until the end of life and triggers different mood and organic alterations that influence health-related quality of life. The objective of our study was to identify the factors that negatively impact the quality of life of patients with Parkinson's disease and construct a predictive model of health-related quality of life in these patients. METHODS An analytical, prospective observational study was carried out, including Parkinson's patients at different stages in the Albacete Health Area. The sample consisted of 155 patients (T0) who were followed up at one (T1) and two years (T2). The instruments used were a purpose-designed data collection questionnaire and the "Parkinson's Disease Questionnaire" (PDQ-39), with a global index where a higher score indicates a worse quality of life. A multivariate analysis was performed by multiple linear regression at T0. Next, the model's predictive capacity was evaluated at T1 and T2 using the area under the ROC curve (AUROC). RESULTS Predictive factors were: sex, living in a residence, using a cane, using a wheelchair, having a Parkinson's stage of HY > 2, having Alzheimer's disease or a major neurocognitive disorder, having more than five non-motor symptoms, polypharmacy, and disability greater than 66%. This model showed good predictive capacity at one year and two years of follow-up, with an AUROC of 0.89 (95% CI: 0.83-0.94) and 0.83 (95% CI: 0.76-0.89), respectively. CONCLUSIONS A predictive model constructed with nine variables showed a good discriminative capacity to predict the quality of life of patients with Parkinson's disease at one and two years of follow-up.
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Candel-Parra E, Córcoles-Jiménez MP, Delicado-Useros V, Hernández-Martínez A, Molina-Alarcón M. Relationship between Motor and Nonmotor Symptoms and Quality of Life in Patients with Parkinson's Disease. NURSING REPORTS 2021; 12:1-12. [PMID: 35076598 PMCID: PMC8788427 DOI: 10.3390/nursrep12010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/13/2021] [Accepted: 12/21/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Parkinson’s disease (PD) is a chronic neurodegenerative disease that implies a progressive and invalidating functional organic disorder, which continues to evolve till the end of life and causes different mental and physical alterations that influence the quality of life of those affected. Objective: To determine the relationship between motor and nonmotor symptoms and the quality of life of persons with PD. Methods: An analytic, descriptive, cross-sectional study was conducted with patients with different degrees of PD in the Albacete Health district. The estimated sample size required was 155 patients. The instruments used for data collection included a purpose-designed questionnaire and “Parkinson’s Disease Questionnaire” (PDQ-39), which measures eight dimensions and has a global index where a higher score indicates a worse quality of life. A descriptive and bivariate analysis was conducted (SPSS® IBM 24.0). Ethical aspects: informed consent and anonymized data. Results: A strong correlation was found between the number of motor and nonmotor symptoms and global health-related quality of life and the domains mobility, activities of daily living, emotional well-being, cognitive status, and pain (p < 0.05). Receiving pharmacological treatment and taking more than four medicines per day was significantly associated with a worse quality of life (p < 0.05). Patients who had undergone surgical treatment did not show better global quality of life (p = 0.076). Conclusions: All nonmotor symptoms and polypharmacy were significantly associated with a worse global quality of life.
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Affiliation(s)
- Eduardo Candel-Parra
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Mancha, Av. de España, s/n, 02001 Albacete, Spain; (E.C.-P.); (M.P.C.-J.); (V.D.-U.)
| | - María Pilar Córcoles-Jiménez
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Mancha, Av. de España, s/n, 02001 Albacete, Spain; (E.C.-P.); (M.P.C.-J.); (V.D.-U.)
| | - Victoria Delicado-Useros
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Mancha, Av. de España, s/n, 02001 Albacete, Spain; (E.C.-P.); (M.P.C.-J.); (V.D.-U.)
| | - Antonio Hernández-Martínez
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Mancha, Av. de España, s/n, 02001 Albacete, Spain; (E.C.-P.); (M.P.C.-J.); (V.D.-U.)
- Instituto de Investigación en Discapacidades Neurológicas (IDINE), University of Castilla-La Mancha, Av. de España, s/n, 02001 Albacete, Spain
- Correspondence: (A.H.-M.); (M.M.-A.)
| | - Milagros Molina-Alarcón
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Mancha, Av. de España, s/n, 02001 Albacete, Spain; (E.C.-P.); (M.P.C.-J.); (V.D.-U.)
- Instituto de Investigación en Discapacidades Neurológicas (IDINE), University of Castilla-La Mancha, Av. de España, s/n, 02001 Albacete, Spain
- Correspondence: (A.H.-M.); (M.M.-A.)
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Leavy B, Hagströmer M, Conradsson DM, Franzén E. Physical Activity and Perceived Health in People With Parkinson Disease During the First Wave of Covid-19 Pandemic: A Cross-sectional Study From Sweden. J Neurol Phys Ther 2021; 45:266-272. [PMID: 34369451 DOI: 10.1097/npt.0000000000000372] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND People with Parkinson disease (PD) are known to be at risk of physical inactivity and may therefore be especially vulnerable to negative health outcomes during the COVID-19 pandemic due to social distancing recommendations. PURPOSE To investigate sensor-derived physical activity and perceived health of people with PD during the first wave of the COVID-19 pandemic, as well as the factors associated with these outcomes. METHODS Physical activity was measured over 7 days using the Actigraph GT3x accelerometer. Data were collected regarding perceived health status and physical activity habits, as well as rehabilitation attendance during the pandemic. Multiple linear and logistic regression analyses were used to identify factors associated with physical activity and perceived changes in health. RESULTS Of 89 participants, a majority (67%) reported a pandemic-related reduction in exercise habits. Women more commonly reported a reduction in scheduled exercise and cancelled rehabilitation than men. Study participants took on average 5876 ± 3180 steps per day. In the multivariate analysis, female gender, being 70 years of age and older, and greater reported mobility problems were associated with being less physically active. A pandemic-induced deterioration in health was reported by 42% and women were 5 times more likely than men to do so (odds ratio: 5.12, 95% confidence interval, 1.87-15.03; P = 0.002). DISCUSSION AND CONCLUSIONS Despite a pandemic-related reduction in reported exercise habits and rehabilitation, the participants in this Swedish sample were relatively physically active. However, women were less active at moderate-vigorous levels and were at greater risk of deterioration in perceived health during this time.Video Abstract available for more insight from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A359).
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Affiliation(s)
- Breiffni Leavy
- Department of Neurobiology (B.L., M.H., D.A.C., E.F.), Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden; Research and Development Department (B.L., E.F.), Stockholm Sjukhem's Foundation, Stockholm, Sweden; Academic Primary Care Centre (M.H.), Region Stockholm, Stockholm, Sweden; and Medical Unit Occupational Therapy & Physiotherapy (D.M.C., E.F.), Theme Women's Health and Allied Health Professional, Karolinska University Hospital, Stockholm, Sweden
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Gomes da Costa LV, Trippo KV, Duarte GP, Cruz AO, Filho JO, Ferraz DD. Depressive symptoms in elderly patients with Parkinson's disease: frequency and associated factors. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2021. [DOI: 10.12968/ijtr.2019.0138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/aims Emotional health is an important factor in clinical and functional manifestations of Parkinson's disease. The aim of this study was to correlate clinical features with depressive symptoms in elderly patients with Parkinson's disease. Methods A cross-sectional study was conducted. The Geriatric Depression Scale 15 was used to evaluate depressive symptoms, the modified Hoehn and Yahr scale was used to describe the symptom progression of Parkinson's disease and the Parkinson's Disease Questionnaire 39 to assess the quality of life. The Pearson correlation and the chi-square test were used. Significance level was set at 5%. Results A total of 81 individuals participated and 48 (60.8%) presented with depressive symptoms. Participants in the moderate stage of Parkinson's disease and women presented a higher frequency of depressive symptoms. Cognition, communication and mobility presented the highest correlation with depressive symptoms. Conclusions The participants presented a high frequency of depressive symptoms that is correlated with a decrease in mobility, communication and cognitive functions. It is recommended that the rehabilitation of elderly people with Parkinson's disease should be performed by a multidisciplinary team, whose objectives are to improve mobility, cognition and communication, which can help reduce depressive symptoms and depression in elderly people with Parkinson's disease.
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Chuquilín-Arista F, Álvarez-Avellón T, Menéndez-González M. Impact of Depression and Anxiety on Dimensions of Health-Related Quality of Life in Subjects with Parkinson's Disease Enrolled in an Association of Patients. Brain Sci 2021; 11:brainsci11060771. [PMID: 34200659 PMCID: PMC8226752 DOI: 10.3390/brainsci11060771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/05/2021] [Accepted: 06/08/2021] [Indexed: 01/01/2023] Open
Abstract
Parkinson's disease (PD) is a complex disorder characterized by a wide spectrum of symptoms. Depression and anxiety are common manifestations in PD and may be determinants of health-related quality of life (HRQoL). The objective of this study is to determine the association of depression and anxiety with the dimensions of HRQoL in subjects with PD enrolled in an association of patients. Ninety-five community-based patients with PD diagnosis at different disease stages were studied. HRQoL was assessed using the Parkinson's Disease Questionnaire (PDQ-39); depression and anxiety were assessed using the Beck Depression Inventory (BDI-II) and the State-Trait Anxiety Inventory (STAI), respectively. Our results showed that depression and anxiety were negatively associated with HRQoL measured by PDSI. Higher motor dysfunction measured by Hoehn and Yahr (H&Y) staging was also associated with worse HRQoL. Depression was the most influential variable in the model. All PDQ-39 dimensions except social support and bodily discomfort were associated with depression. Anxiety was associated with the emotional well-being and bodily discomfort dimensions. These results suggest that physicians should pay attention to the presence of psychiatric symptoms and treat them appropriately.
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Affiliation(s)
- Fany Chuquilín-Arista
- Community and Family Medicine, Health Area VII—Asturias, Plaza de los Sindicatos Mineros 3, 33600 Mieres, Spain
- Health Science Research, Doctoral School, University of Valladolid, Calle Real de Burgos s/n, 47011 Valladolid, Spain
- Correspondence:
| | - Tania Álvarez-Avellón
- Department of Psychology, Universidad de Oviedo, Plaza Feijoo s/n, 33003 Oviedo, Spain;
| | - Manuel Menéndez-González
- Department of Neurology, Hospital Universitario Central de Asturias (HUCA), Avenida Roma s/n, 33011 Oviedo, Spain;
- Instituto de Salud del Principado de Asturias (ISPA), Avenida del Hospital Universitario s/n, 33011 Oviedo, Spain
- Department of Medicine, Universidad de Oviedo, Calle Julián Clavería 6, 33006 Oviedo, Spain
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Candel-Parra E, Córcoles-Jiménez MP, Delicado-Useros V, Hernández-Martínez A, Molina-Alarcón M. Evolution of Quality of Life in Persons with Parkinson's Disease: A Prospective Cohort Study. J Clin Med 2021; 10:jcm10091824. [PMID: 33922142 PMCID: PMC8122703 DOI: 10.3390/jcm10091824] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/15/2021] [Accepted: 04/20/2021] [Indexed: 11/16/2022] Open
Abstract
Parkinson's disease (PD) is a chronic neurodegenerative disorder that results in important functional symptoms, altered mood, and deterioration in quality of life (QoL). This study aimed to determine the evolution of the QoL in persons with PD in the Albacete health district over a two-year period and identify associated sociodemographic, clinical, and socio-health characteristics. A cohort study was conducted of patients at different stages of PD in the Albacete health district. Calculated sample size: 155 patients. Instruments: A purpose-designed questionnaire for data collection and the "Parkinson Disease Questionnaire" (PDQ-39), which measures 8 dimensions and a global index where a higher score indicates worse quality of life. Three measurements were made: baseline, one year, two years. A descriptive and bivariate analysis was conducted. Ethical aspects: informed consent, anonymized data. Results: Mean age 69.51 (standard deviation, SD 8.73) years, 60% male, 75.5% married, and 85.5% lived with family. The most frequent motor symptoms were slow movement (86.23%), postural instability (55.5%), tremor (45.5%), and dyskinesia (24.6%). Among the non-motor symptoms were fatigue (66.2%), pain, daytime somnolence, constipation, and apathy, with approximately 50% each. The mean QoL score at baseline was 27.47 (SD 16.14); 95% CI (confidence interval) 24.91-30.03. At two years, global QoL had slightly worsened (28.3; SD 17.26; 95% CI 25.41-31.18), with a statistically significant worsening in mobility, activities of daily living, and communication, whereas social support improved.
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Affiliation(s)
- Eduardo Candel-Parra
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Mancha, Av. de España, 02001 Albacete, Spain; (E.C.-P.); (M.P.C.-J.); (V.D.-U.)
| | - María Pilar Córcoles-Jiménez
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Mancha, Av. de España, 02001 Albacete, Spain; (E.C.-P.); (M.P.C.-J.); (V.D.-U.)
| | - Victoria Delicado-Useros
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Mancha, Av. de España, 02001 Albacete, Spain; (E.C.-P.); (M.P.C.-J.); (V.D.-U.)
| | - Antonio Hernández-Martínez
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Mancha, 13071 Ciudad Real, Spain
- Instituto de Investigación en Discapacidades Neurológicas (IDINE), University of Castilla-La Mancha, Av. de España, 02001 Albacete, Spain
- Correspondence: (A.H.-M.); (M.M.-A.)
| | - Milagros Molina-Alarcón
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Mancha, Av. de España, 02001 Albacete, Spain; (E.C.-P.); (M.P.C.-J.); (V.D.-U.)
- Instituto de Investigación en Discapacidades Neurológicas (IDINE), University of Castilla-La Mancha, Av. de España, 02001 Albacete, Spain
- Correspondence: (A.H.-M.); (M.M.-A.)
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13
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Rosqvist K, Odin P, Lorenzl S, Meissner WG, Bloem BR, Ferreira JJ, Dodel R, Schrag A. Factors Associated with Health-Related Quality of Life in Late-Stage Parkinson's Disease. Mov Disord Clin Pract 2021; 8:563-570. [PMID: 33981789 DOI: 10.1002/mdc3.13186] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 02/22/2021] [Accepted: 02/25/2021] [Indexed: 11/08/2022] Open
Abstract
Background There is limited knowledge on health-related quality of life (HRQoL) in late-stage Parkinson's disease (PD). Objective To assess factors associated with HRQoL in patients with late-stage PD, with a focus on health care provision. Methods The Care of Late Stage Parkinsonism (CLaSP) project is the largest study on late-stage PD to date. The current study analyzed data of 401 patients from 6 European countries in whom HRQoL was assessed with the 8-item PD Questionnaire in patients without dementia. Factors potentially associated with HRQoL were assessed and examined in linear regression analyses. Results Better HRQoL was associated with living at home, greater independence in activities of daily living (Schwab and England Scale), less severe disease (Hoehn and Yahr stage), better motor function (Unified PD Rating Scale Part III), and lower non-motor symptoms burden (Non-Motor Symptoms Scale [NMSS]) across all NMSS domains. Having a PDspecialist as physician for PD, contact with a PDnurse, and no hospital admission during the past 3 months were associated with better HRQoL, but having seen a physiotherapist or occupational therapist was associated with worse HRQoL. Conclusions The results emphasize the importance of optimizing treatment for motor and multiple non-motor symptoms to improve HRQoL in patients with late-stage PD. PD-specific health care resources, particularly PDnurses, are likely important in addressing issues to improve HRQoL in this population. Worse HRQoL in those who had recently seen a physiotherapist or occupational therapist may reflect referral based on factors not measured in this study.
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Affiliation(s)
- Kristina Rosqvist
- Division of Neurology, Department of Clinical Sciences Lund, Faculty of Medicine Lund University Lund Sweden
| | - Per Odin
- Division of Neurology, Department of Clinical Sciences Lund, Faculty of Medicine Lund University Lund Sweden.,Department of Neurology, Rehabilitation Medicine, Memory and Geriatrics Skåne University Hospital Lund Sweden
| | - Stefan Lorenzl
- Interdisciplinary Center for Palliative Medicine and Clinic for Neurology University of Munich, the Großhadern clinic Munich Germany.,Institute of Nursing Science and Practice Salzburg Austria
| | - Wassilios G Meissner
- Department of Neurology the University Hospital of Bordeaux Bordeaux France.,Université de Bordeaux, Institut des Maladies Neurodégénératives, CNRS, UMR 5293 Bordeaux France.,Department of Medicine University of Otago Christchurch New Zealand.,New Zealand Brain Research Institute Christchurch New Zealand
| | - Bastiaan R Bloem
- Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour Nijmegen The Netherlands
| | - Joaquim J Ferreira
- Faculty of Medicine Molecular Medicine Institute, the University of Lisbon Lisbon Portugal
| | - Richard Dodel
- Department of Geriatric Medicine University Hospital Essen Essen Germany
| | - Anette Schrag
- Queen Square Institute of Neurology University College London London UK
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14
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Kessler D, Hatch S, Alexander L, Grimes D, Côté D, Liddy C, Mestre T. The Integrated Parkinson's disease Care Network (IPCN): Qualitative evaluation of a new approach to care for Parkinson's disease. PATIENT EDUCATION AND COUNSELING 2021; 104:136-142. [PMID: 32660740 DOI: 10.1016/j.pec.2020.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 06/30/2020] [Accepted: 07/04/2020] [Indexed: 05/21/2023]
Abstract
OBJECTIVES To evaluate the acceptability of the Integrated Parkinson's disease Care Network (IPCN) from the perspectives of persons with Parkinson's disease (PD), their care partners and healthcare providers, including identification of important components and areas for improvement. METHODS We used a descriptive qualitative approach with interviews (n = 15) and focus groups (n = 31) with persons with PD who were newly diagnosed and those with advanced PD, care partners and healthcare providers. Questions were designed to gather feedback on each component of the IPCN. RESULTS Four overarching categories emerged: CCI support, New knowledge, Goal identification and achievement, and Readiness for self-management. These represent important aspects of participants' experiences of the IPCN. CONCLUSION Most participants experienced the IPCN as helpful for managing living with PD and accessing resources. The relationship with the CCI was a critical component; the CCI was perceived to be knowledgeable, accessible, and responsive. PRACTICE IMPLICATIONS The IPCN is a model to promote coordinated care and self-management. This study supports the key components of the IPCN as important for supporting patients in managing their lives with PD. Incorporation of other strategies to support self-management may enhance the model. Availability of and access to community resources was identified as an ongoing challenge.
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Affiliation(s)
- Dorothy Kessler
- School of Rehabilitation Therapy, 31 George Street, Queen's University, Kingston, Ontario, K7L 3N6, Canada; C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, 43 Bruyère Street, Annex E, Ottawa, ON, K1N 5C8, Canada.
| | - Stacey Hatch
- School of Rehabilitation Therapy, 31 George Street, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - Libby Alexander
- School of Rehabilitation Therapy, 31 George Street, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - David Grimes
- Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON, K1H 8L6, Canada; University of Ottawa Brain and Mind Research Institute, Faculty of Medicine, University of Ottawa, Roger Guindon Hall, 451 Smyth Road, Ottawa, ON, K1J 8M5, Canada
| | - Diane Côté
- Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON, K1H 8L6, Canada
| | - Clare Liddy
- Department of Family Medicine, University of Ottawa, 600 Peter Morand Cres. Suite 201, Ottawa, ON, K1G 5Z3, Canada; C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, 43 Bruyère Street, Annex E, Ottawa, ON, K1N 5C8, Canada
| | - Tiago Mestre
- Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON, K1H 8L6, Canada; University of Ottawa Brain and Mind Research Institute, Faculty of Medicine, University of Ottawa, Roger Guindon Hall, 451 Smyth Road, Ottawa, ON, K1J 8M5, Canada
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15
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Jiang S, Berger S, Hu Y, Bartsch D, Tian Y. Alterations of the Motor and Olfactory Functions Related to Parkinson's Disease in Transgenic Mice With a VMAT2-Deficiency in Dopaminergic Neurons. Front Neurosci 2020; 14:356. [PMID: 32410942 PMCID: PMC7198702 DOI: 10.3389/fnins.2020.00356] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 03/24/2020] [Indexed: 12/26/2022] Open
Abstract
Parkinson's disease (PD) is one of the most common neurodegenerative diseases, with approximately six million people affected worldwide. Vesicular monoamine transporter 2 (VMAT2) dysfunction has recently become a hot topic in the pathophysiology of PD, and the advent of transgenic mice has also accelerated the development of behavioral studies in animal models. However, there are only a few systematic behavioral tests that embrace abundant motor and non-motor performance in a unique mutant mouse model which correspond to the varied symptoms observed in human PD. The aim of this study is to evaluate the responsibility of the unique reduction of dopamine in the varied motor and non-motor symptoms of PD via a transgenic mice model. We analyzed neurotransmitter concentrations in the brain tissue of 18-month-old mutant mice, with selective inactivation of one allele of Vmat2 in dopaminergic neurons (VMAT2DATcre-HET) to confirm the selective reduction of dopamine, and then examined behavioral functions. Neurochemical tests showed lower dopamine concentrations in specific brain regions of VMAT2DATcre-HET mice, especially the ventral tegmental area/substantia nigra and striatum, together with relatively unchanging concentrations of norepinephrine and serotonin, demonstrating the dopaminergic specificity of this mouse model. Behavioral tasks showed impairments in several motor functions and major defects in olfactory abilities in the VMAT2DATcre-HET mice. However, no significant changes were found in the majority of non-motor tests, such as emotional performance and sleep patterns. We concluded from this study that the selective inactivation of one allele of the Vmat2 gene in dopaminergic neurons was related to dopamine reduction, resulting in phenotypes resembling some of the major deficits in PD, especially those of motor symptoms and olfactory functions.
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Affiliation(s)
- Song Jiang
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China.,Department of Molecular Biology, Central Institute of Mental Health, Heidelberg University Faculty of Medicine in Mannheim, Mannheim, Germany
| | - Stefan Berger
- Department of Molecular Biology, Central Institute of Mental Health, Heidelberg University Faculty of Medicine in Mannheim, Mannheim, Germany
| | - Yajuan Hu
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Anhui Medical University, Hefei, China
| | - Dusan Bartsch
- Department of Molecular Biology, Central Institute of Mental Health, Heidelberg University Faculty of Medicine in Mannheim, Mannheim, Germany
| | - Yanghua Tian
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Anhui Medical University, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
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16
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Pontone GM, Mills KA. A call for better depression treatment in people with Parkinson disease. Neurology 2020; 94:691-692. [DOI: 10.1212/wnl.0000000000009285] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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17
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Dobkin RD, Mann SL, Gara MA, Interian A, Rodriguez KM, Menza M. Telephone-based cognitive behavioral therapy for depression in Parkinson disease: A randomized controlled trial. Neurology 2020; 94:e1764-e1773. [PMID: 32238507 PMCID: PMC7282876 DOI: 10.1212/wnl.0000000000009292] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 11/18/2019] [Indexed: 01/23/2023] Open
Abstract
Objective To determine whether, for patients with depression and Parkinson disease (PD), telephone-based cognitive-behavioral treatment (T-CBT) alleviates depressive symptoms significantly more than treatment as usual (TAU), we conducted a randomized controlled trial to evaluate the efficacy of a 10-session T-CBT intervention for depression in PD, compared to TAU. Methods Seventy-two people with PD (PWP) were randomized to T-CBT + TAU or TAU only. T-CBT tailored to PWPs’ unique needs was provided weekly for 3 months, then monthly during 6-month follow-up. CBT targeted negative thoughts (e.g., “I have no control”; “I am helpless”) and behaviors (e.g., social withdrawal, excessive worry). It also trained care partners to help PWP practice healthy habits. Blind raters assessed outcomes at baseline, midtreatment, treatment end, and 1 and 6 months post-treatment. Analyses were intent to treat. Results T-CBT outperformed TAU on all depression, anxiety, and quality of life measures. The primary outcome (Hamilton Depression Rating Scale score) improved significantly in T-CBT compared to TAU by treatment end. Mean improvement from baseline was 6.53 points for T-CBT and −0.27 points for TAU (p < 0.0001); gains persisted over 6-month follow-up (p < 0.0001). Improvements were moderated by a reduction in negative thoughts in the T-CBT group only, reflecting treatment target engagement. Conclusions T-CBT may be an effective depression intervention that addresses a significant unmet PD treatment need and bypasses access barriers to multidisciplinary, evidence-based care. Clinicaltrials.gov identifier NCT02505737. Classification of evidence This study provides Class I evidence that for patients with depression and PD, T-CBT significantly alleviated depressive symptoms compared to usual care.
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Affiliation(s)
- Roseanne D Dobkin
- From the Departments of Psychiatry (R.D.D., M.A.G., K.M.R., M.M.) and Neurology (M.M.), Rutgers-Robert Wood Johnson Medical School, Piscataway; and VA New Jersey Health Care System (R.D.D., S.L.M., A.I.), Lyons.
| | - Sarah L Mann
- From the Departments of Psychiatry (R.D.D., M.A.G., K.M.R., M.M.) and Neurology (M.M.), Rutgers-Robert Wood Johnson Medical School, Piscataway; and VA New Jersey Health Care System (R.D.D., S.L.M., A.I.), Lyons
| | - Michael A Gara
- From the Departments of Psychiatry (R.D.D., M.A.G., K.M.R., M.M.) and Neurology (M.M.), Rutgers-Robert Wood Johnson Medical School, Piscataway; and VA New Jersey Health Care System (R.D.D., S.L.M., A.I.), Lyons
| | - Alejandro Interian
- From the Departments of Psychiatry (R.D.D., M.A.G., K.M.R., M.M.) and Neurology (M.M.), Rutgers-Robert Wood Johnson Medical School, Piscataway; and VA New Jersey Health Care System (R.D.D., S.L.M., A.I.), Lyons
| | - Kailyn M Rodriguez
- From the Departments of Psychiatry (R.D.D., M.A.G., K.M.R., M.M.) and Neurology (M.M.), Rutgers-Robert Wood Johnson Medical School, Piscataway; and VA New Jersey Health Care System (R.D.D., S.L.M., A.I.), Lyons
| | - Matthew Menza
- From the Departments of Psychiatry (R.D.D., M.A.G., K.M.R., M.M.) and Neurology (M.M.), Rutgers-Robert Wood Johnson Medical School, Piscataway; and VA New Jersey Health Care System (R.D.D., S.L.M., A.I.), Lyons
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18
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Dlay JK, Duncan GW, Khoo TK, Williams-Gray CH, Breen DP, Barker RA, Burn DJ, Lawson RA, Yarnall AJ. Progression of Neuropsychiatric Symptoms over Time in an Incident Parkinson's Disease Cohort (ICICLE-PD). Brain Sci 2020; 10:E78. [PMID: 32024222 PMCID: PMC7071603 DOI: 10.3390/brainsci10020078] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 01/25/2020] [Accepted: 01/31/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Cross-sectional studies have identified that the prevalence of neuropsychiatric symptoms (NPS) in Parkinson's disease (PD) ranges from 70-89%. However, there are few longitudinal studies determining the impact of NPS on quality of life (QoL) in PD patients and their caregivers. We seek to determine the progression of NPS in early PD. METHODS Newly diagnosed idiopathic PD cases (n = 212) and age-matched controls (n = 99) were recruited into a longitudinal study. NPS were assessed using the Neuropsychiatric Inventory with Caregiver Distress scale (NPI-D). Further neuropsychological and clinical assessments were completed by participants, with reassessment at 18 and 36 months. Linear mixed-effects modelling determined factors associated with NPI-D and QoL over 36 months. RESULTS Depression, anxiety, apathy and hallucinations were more frequent in PD than controls at all time points (p < 0.05). Higher motor severity at baseline was associated with worsening NPI-D scores over time (β = 0.1, p < 0.05), but not cognition. A higher NPI total score was associated with poorer QoL at any time point (β = 0.3, p < 0.001), but not changed in QoL scores. CONCLUSION NPS are significantly associated with poorer QoL, even in early PD. Screening for NPS from diagnosis may allow efficient delivery of better support and treatment to patients and their families.
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Affiliation(s)
- J. K. Dlay
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (J.K.D.); (G.W.D.); (R.A.L.)
| | - G. W. Duncan
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (J.K.D.); (G.W.D.); (R.A.L.)
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK
| | - T. K. Khoo
- School of Medicine and Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia;
- School of Medicine, University of Wollongong, New South Wales 2522, Australia
| | - C. H. Williams-Gray
- John van Geest Centre for Brain Repair, University of Cambridge, Cambridge CB2 0PY, UK; (C.H.W.-G.); (R.A.B.)
| | - D. P. Breen
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK
- Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh EH16 4SB, UK
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh EH16 4UX, UK
| | - R. A. Barker
- John van Geest Centre for Brain Repair, University of Cambridge, Cambridge CB2 0PY, UK; (C.H.W.-G.); (R.A.B.)
| | - D. J. Burn
- Faculty of Medical Sciences, Newcastle University & Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE2 4HH, UK;
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, UK
| | - R. A. Lawson
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (J.K.D.); (G.W.D.); (R.A.L.)
| | - A. J. Yarnall
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (J.K.D.); (G.W.D.); (R.A.L.)
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, UK
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19
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Abstract
Depression and anxiety are common neuropsychiatric manifestations of Parkinson disease. However, they are often under-recognized because the somatic symptoms of depression often overlap with the motor symptoms of Parkinson disease and there is low self-reporting. Clinicians need to be vigilant about early detection and treatment of anxiety and depression in the patient with Parkinson disease. The development of new therapeutic strategies, including diet, exercise, and counseling along with antidepressants provide a holistic approach to management.
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Affiliation(s)
- Sudeshna Ray
- Booth Gardner Parkinson's Care Center, Evergreen Neuroscience Institute, 12039 NE 128th St, MS-77, Kirkland, WA 98034, USA
| | - Pinky Agarwal
- Booth Gardner Parkinson's Care Center, Evergreen Neuroscience Institute, 12039 NE 128th St, MS-77, Kirkland, WA 98034, USA; University of Washington, Seattle, WA, USA.
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20
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Rutten S, Vriend C, Smit JH, Berendse HW, van Someren EJW, Hoogendoorn AW, Twisk JWR, van der Werf YD, van den Heuvel OA. Bright light therapy for depression in Parkinson disease: A randomized controlled trial. Neurology 2019; 92:e1145-e1156. [PMID: 30770426 DOI: 10.1212/wnl.0000000000007090] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 11/05/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess the efficacy of bright light therapy (BLT) in reducing depressive symptoms in patients with Parkinson disease (PD) and major depressive disorder (MDD) compared to a control light. METHODS In this double-blind controlled trial, we randomized patients with PD and MDD to treatment with BLT (±10,000 lux) or a control light (±200 lux). Participants were treated for 3 months, followed by a 6-month naturalistic follow-up. The primary outcome of the study was the Hamilton Depression Rating Scale (HDRS) score. Secondary outcomes were objective and subjective sleep measures and salivary melatonin and cortisol concentrations. Assessments were repeated halfway, at the end of treatment, and 1, 3, and 6 months after treatment. Data were analyzed with a linear mixed-model analysis. RESULTS We enrolled 83 participants. HDRS scores decreased in both groups without a significant between-group difference at the end of treatment. Subjective sleep quality improved in both groups, with a larger improvement in the BLT group (B [SE] = 0.32 [0.16], p = 0.04). Total salivary cortisol secretion decreased in the BLT group, while it increased in the control group (B [SE] = -8.11 [3.93], p = 0.04). CONCLUSION BLT was not more effective in reducing depressive symptoms than a control light. Mood and subjective sleep improved in both groups. BLT was more effective in improving subjective sleep quality than control light, possibly through a BLT-induced decrease in cortisol levels. CLINICALTRIALSGOV IDENTIFIER NCT01604876. CLASSIFICATION OF EVIDENCE This study provides Class I evidence that BLT is not superior to a control light device in reducing depressive symptoms in patients with PD with MDD.
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Affiliation(s)
- Sonja Rutten
- From Amsterdam UMC (S.R., C.V., J.H.S., E.J.W.v.S., A.W.H., O.A.v.d.H.), Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience; Department of Research and Innovation (S.R., J.H.S., A.W.H., O.A.v.d.H.), GGZ InGeest; Amsterdam UMC (C.V., H.W.B., Y.D.v.d.W.), Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience; Amsterdam UMC (H.W.B.), Vrije Universiteit Amsterdam, Department of Neurology, Amsterdam Neuroscience; Department of Sleep and Cognition (E.J.W.v.S., Y.D.v.d.W.), Netherlands Institute for Neuroscience; Department of Integrative Neurophysiology (E.J.W.v.S.), Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU University; and Amsterdam UMC (J.W.T.), Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam, the Netherlands.
| | - Chris Vriend
- From Amsterdam UMC (S.R., C.V., J.H.S., E.J.W.v.S., A.W.H., O.A.v.d.H.), Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience; Department of Research and Innovation (S.R., J.H.S., A.W.H., O.A.v.d.H.), GGZ InGeest; Amsterdam UMC (C.V., H.W.B., Y.D.v.d.W.), Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience; Amsterdam UMC (H.W.B.), Vrije Universiteit Amsterdam, Department of Neurology, Amsterdam Neuroscience; Department of Sleep and Cognition (E.J.W.v.S., Y.D.v.d.W.), Netherlands Institute for Neuroscience; Department of Integrative Neurophysiology (E.J.W.v.S.), Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU University; and Amsterdam UMC (J.W.T.), Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam, the Netherlands
| | - Jan H Smit
- From Amsterdam UMC (S.R., C.V., J.H.S., E.J.W.v.S., A.W.H., O.A.v.d.H.), Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience; Department of Research and Innovation (S.R., J.H.S., A.W.H., O.A.v.d.H.), GGZ InGeest; Amsterdam UMC (C.V., H.W.B., Y.D.v.d.W.), Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience; Amsterdam UMC (H.W.B.), Vrije Universiteit Amsterdam, Department of Neurology, Amsterdam Neuroscience; Department of Sleep and Cognition (E.J.W.v.S., Y.D.v.d.W.), Netherlands Institute for Neuroscience; Department of Integrative Neurophysiology (E.J.W.v.S.), Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU University; and Amsterdam UMC (J.W.T.), Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam, the Netherlands
| | - Henk W Berendse
- From Amsterdam UMC (S.R., C.V., J.H.S., E.J.W.v.S., A.W.H., O.A.v.d.H.), Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience; Department of Research and Innovation (S.R., J.H.S., A.W.H., O.A.v.d.H.), GGZ InGeest; Amsterdam UMC (C.V., H.W.B., Y.D.v.d.W.), Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience; Amsterdam UMC (H.W.B.), Vrije Universiteit Amsterdam, Department of Neurology, Amsterdam Neuroscience; Department of Sleep and Cognition (E.J.W.v.S., Y.D.v.d.W.), Netherlands Institute for Neuroscience; Department of Integrative Neurophysiology (E.J.W.v.S.), Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU University; and Amsterdam UMC (J.W.T.), Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam, the Netherlands
| | - Eus J W van Someren
- From Amsterdam UMC (S.R., C.V., J.H.S., E.J.W.v.S., A.W.H., O.A.v.d.H.), Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience; Department of Research and Innovation (S.R., J.H.S., A.W.H., O.A.v.d.H.), GGZ InGeest; Amsterdam UMC (C.V., H.W.B., Y.D.v.d.W.), Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience; Amsterdam UMC (H.W.B.), Vrije Universiteit Amsterdam, Department of Neurology, Amsterdam Neuroscience; Department of Sleep and Cognition (E.J.W.v.S., Y.D.v.d.W.), Netherlands Institute for Neuroscience; Department of Integrative Neurophysiology (E.J.W.v.S.), Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU University; and Amsterdam UMC (J.W.T.), Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam, the Netherlands
| | - Adriaan W Hoogendoorn
- From Amsterdam UMC (S.R., C.V., J.H.S., E.J.W.v.S., A.W.H., O.A.v.d.H.), Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience; Department of Research and Innovation (S.R., J.H.S., A.W.H., O.A.v.d.H.), GGZ InGeest; Amsterdam UMC (C.V., H.W.B., Y.D.v.d.W.), Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience; Amsterdam UMC (H.W.B.), Vrije Universiteit Amsterdam, Department of Neurology, Amsterdam Neuroscience; Department of Sleep and Cognition (E.J.W.v.S., Y.D.v.d.W.), Netherlands Institute for Neuroscience; Department of Integrative Neurophysiology (E.J.W.v.S.), Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU University; and Amsterdam UMC (J.W.T.), Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam, the Netherlands
| | - Jos W R Twisk
- From Amsterdam UMC (S.R., C.V., J.H.S., E.J.W.v.S., A.W.H., O.A.v.d.H.), Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience; Department of Research and Innovation (S.R., J.H.S., A.W.H., O.A.v.d.H.), GGZ InGeest; Amsterdam UMC (C.V., H.W.B., Y.D.v.d.W.), Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience; Amsterdam UMC (H.W.B.), Vrije Universiteit Amsterdam, Department of Neurology, Amsterdam Neuroscience; Department of Sleep and Cognition (E.J.W.v.S., Y.D.v.d.W.), Netherlands Institute for Neuroscience; Department of Integrative Neurophysiology (E.J.W.v.S.), Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU University; and Amsterdam UMC (J.W.T.), Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam, the Netherlands
| | - Ysbrand D van der Werf
- From Amsterdam UMC (S.R., C.V., J.H.S., E.J.W.v.S., A.W.H., O.A.v.d.H.), Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience; Department of Research and Innovation (S.R., J.H.S., A.W.H., O.A.v.d.H.), GGZ InGeest; Amsterdam UMC (C.V., H.W.B., Y.D.v.d.W.), Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience; Amsterdam UMC (H.W.B.), Vrije Universiteit Amsterdam, Department of Neurology, Amsterdam Neuroscience; Department of Sleep and Cognition (E.J.W.v.S., Y.D.v.d.W.), Netherlands Institute for Neuroscience; Department of Integrative Neurophysiology (E.J.W.v.S.), Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU University; and Amsterdam UMC (J.W.T.), Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam, the Netherlands
| | - Odile A van den Heuvel
- From Amsterdam UMC (S.R., C.V., J.H.S., E.J.W.v.S., A.W.H., O.A.v.d.H.), Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience; Department of Research and Innovation (S.R., J.H.S., A.W.H., O.A.v.d.H.), GGZ InGeest; Amsterdam UMC (C.V., H.W.B., Y.D.v.d.W.), Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience; Amsterdam UMC (H.W.B.), Vrije Universiteit Amsterdam, Department of Neurology, Amsterdam Neuroscience; Department of Sleep and Cognition (E.J.W.v.S., Y.D.v.d.W.), Netherlands Institute for Neuroscience; Department of Integrative Neurophysiology (E.J.W.v.S.), Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU University; and Amsterdam UMC (J.W.T.), Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam, the Netherlands
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Dallé E, Mabandla MV. Early Life Stress, Depression And Parkinson's Disease: A New Approach. Mol Brain 2018; 11:18. [PMID: 29551090 PMCID: PMC5858138 DOI: 10.1186/s13041-018-0356-9] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 02/27/2018] [Indexed: 12/20/2022] Open
Abstract
This review aims to shed light on the relationship that involves exposure to early life stress, depression and Parkinson's disease (PD). A systematic literature search was conducted in Pubmed, MEDLINE, EBSCOHost and Google Scholar and relevant data were submitted to a meta-analysis . Early life stress may contribute to the development of depression and patients with depression are at risk of developing PD later in life. Depression is a common non-motor symptom preceding motor symptoms in PD. Stimulation of regions contiguous to the substantia nigra as well as dopamine (DA) agonists have been shown to be able to attenuate depression. Therefore, since PD causes depletion of dopaminergic neurons in the substantia nigra, depression, rather than being just a simple mood disorder, may be part of the pathophysiological process that leads to PD. It is plausible that the mesocortical and mesolimbic dopaminergic pathways that mediate mood, emotion, and/or cognitive function may also play a key role in depression associated with PD. Here, we propose that a medication designed to address a deficiency in serotonin is more likely to influence motor symptoms of PD associated with depression. This review highlights the effects of an antidepressant, Fluvoxamine maleate, in an animal model that combines depressive-like symptoms and Parkinsonism.
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Affiliation(s)
- Ernest Dallé
- School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, 4000 South Africa
| | - Musa V. Mabandla
- School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, 4000 South Africa
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Mantovani S, Smith SS, Gordon R, O'Sullivan JD. An overview of sleep and circadian dysfunction in Parkinson's disease. J Sleep Res 2018; 27:e12673. [PMID: 29493044 DOI: 10.1111/jsr.12673] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 01/15/2018] [Accepted: 01/15/2018] [Indexed: 12/18/2022]
Abstract
Sleep and circadian alterations are amongst the very first symptoms experienced in Parkinson's disease, and sleep alterations are present in the majority of patients with overt clinical manifestation of Parkinson's disease. However, the magnitude of sleep and circadian dysfunction in Parkinson's disease, and its influence on the pathophysiology of Parkinson's disease remains often unclear and a matter of debate. In particular, the confounding influences of dopaminergic therapy on sleep and circadian dysfunction are a major challenge, and need to be more carefully addressed in clinical studies. The scope of this narrative review is to summarise the current knowledge around both sleep and circadian alterations in Parkinson's disease. We provide an overview on the frequency of excessive daytime sleepiness, insomnia, restless legs, obstructive apnea and nocturia in Parkinson's disease, as well as addressing sleep structure, rapid eye movement sleep behaviour disorder and circadian features in Parkinson's disease. Sleep and circadian disorders have been linked to pathological conditions that are often co-morbid in Parkinson's disease, including cognitive decline, memory impairment and neurodegeneration. Therefore, targeting sleep and circadian alterations could be one of the earliest and most promising opportunities to slow disease progression. We hope that this review will contribute to advance the discussion and inform new research efforts to progress our knowledge in this field.
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Affiliation(s)
- Susanna Mantovani
- Faculty of Medicine, The University of Queensland, UQ Centre for Clinical Research, Herston, QLD, Australia.,Wesley Medical Research, Auchenflower, QLD, Australia.,Department of Neurology, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Simon S Smith
- Institute for Social Science Research (ISSR), The University of Queensland, Indooroopilly, Australia
| | - Richard Gordon
- Faculty of Medicine, The University of Queensland, UQ Centre for Clinical Research, Herston, QLD, Australia.,Wesley Medical Research, Auchenflower, QLD, Australia
| | - John D O'Sullivan
- Faculty of Medicine, The University of Queensland, UQ Centre for Clinical Research, Herston, QLD, Australia.,Wesley Medical Research, Auchenflower, QLD, Australia.,Department of Neurology, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
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Schrag A, Taddei RN. Depression and Anxiety in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 133:623-655. [DOI: 10.1016/bs.irn.2017.05.024] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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