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Wang X, Zhou C, Li Y, Yang H, Sun X, Li S, Li J. Sex-dependent associations of serum BDNF, glycolipid metabolism and cognitive impairments in Parkinson's disease with depression: a comprehensive analysis. J Neural Transm (Vienna) 2024:10.1007/s00702-024-02802-1. [PMID: 38967809 DOI: 10.1007/s00702-024-02802-1] [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: 04/10/2024] [Accepted: 06/25/2024] [Indexed: 07/06/2024]
Abstract
Brain-derived neurotrophic factor (BDNF) and glycolipid metabolism have been implicated in cognitive impairments and depression among Parkinson's disease (PD). However, the role of sex differences in this relationship remains elusive. This study aimed to investigate the potential sex differences in the link between serum BDNF levels, glycolipid metabolism and cognitive performance among depressive PD patients. PD patients comprising 108 individuals with depression and 108 without depression were recruited for this study. Cognitive function was assessed using the Montreal Cognitive Assessment Beijing version (MOCA-BJ). The severity of depressive symptoms was assessed using the Hamilton Depression Rating Scale (HAMD-17), while motor symptoms were evaluated using the Revised Hoehn and Yahr rating scale (H-Y) and the Unified Parkinson's Disease Rating Scale Part III (UPDRS-III). Laboratory testing and enzyme-linked immunosorbent assay (ELISA) are used to measure serum levels of glycolipid metabolism and BDNF. Females showed superior performance in delayed recall (all p < 0.05), male PD patients exhibited higher scores in naming tasks compared to females in non-depression group. There was no sex differences in serum BDNF levels between depression and non-depression groups. Liner regression analysis indicated BDNF as an independent risk factor for language deficits in male PD patients with depression (p < 0.05), while cholesterol (CHOL) emerged as a cognitive influencing factor, particularly in delayed recall among male PD patients with depression (p < 0.05). Our study reveals extensive cognitive impairments in PD patients with depression. Moreover, BDNF and CHOL may contribute to the pathological mechanisms underlying cognitive deficits, particularly in male patients with depression.
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Affiliation(s)
- Xinxu Wang
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
- Brain Assessment & Intervention Laboratory, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Chi Zhou
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
- Tongling Third People's Hospital, Tongling, 244000, China
| | - Yanzhe Li
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
- Brain Assessment & Intervention Laboratory, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Hechao Yang
- Brain Assessment & Intervention Laboratory, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
- Department of Psychiatry, Tianjin Huanhu Hospital, Tianjin, 300222, China
| | - Xiaoxiao Sun
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Shen Li
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China.
- Brain Assessment & Intervention Laboratory, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China.
| | - Jie Li
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China.
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Bock MA, Macchi ZA, Harrison KL, Katz M, Dini M, Jones J, Ayele R, Kutner JS, Pantilat SZ, Martin C, Sillau S, Kluger B. Does a novel community-based outpatient palliative care intervention for Parkinson's disease and related disorders improve care? Qualitative results from patients and care partners. Palliat Med 2024; 38:240-250. [PMID: 38267836 PMCID: PMC10865748 DOI: 10.1177/02692163231219923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
BACKGROUND Palliative care has the potential to address significant unmet needs in people with Parkinson's disease and related disorders, but models that rely on in-person specialty palliative care teams have limited scalability. AIM To describe patient and care partner experiences with a novel, community-based palliative care intervention for Parkinson's disease. DESIGN Qualitative study embedded in a randomized clinical trial to document participant experiences with a novel palliative care intervention (community neurologist training and remote team-based specialist palliative care). Transcripts were coded and thematically analyzed through a combination of team-based inductive and deductive coding. SETTING/PARTICIPANTS Twenty-eight patients and 33 care partners purposively sampled from participants in a randomized clinical trial of a palliative care intervention for Parkinson's disease and related disorders conducted at nine sites. RESULTS Benefits of the intervention included management of a wider range of non-motor symptoms, facilitation of conversations about the future, greater engagement with the health care team, and increased referrals to resources. Participants identified areas of improvement, including uptake of palliative care training by community neurologists, additional prognostic counseling, and clarity and timeliness of communication with the multidisciplinary team. CONCLUSIONS Clinicians caring for people with Parkinson's disease and related disorders should screen for non-motor symptoms, provide regular prognostic counseling, and refer to specialty palliative care services earlier in the course of illness. Future interventions should be designed to promote uptake of palliative care training by community neurologists and further optimize referral to and coordination with in-person or remote specialty palliative teams.
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Affiliation(s)
- Meredith A Bock
- Department of Neurology at University of California, San Francisco, CA, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Zachary A Macchi
- Departments of Neurology and Medicine at University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA
| | - Krista L Harrison
- Department of Medicine, Division of Geriatrics at University of California, San Francisco, CA, USA
| | - Maya Katz
- Department of Neurology at Stanford University, Stanford, CA, USA
| | - Megan Dini
- Parkinson’s Foundation, New York, NY, USA
| | - Jacqueline Jones
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Roman Ayele
- Departments of Neurology and Medicine at University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA
| | - Jean S Kutner
- Department of Medicine, Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Steven Z Pantilat
- Department of Medicine, Division of Palliative Medicine at University of California, San Francisco, CA, USA
| | - Christine Martin
- Center for Health and Technology, University of Rochester, Rochester, NY, USA
| | - Stefan Sillau
- Departments of Neurology and Medicine at University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA
| | - Benzi Kluger
- Departments of Neurology and Medicine, Division of Palliative Care, University of Rochester, Rochester, NY, USA
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Khayyat YM, Abdul Wahab RA, Natto NK, Al Wafi AA, Al Zahrani AA. Impact of anxiety and depression on the swallowing process among patients with neurological disorders and head and neck neoplasia: systemic review. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2023; 59:75. [DOI: 10.1186/s41983-023-00674-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 05/23/2023] [Indexed: 09/25/2023] Open
Abstract
Abstract
Background
Dysphagia is associated with depression and anxiety due to the severity, impact of symptoms itself or secondary to the underlying cause. This is more recognizable to brain diseases that has consequences common to the neural supply of the swallowing act and the cognition and behavior. Limited data are available to explore, quantitate and monitor these neurological outcomes. Our aim of this research to review the literature pertinent to depressive disorders, anxiety, and/or the quality of life (QoL) and psychological well-being. Search of Medline and Google Scholar databases for relevant articles had revealed a total of 1568 citations; 30 articles met the inclusion and exclusion criteria.
Results
Data about the direct effect of dysphagia on psychiatric aspects are limited. Studies of the relationship between severity of dysphagia and depressive symptoms demonstrated that several evaluation tools are available for objective and subjective assessment. The severity and progression of dysphagia was significantly associated with increased depressive symptoms.
Conclusion
Dysphagia is associated with and positively correlated to depression and anxiety scores observed in Parkinson disease (PD), multiple sclerosis (MS) and stroke. Similar association is observed in patients with head and neck cancer, tongue cancer and oral cancer. A bidirectional positive correlation exists with a vicious circle that loops between dysphagia and psychological disease. Moreover, the severity of dysphagia shows correlation with depression and/or anxiety scores (Fig. 1, Graphical abstract).
Graphical Abstract
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Rezazadeh Yazd SA, Gashtil S, Moradpoor M, Pishdar S, Nabian P, Kazemi Z, Naeim M. Reducing depression and anxiety symptoms in patients with Parkinson's disease: The effectiveness of group cognitive behavioral therapy. Parkinsonism Relat Disord 2023; 112:105456. [PMID: 37244105 DOI: 10.1016/j.parkreldis.2023.105456] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/19/2023] [Accepted: 05/21/2023] [Indexed: 05/29/2023]
Abstract
INTRODUCTION /Objective: The aim of this study was to investigate the effectiveness of group cognitive behavioral therapy in depression and anxiety symptoms in patients with Parkinson's Tehran city. METHODS This quasi-experimental study was conducted with experimental and control groups at pretest, posttest, and follow-up. Patients 60-75 years old with Parkinson's disease centers and psychiatric services made up the study population. Based on a random sample of 90 people in Tehran city who scored highly on both the Beck Anxiety Inventory and the Beck Depression Scale, in two 45-person groups-the experimental group and the control group-were randomly assigned. The experimental group underwent group cognitive behavioral therapy for 8 weeks, while the control group just received training once per week. Methods of analysis of variance with repeated measures were employed to test the hypotheses. RESULTS The outcomes showed the independent variable is successful in lowering symptoms of anxiety and depression. Patients with Parkinson's disease who participated in group cognitive behavioral therapy for stress reduction showed a reduction in their anxiety and depressive symptoms. CONCLUSION Effective psychological interventions, like group cognitive behavioral therapy, can improve mood, lessen anxiety and depression, and help patients adhere more closely to treatment guidelines. As a result, these patients can help prevent the complications of Parkinson's disease and take effective action to raise their level of physical and mental health.
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Affiliation(s)
| | - Sahar Gashtil
- Research Department, Psychology and Counseling Organization, Tehran, Iran
| | | | - Sedigheh Pishdar
- Department of Psychology, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas Branch, Iran
| | - Pantea Nabian
- Department of Psychology, Tehran University, Tehran, Iran.
| | - Zahra Kazemi
- Research Department, Psychology and Counseling Organization, Tehran, Iran
| | - Mahdi Naeim
- Research Department, Psychology and Counseling Organization, Tehran, Iran.
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Weintraub D, Aarsland D, Biundo R, Dobkin R, Goldman J, Lewis S. Management of psychiatric and cognitive complications in Parkinson's disease. BMJ 2022; 379:e068718. [PMID: 36280256 DOI: 10.1136/bmj-2021-068718] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Neuropsychiatric symptoms (NPSs) such as affective disorders, psychosis, behavioral changes, and cognitive impairment are common in Parkinson's disease (PD). However, NPSs remain under-recognized and under-treated, often leading to adverse outcomes. Their epidemiology, presentation, risk factors, neural substrate, and management strategies are incompletely understood. While psychological and psychosocial factors may contribute, hallmark PD neuropathophysiological changes, plus the associations between exposure to dopaminergic medications and occurrence of some symptoms, suggest a neurobiological basis for many NPSs. A range of psychotropic medications, psychotherapeutic techniques, stimulation therapies, and other non-pharmacological treatments have been studied, are used clinically, and are beneficial for managing NPSs in PD. Appropriate management of NPSs is critical for comprehensive PD care, from recognizing their presentations and timing throughout the disease course, to the incorporation of different therapeutic strategies (ie, pharmacological and non-pharmacological) that utilize a multidisciplinary approach.
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Affiliation(s)
- Daniel Weintraub
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
- Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA
| | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- Centre for Age-Related Diseases, Stavanger University Hospital, Stavanger, Norway
| | - Roberta Biundo
- Department of General Psychology, University of Padua, Padua, Italy
- Study Center for Neurodegeneration (CESNE), Department of Neuroscience, University of Padua, Padua, Italy
| | - Roseanne Dobkin
- Department of Psychiatry, Rutgers-The State University of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Jennifer Goldman
- Shirley Ryan AbilityLab, Parkinson's Disease and Movement Disorders, Chicago, IL
- Departments of Physical Medicine and Rehabilitation and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Simon Lewis
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, University of Sydney, Sydney, New South Wales, Australia
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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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DeMarco EC, Al-Hammadi N, Hinyard L. Exploring Treatment for Depression in Parkinson's Patients: A Cross-Sectional Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168596. [PMID: 34444343 PMCID: PMC8392211 DOI: 10.3390/ijerph18168596] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/05/2021] [Accepted: 08/08/2021] [Indexed: 12/19/2022]
Abstract
Depression is a highly prevalent, often underrecognized and undertreated comorbidity of Parkinson's disease closely correlated to health-related quality of life. National trends in depression care for patients with Parkinson's disease are not well documented. This paper identifies a cohort of patients with Parkinson's disease from nationally representative survey data and analyzes trends in depression care. Using data from the 2005-2006 through 2015-2016 waves of the National Health and Nutrition Examination Survey (NHANES), individuals were classified as Parkinson's patients by reported medication use. PHQ-9 scores were used to identify individuals screening positive for depression. A composite treatment variable examined the reported use of mental health services and antidepressant medication. Survey participants with probable PD screened positive for depression, reported the use of antidepressant medication, and reported visits to mental health services more frequently than the control group. Survey participants with PD who screened positive for depression were more likely to report limitations in physical functioning due to an emotional problem than controls. While depression is highly prevalent among individuals with Parkinson's disease, they are more likely to receive any treatment. Further research is required to investigate differences in patterns of treatment, contributing factors of emotions to limitations in physical functioning, and appropriate interventions.
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Affiliation(s)
- Elisabeth C. DeMarco
- Department of Health & Clinical Outcomes Research, Saint Louis University School of Medicine, St. Louis, MO 63104, USA; (E.C.D.); (N.A.-H.)
| | - Noor Al-Hammadi
- Department of Health & Clinical Outcomes Research, Saint Louis University School of Medicine, St. Louis, MO 63104, USA; (E.C.D.); (N.A.-H.)
- Advanced HEAlth Data (AHEAD) Institute, Saint Louis University, St. Louis, MO 63104, USA
| | - Leslie Hinyard
- Department of Health & Clinical Outcomes Research, Saint Louis University School of Medicine, St. Louis, MO 63104, USA; (E.C.D.); (N.A.-H.)
- Advanced HEAlth Data (AHEAD) Institute, Saint Louis University, St. Louis, MO 63104, USA
- Correspondence: ; Tel.: +314-977-9473
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Abraham DS, Pham Nguyen TP, Hennessy S, Gray SL, Xie D, Weintraub D, Willis AW. Annual Prevalence of Use of Potentially Inappropriate Medications for Treatment of Affective Disorders in Parkinson's Disease. Am J Geriatr Psychiatry 2021; 29:35-47. [PMID: 32553997 PMCID: PMC7671949 DOI: 10.1016/j.jagp.2020.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/06/2020] [Accepted: 05/13/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To examine the national prevalence of pharmacological treatment of affective disorders in older adults with Parkinson's disease (PD), and determine the prevalence and risk factors for receipt of an American Geriatrics Society Beers Criteria® defined potentially inappropriate medication (PIM) for affective disorder treatment. DESIGN Cross-sectional analysis of 2014 Medicare data. SETTING Research Identifiable File data from the Centers for Medicare and Medicaid Services. PARTICIPANTS Individuals ≥65 years of age with PD whose inpatient, outpatient, and prescription care is administered through the U.S. Medicare Program. MEASUREMENTS The 2014 prevalence of affective (i.e., depressive and anxiety) disorders was calculated. We assessed prescription fills for affective disorder treatment and classified prescriptions according to PIM status. Patient and clinician factors associated with PIM prescriptions were determined. RESULTS Of 84,323 beneficiaries with PD, 15.1% had prevalent depression only, 7.5% had anxiety only, and 8.5% had comorbid depression and anxiety. Among those with depression only, 80.7% were treated in 2014 (12.8% of treated received at least one PIM). The annual treatment prevalence was 62.9% (75.9% PIM) and 93.1% (63.9% PIM) in the anxiety only and comorbid group, respectively. In most groups, PIM use was less likely among men and those with dementia; geriatricians were less likely to prescribe PIMs. CONCLUSION Treatment of affective disorders in persons diagnosed with PD is high. PIM use is also common, particularly in persons with anxiety. Future research will quantify the potential effects of these PIMs on clinical and patient outcomes.
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Affiliation(s)
- Danielle S Abraham
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, (DSA, TPPN, DW, AWW), Philadelphia, PA; Department of Neurology Translational Center for Excellence for Neuroepidemiology and Neurological Outcomes Research, University of Pennsylvania Perelman School of Medicine, (DSA, TPPN, AWW), Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, (DSA, TPPN, SH, DX, AWW), Philadelphia, PA; Department of Biostatics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, (DSA, TPPN, SH, DX, AWW), Philadelphia, PA.
| | - Thanh Phuong Pham Nguyen
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, (DSA, TPPN, DW, AWW), Philadelphia, PA; Department of Neurology Translational Center for Excellence for Neuroepidemiology and Neurological Outcomes Research, University of Pennsylvania Perelman School of Medicine, (DSA, TPPN, AWW), Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, (DSA, TPPN, SH, DX, AWW), Philadelphia, PA; Department of Biostatics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, (DSA, TPPN, SH, DX, AWW), Philadelphia, PA
| | - Sean Hennessy
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, (DSA, TPPN, SH, DX, AWW), Philadelphia, PA; Department of Biostatics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, (DSA, TPPN, SH, DX, AWW), Philadelphia, PA
| | - Shelly L Gray
- Department of Pharmacy, University of Washington School of Pharmacy, (SLG), Seattle, WA
| | - Dawei Xie
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, (DSA, TPPN, SH, DX, AWW), Philadelphia, PA; Department of Biostatics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, (DSA, TPPN, SH, DX, AWW), Philadelphia, PA
| | - Daniel Weintraub
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, (DSA, TPPN, DW, AWW), Philadelphia, PA; Parkinson's Disease Research, Education and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, (DW), Philadelphia, PA; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, (DW), Philadelphia, PA
| | - Allison W Willis
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, (DSA, TPPN, DW, AWW), Philadelphia, PA; Department of Neurology Translational Center for Excellence for Neuroepidemiology and Neurological Outcomes Research, University of Pennsylvania Perelman School of Medicine, (DSA, TPPN, AWW), Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, (DSA, TPPN, SH, DX, AWW), Philadelphia, PA; Department of Biostatics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, (DSA, TPPN, SH, DX, AWW), Philadelphia, PA
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Orayj K. Impact of Antidepressants on Cardiac Events and All-Cause Mortality in Parkinson's Disease: A National Data-Linkage Study. Neuropsychiatr Dis Treat 2021; 17:2499-2510. [PMID: 34354357 PMCID: PMC8331107 DOI: 10.2147/ndt.s325521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 07/27/2021] [Indexed: 12/03/2022] Open
Abstract
PURPOSE This study investigated the 1-year risk of ischemic heart disease (IHD), all cardiovascular events, and all-cause mortality among newly diagnosed Parkinson's disease (PD) patients who used antidepressants compared to those who did not. PATIENTS AND METHODS Patients with PD aged 40 years or older were identified using data from 2000 through 2016 held within the Welsh Secure Anonymized Information Linkage (SAIL) databank. Antidepressant users were propensity-score matched 1:1 with non-users, adjusting for patients' demographics, socioeconomic status, and multiple comorbidities. Cox proportional hazard regression analyses were performed to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between the antidepressants and the study outcomes. The follow-up period was 1 year after the initial prescription of antidepressants. RESULTS The study group comprised a total of 3364 participants, with numbers split equally between the antidepressant-user and non-user groups, based on the propensity score-matching process. Overall, the propensity score-adjusted model showed that antidepressant usage in PD patients was not significantly associated with the risk of IHD (HR = 1.05; 95% CI 0.63-1.75) or all cardiovascular events (HR = 1.01; 95% CI 0.71-1.45) compared to non-users. The propensity score-adjusted model also showed that the use of any antidepressant, regardless of its category, was not statistically significantly associated with all-cause mortality (HR = 0.81; 95% CI 0.65-1.02). However, this association reached statistical significance in the multivariate adjusted model (HR = 0.67; 95% CI 0.54-0.84). CONCLUSION There was no evidence that antidepressant use was associated with an increased risk of IHD or all cardiovascular events in newly diagnosed PD patients who suffered from depression. Furthermore, antidepressant use might reduce the mortality rate in PD patients during the first year after initiation.
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Affiliation(s)
- Khalid Orayj
- Clinical Pharmacy Department, School of Pharmacy, King Khalid University, Abha, Saudi Arabia
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10
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Crispino P, Gino M, Barbagelata E, Ciarambino T, Politi C, Ambrosino I, Ragusa R, Marranzano M, Biondi A, Vacante M. Gender Differences and Quality of Life in Parkinson's Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E198. [PMID: 33383855 PMCID: PMC7795924 DOI: 10.3390/ijerph18010198] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/05/2020] [Accepted: 12/26/2020] [Indexed: 12/15/2022]
Abstract
Parkinson's disease has been found to significantly affect health-related quality of life. The gender differences of the health-related quality of life of subjects with Parkinson's disease have been observed in a number of studies. These differences have been reported in terms of the age at onset, clinical manifestations, and response to therapy. In general, women with Parkinson's disease showed more positive disease outcomes with regard to emotion processing, non-motor symptoms, and cognitive functions, although women report more Parkinson's disease-related clinical manifestations. Female gender predicted poor physical functioning and socioemotional health-related quality of life, while male gender predicted the cognitive domain of health-related quality of life. Some studies reported gender differences in the association between health-related quality of life and non-motor symptoms. Depression and fatigue were the main causes of poorer health-related quality of life in women, even in the early stages of Parkinson's disease. The aim of this review was to collect the best available evidence on gender differences in the development of Parkinson's disease symptoms and health-related quality of life.
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Affiliation(s)
- Pietro Crispino
- Internal Medicine Department, Lagonegro Hospital, 85042 Lagonegro (PZ), Italy;
| | - Miriam Gino
- Department of Internal Medicine, Rivoli Hospital, 10098 Rivoli (TO), Italy;
| | - Elena Barbagelata
- Department of Internal Medicine, ASL 4 Chiavarese, Sestri Levante Hospital, 16039 Sestri Levante (GE), Italy;
| | - Tiziana Ciarambino
- Department of Medical, Surgical, Neurological, Metabolic and Geriatrics Sciences, Marcianise Hospital, ASL Caserta, University of Campania “L. Vanvitelli”, 81025 Naples, Italy;
| | - Cecilia Politi
- Department of Internal Medicine, Veneziale Hospital, 86170 Isernia, Italy;
| | | | - Rosalia Ragusa
- Health Technology Assessment Committee, University Hospital G. Rodolico, 95123 Catania, Italy;
| | - Marina Marranzano
- Department of Medical, Surgical and Advanced Sciences, University of Catania, 95123 Catania, Italy;
| | - Antonio Biondi
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, 95123 Catania, Italy;
| | - Marco Vacante
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, 95123 Catania, Italy;
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Weintraub D. Management of psychiatric disorders in Parkinson's disease : Neurotherapeutics - Movement Disorders Therapeutics. Neurotherapeutics 2020; 17:1511-1524. [PMID: 32514891 PMCID: PMC7851231 DOI: 10.1007/s13311-020-00875-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Affective disorders (depression and anxiety), psychosis, impulse control disorders, and apathy are common and sometimes disabling psychiatric conditions in Parkinson disease (PD). Psychiatric aspects of PD are associated with numerous adverse outcomes, yet in spite of this and their high frequency, there remains incomplete understanding of epidemiology, presentation, risk factors, neural substrate, and management strategies. Psychiatric features are typically co- or multimorbid, and there is great intra- and interindividual variability in presentation [1]. The neuropathophysiological changes that occur in PD, as well as the association between PD treatment and particular psychiatric disorders, suggest a neurobiological contribution to many psychiatric symptoms. There is evidence that psychiatric disorders in PD are still under-recognized and undertreated, and although psychotropic medication use is common, randomized controlled trials demonstrating efficacy and tolerability are largely lacking. Future research on neuropsychiatric complications in PD should be oriented toward determining modifiable correlates or risk factors, and most importantly, establishing efficacious and well-tolerated treatment strategies.
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Affiliation(s)
- Daniel Weintraub
- Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
- Parkinson's Disease Research, Education and Clinical Center (PADRECC), Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA.
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Weintraub D, Mamikonyan E. The Neuropsychiatry of Parkinson Disease: A Perfect Storm. Am J Geriatr Psychiatry 2019; 27:998-1018. [PMID: 31006550 PMCID: PMC7015280 DOI: 10.1016/j.jagp.2019.03.002] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/04/2019] [Accepted: 03/04/2019] [Indexed: 12/16/2022]
Abstract
Affective disorders, cognitive decline, and psychosis have long been recognized as common in Parkinson disease (PD), and other psychiatric disorders include impulse control disorders, anxiety symptoms, disorders of sleep and wakefulness, and apathy. Psychiatric aspects of PD are associated with numerous adverse outcomes, yet in spite of this and their frequent occurrence, there is incomplete understanding of epidemiology, presentation, risk factors, neural substrate, and management strategies. Psychiatric features are typically multimorbid, and there is great intra- and interindividual variability in presentation. The hallmark neuropathophysiological changes that occur in PD, plus the association between exposure to dopaminergic medications and certain psychiatric disorders, suggest a neurobiological basis for many psychiatric symptoms, although psychological factors are involved as well. There is evidence that psychiatric disorders in PD are still under-recognized and undertreated and although psychotropic medication use is common, controlled studies demonstrating efficacy and tolerability are largely lacking. Future research on neuropsychiatric complications in PD should be oriented toward determining modifiable correlates or risk factors and establishing efficacious and well-tolerated treatment strategies.
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Affiliation(s)
- Daniel Weintraub
- Perelman School of Medicine (DW, EM), University of Pennsylvania, Philadelphia; Parkinson's Disease Research, Education and Clinical Center (PADRECC) (DW), Philadelphia Veterans Affairs Medical Center, Philadelphia.
| | - Eugenia Mamikonyan
- Perelman School of Medicine (DW, EM), University of Pennsylvania, Philadelphia
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[Prescribing patterns of antiparkinson drugs in a group of Colombian patients, 2015]. BIOMEDICA 2018; 38:417-426. [PMID: 30335247 DOI: 10.7705/biomedica.v38i4.3781] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 03/13/2018] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Parkinson's disease, whose prevalence in Colombia is 4.7 per 1,000 inhabitants, is a public health problem and a therapeutic challenge for health professionals. OBJECTIVE To determine the prescribing patterns of antiparkinson drugs and the variables associated with its use in a population from Colombia. MATERIALS AND METHODS We conducted a descriptive cross-sectional study. We selected patients who had been given antiparkinson drugs uninterruptedly between January 1st and March 31st, 2015 from a systematized database of approximately 3.5 million people affiliated to the Colombian health system. We included sociodemographic, pharmacologic and comedication variables. For the multivariate analysis, we used the IBM SPSS™-22 software. RESULTS A total of 2,898 patients was included; the mean age was 65.1years, and 50.7% were men; 69.4% (n=2010) of people received monotherapy and 30.6% combination therapy with two to five antiparkinson drugs. The most frequently prescribed drugs were: levodopa 45.5% (n=1,318 patients), biperiden 23.1% (670), amantadine 18.3% (531) and pramipexole 16.3% (471). The most commonly used association was levodopa/carbidopa + entacapone (n=311; 10.7%). Multivariate analysis showed that being male (OR=1.56; 95%CI: 1.321-1.837), over 60 years (OR=1.41; 95%CI 1.112-1.782) and receiving treatment in the city of Barranquilla (OR=2.23; 95%CI 1.675-2.975) were statistically associated with a greater risk of using combination therapy; 68.2% (n=1,977) patients were given concomitant treatment with other drugs. CONCLUSIONS Prescribing habits of drugs with high therapeutic value predominated, mainly in antiparkinson drugs monotherapy. Most were employed in the usual recommended doses. It is necessary to explore the clinical effectiveness of the medications studied and differentiate between disease and parkinsonian syndromes subtypes.
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Jurado-Coronel JC, Cabezas R, Ávila Rodríguez MF, Echeverria V, García-Segura LM, Barreto GE. Sex differences in Parkinson's disease: Features on clinical symptoms, treatment outcome, sexual hormones and genetics. Front Neuroendocrinol 2018; 50:18-30. [PMID: 28974386 DOI: 10.1016/j.yfrne.2017.09.002] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 09/12/2017] [Accepted: 09/29/2017] [Indexed: 01/14/2023]
Abstract
Parkinson's disease (PD) is the second most frequent age-related neurodegenerative disorder. Sex is an important factor in the development of PD, as reflected by the fact that it is more common in men than in women by an approximate ratio of 2:1. Our hypothesis is that differences in PD among men and women are highly determined by sex-dependent differences in the nigrostriatal dopaminergic system, which arise from environmental, hormonal and genetic influences. Sex hormones, specifically estrogens, influence PD pathogenesis and might play an important role in PD differences between men and women. The objective of this review was to discuss the PD physiopathology and point out sex differences in nigrostriatal degeneration, symptoms, genetics, responsiveness to treatments and biochemical and molecular mechanisms among patients suffering from this disease. Finally, we discuss the role estrogens may have on PD sex differences.
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Affiliation(s)
- Juan Camilo Jurado-Coronel
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá D.C., Colombia
| | - Ricardo Cabezas
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá D.C., Colombia
| | | | - Valentina Echeverria
- Universidad San Sebastián, Fac. Cs de la Salud, Lientur 1457, Concepción, 4080871, Chile; Research & Development Service, Bay Pines VA Healthcare System, Bay Pines, FL 33744, USA
| | - Luis Miguel García-Segura
- Instituto Cajal, CSIC, Madrid, Spain; CIBER de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - George E Barreto
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá D.C., Colombia; Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago, Chile.
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Patterns and Predictors of Depression Treatment among Older Adults with Parkinson's Disease and Depression in Ambulatory Care Settings in the United States. PARKINSONS DISEASE 2018; 2018:3402983. [PMID: 29686832 PMCID: PMC5852869 DOI: 10.1155/2018/3402983] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 01/17/2018] [Indexed: 11/18/2022]
Abstract
Little is known regarding depression treatment patterns and predictors among older adults with comorbid Parkinson's disease and depression (dPD) in the United States (US). The objective of this study was to assess the patterns and predictors of depression treatment among older adults with dPD in the US. We adopted a cross-sectional study design by pooling multiple-year data (2005-2011) from the National Ambulatory Medical Care Survey (NAMCS) and the outpatient department of the National Hospital Ambulatory Medical Care Survey (NHAMCS). The final study sample consisted of visits by older adults with dPD. Depression treatment was defined as antidepressant use with or without psychotherapy. To identify predictors of depression treatment, multivariate logistic regression analysis was conducted adjusting for predisposing, enabling, and need factors. Individuals with dPD and polypharmacy were 74% more likely to receive depression treatment (odds ratio = 1.743, 95% CI 1.376-2.209), while dPD subjects with comorbid chronic conditions were 44% less likely (odds ratio = 0.559, 95% CI 0.396-0.790) to receive depression treatment. Approximately six out of ten older adults with PD and depression received depression treatment. Treatment options for dPD are underutilized in routine clinical practice, and further research should explore how overall medical complexity presents a barrier to depression treatment.
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Verdonschot RJCG, Baijens LWJ, Vanbelle S, van de Kolk I, Kremer B, Leue C. Affective symptoms in patients with oropharyngeal dysphagia: A systematic review. J Psychosom Res 2017; 97:102-110. [PMID: 28606489 DOI: 10.1016/j.jpsychores.2017.04.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 03/21/2017] [Accepted: 04/14/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Affective disorders are prevalent in different somatic conditions and influence somatic symptom bother and quality of life. Mood and anxiety disorders impact patients' compliance and adherence to treatment. This systematic review summarizes published studies on affective complaints in patients with oropharyngeal dysphagia (OD) in order to determine the quality of studies concerning any association of OD with symptoms of depression and/or anxiety. METHODS A literature search was carried out using electronic databases Embase, Medline, Web-of-science, PsycINFO, Cochrane Library, and Google scholar. Two reviewers made the preselecting cut by screening all articles on title and abstract and independently screened the full texts of this initial set of articles. Methodological quality of the studies that met the inclusion criteria was assessed independently. RESULTS Twenty-six articles were included in the analysis after full-text screening and by applying the inclusion and exclusion criteria. All studies concluded that symptoms of depression were associated with impaired swallowing function, and 9 out of 12 studies concluded that symptoms of anxiety were associated with functional impairment of swallowing. The reviewers found heterogeneous outcomes and methodological limitations, which prevented data from pooling. CONCLUSION Although no meta-analytic conclusions can be drawn, it appears that symptoms of anxiety and depression are common in OD. Caregivers have to be aware of this in order to detect affective comorbidity. Given that affective conditions influence patients' treatment adherence and compliance, integrated care approaches should be advocated in case of comorbidity. Studies on treatment effect are lacking and well-designed prospective research is needed.
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Affiliation(s)
- Rob J C G Verdonschot
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands; Emergency Department, Erasmus Medical Center, Rotterdam, The Netherlands.
| | - Laura W J Baijens
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands; GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Sophie Vanbelle
- Department of Methodology and Statistics, CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Ilona van de Kolk
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bernd Kremer
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands; GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Carsten Leue
- Department of Psychiatry and Psychology, Maastricht University Medical Center, Maastricht, The Netherlands
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Brain perfusion alterations in depressed patients with Parkinson’s disease. Ann Nucl Med 2016; 30:731-737. [DOI: 10.1007/s12149-016-1119-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 08/18/2016] [Indexed: 12/31/2022]
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18
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Relationships among Depression, Anxiety, Sleep, and Quality of Life in Patients with Parkinson's Disease in Taiwan. PARKINSONS DISEASE 2016; 2016:4040185. [PMID: 27293956 PMCID: PMC4884599 DOI: 10.1155/2016/4040185] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 04/10/2016] [Accepted: 04/12/2016] [Indexed: 11/24/2022]
Abstract
The aim of this study was to examine the relationships among depression, anxiety, sleep disturbances, Parkinson's disease (PD) symptoms, PD medications, and health-related quality of life (QOL) and to identify the predictors of health-related QOL in PD patients. To do this, we administered a battery of questionnaires and rating scales (validated Chinese versions), including the Unified Parkinson's Disease Rating Scale, 39-item Parkinson's Disease Questionnaire, Parkinson's Disease Sleep Scale-2, Beck Depression Inventory, and Beck Anxiety Inventory, to 134 patients with PD whose Minimental State Examination scores were ≥24. We found that patients who reported having poorer QOL had longer disease durations, more severe PD symptoms, higher Hoehn and Yahr stages, and higher levodopa dosages, as well as higher levels of anxiety and depression, more sleep disturbances, and poorer overall cognitive statuses. Among these variables, the cognitive status, dependency of activities of daily living, depression, and anxiety were identified as predictors of QOL in PD patients and were all significant and independent factors of poor QOL in PD patients. The clinicians should be aware of the effects of these factors on QOL and attempt to treat comorbid psychiatric conditions to improve the PD patients' QOL.
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Chlond M, Bergmann F, Güthlin C, Schnoor H, Larisch A, Eggert K. Patient education for patients with Parkinson’s disease: A randomised controlled trial. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.baga.2015.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abdel-Salam OME. Prevalence, clinical features and treatment of depression in Parkinson’s disease: An update. World J Neurol 2015; 5:17-38. [DOI: 10.5316/wjn.v5.i1.17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Revised: 01/10/2015] [Accepted: 02/09/2015] [Indexed: 02/06/2023] Open
Abstract
Parkinson’s disease (PD) is one of the most prevalent neurodegenerative diseases which typically affects individuals over 65 years. Although the symptomatology is predominantly motor, neuropsychiatric manifestations, e.g., depression, apathy, anxiety, and cognitive impairment occur in the course of the illness and can have a great impact on the quality of life in these patients. Parkinson’s disease is commonly comorbid with depression with prevalence rates of depression, generally higher than those reported in general population. Depression in PD is frequently underestimated and consequently undertreated, which have significant effects on the quality of life in these patients. The neurobiology of depression in PD is complex and involves alterations in dopaminergic, serotonergic, noradrenergic and possibly other neurotransmitter systems which are affected in the course of the disease. The tricyclic antidepressants and the selective serotonin reuptake inhibitors are the two classes of antidepressant drugs used for depressive symptoms in PD. Several published studies suggested that both classes are of comparable efficacy. Other serotonergic antidepressants, e.g., nefazodone and trazodone have also been of benefit. Meanwhile, there are limited data available on other drugs but these suggest a benefit from the serotonin and noradrenaline reuptake inhibitors such as mirtazapine, venlafaxine, atomoxetine and duloxetine. Some of the drugs used in symptomatic treatment of PD, e.g., the irreversible selective inhibitors of the enzyme monoamine oxidase-B, rasagiline and selegiline as well as the dopamine receptor agonist pramipexole are likely to have direct antidepressant activity independent of their motor improving action. This would make these drugs an attractive option in depressed subjects with PD. The aim of this review is to provide an updated data on the prevalence, clinical features of depression in subjects with PD. The effects of antiparkinsonian and antidepressant drugs on depressive symptoms in these patients are also discussed.
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Gison A, Rizza F, Bonassi S, Dall'Armi V, Lisi S, Giaquinto S. The sense-of-coherence predicts health-related quality of life and emotional distress but not disability in Parkinson's disease. BMC Neurol 2014; 14:193. [PMID: 25304029 PMCID: PMC4197289 DOI: 10.1186/s12883-014-0193-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 09/23/2014] [Indexed: 11/18/2022] Open
Abstract
Background Personality traits are deemed important in many fields of Medicine. The present study aimed at evaluating i) the presence of Sense-of-Coherence (SOC) in patients suffering from Parkinson’s Disease (PD) in comparison with an age-matched general control population, ii) the influence of SOC on health-related variables, such as depression and anxiety, quality of life (Qol), and activities of daily living (ADL). Methods SOC was measured in 50 PD patients and in 50 matched controls enrolled in cross-sectional study. The other clinical measures included: Mini Mental State Examination (MMSE), Movement Disorder Society revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Well-being Index (WHO-5), Hospital Anxiety and Depression Scale (HADS) and the Barthel Index of ADL (BI). Data were analysed with univariate statistics and loglinear adjusted regression models. Results No difference emerged between PD and controls on socio-demographic and SOC. A statistically significant positive correlation was found between SOC and Qol (0.40, p < 0.004) and a negative significant correlation between SOC and emotional distress (−0.37, p < 0.008). The multivariate regression analysis confirmed the negative effect of SOC on total emotional distress (−3%, p = 0.01) and positive effect on Qol (2%, p = 0.01). SOC and BI were uncorrelated. Conclusions SOC is predictive of QoL and emotional distress in PD, whereas no evidence of a predictive effect for disability could be found. These results support only partially, the Salutogenic Theory in PD, i.e. a strong SOC positively influences psychosocial health, but does not influence physical health.
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Santiago RM, Barbiero J, Gradowski RW, Bochen S, Lima MM, Da Cunha C, Andreatini R, Vital MA. Induction of depressive-like behavior by intranigral 6-OHDA is directly correlated with deficits in striatal dopamine and hippocampal serotonin. Behav Brain Res 2014; 259:70-7. [DOI: 10.1016/j.bbr.2013.10.035] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 10/17/2013] [Accepted: 10/22/2013] [Indexed: 11/25/2022]
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Weerkamp NJ, Tissingh G, Poels PJ, Zuidema SU, Munneke M, Koopmans RT, Bloem BR. Nonmotor Symptoms in Nursing Home Residents with Parkinson's Disease: Prevalence and Effect on Quality of Life. J Am Geriatr Soc 2013; 61:1714-21. [DOI: 10.1111/jgs.12458] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Nico J. Weerkamp
- Department of Neurology; Atrium Medical Center; Heerlen the Netherlands
- Department of Neurology; Nijmegen Center for Evidence Based Practice; Radboud University Nijmegen Medical Center; Nijmegen the Netherlands
| | - Gerrit Tissingh
- Department of Neurology; Atrium Medical Center; Heerlen the Netherlands
| | - Petra J.E. Poels
- Department of Neurology; Nijmegen Center for Evidence Based Practice; Radboud University Nijmegen Medical Center; Nijmegen the Netherlands
| | - Systse U. Zuidema
- Department of General Practice; University of Groningen; University Medical Center Groningen; Groningen the Netherlands
| | - Marten Munneke
- Department of Neurology; Nijmegen Center for Evidence Based Practice; Radboud University Nijmegen Medical Center; Nijmegen the Netherlands
| | - Raymond T.C.M. Koopmans
- Department of Primary and Community Care; Center for Family Medicine, Geriatric Care and Public Health; Radboud University Nijmegen Medical Center; Nijmegen the Netherlands
| | - Bastiaan R. Bloem
- Department of Neurology; Donders Institute for Brain, Cognition and Behavior; Radboud University Nijmegen Medical Center; Nijmegen the Netherlands
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Depressione e malattia di Parkinson. Neurologia 2013. [DOI: 10.1016/s1634-7072(12)63928-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Walterfang M, Chien YH, Imrie J, Rushton D, Schubiger D, Patterson MC. Dysphagia as a risk factor for mortality in Niemann-Pick disease type C: systematic literature review and evidence from studies with miglustat. Orphanet J Rare Dis 2012; 7:76. [PMID: 23039766 PMCID: PMC3552828 DOI: 10.1186/1750-1172-7-76] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2012] [Accepted: 09/24/2012] [Indexed: 02/06/2023] Open
Abstract
Niemann-Pick disease type C (NP-C) is a rare neurovisceral disease characterised by progressive neurological deterioration and premature death, and has an estimated birth incidence of 1:120,000. Mutations in the NPC1 gene (in 95% of cases) and the NPC2 gene (in approximately 4% of cases) give rise to impaired intracellular lipid metabolism in a number of tissues, including the brain. Typical neurological manifestations include vertical supranuclear gaze palsy, saccadic eye movement abnormalities, cerebellar ataxia, dystonia, dysmetria, dysphagia and dysarthria. Oropharyngeal dysphagia can be particularly problematic as it can often lead to food or fluid aspiration and subsequent pneumonia. Epidemiological data suggest that bronchopneumonia subsequent to food or fluid aspiration is a major cause of mortality in NP-C and other neurodegenerative disorders. These findings indicate that a therapy capable of improving or stabilising swallowing function might reduce the risk of aspiration pneumonia, and could have a positive impact on patient survival. Miglustat, currently the only approved disease-specific therapy for NP-C in children and adults, has been shown to stabilise key neurological manifestations in NP-C, including dysphagia. In this article we present findings from a systematic literature review of published data on bronchopneumonia/aspiration pneumonia as a cause of death, and on the occurrence of dysphagia in NP-C and other neurodegenerative diseases. We then examine the potential links between dysphagia, aspiration, pneumonia and mortality with a view to assessing the possible effect of miglustat on patient lifespan.
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Affiliation(s)
- Mark Walterfang
- Royal Melbourne Hospital and Melbourne Neuropsychiatry Centre, Melbourne 3050, Australia
| | - Yin-Hsiu Chien
- Departments of Paediatrics and Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan
| | | | - Derren Rushton
- Actelion Pharmaceuticals Pty Ltd, New South Wales, Australia
| | - Danielle Schubiger
- Royal Melbourne Hospital and Melbourne Neuropsychiatry Centre, Melbourne 3050, Australia
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Abrantes AM, Friedman JH, Brown RA, Strong DR, Desaulniers J, Ing E, Saritelli J, Riebe D. Physical activity and neuropsychiatric symptoms of Parkinson disease. J Geriatr Psychiatry Neurol 2012; 25:138-45. [PMID: 22914597 DOI: 10.1177/0891988712455237] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Neuropsychiatric symptoms of Parkinson disease (PD) such as fatigue, depression, and apathy are common and detract from quality of life. There is little published on the impact of physical activity on the neuropsychiatric symptoms of PD. A convenience sample of 45 patients with PD (mean age = 66.1 years; 33% female) completed questionnaires on physical activity, neuropsychiatric symptoms, and specific exercise preferences. Covarying for age and gender, higher levels of physical activity were associated with significantly less fatigue, as well as a trend for less apathy and depression and greater positive affect. Exercise preferences included moderate intensity (73%), at home (56%), in the morning (73%), scheduled (69%), options for varied activities (73%), and preference for both structured/supervised (50%), and unsupervised/self-paced (50%) programs. Preferred activities included the use of aerobic exercise equipment, resistance training, and yoga. Developing and tailoring exercise programs that incorporate specific preferences may result in more effective interventions for patients with PD.
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Yang S, Sajatovic M, Walter BL. Psychosocial interventions for depression and anxiety in Parkinson's disease. J Geriatr Psychiatry Neurol 2012; 25:113-21. [PMID: 22689704 DOI: 10.1177/0891988712445096] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Depression has been estimated to affect 1 in 3 individuals with Parkinson's disease (PD) and can lead to worse health outcomes and decreased quality of life. Anxiety further complicates PD outcomes. Pharmacologic treatments of depression and anxiety can have negative side effects in patients with PD, including exacerbation of PD symptoms. There is a critical need for alternative treatment approaches that address depression and anxiety among patients with PD. Psychosocial or behavioral approaches are known to be effective for depression generally, but only a handful of studies have examined the role of psychosocial treatments of patients with depression in PD. OBJECTIVE The aim of this article was to review published psychosocial treatment studies of depression and anxiety in patients with PD. METHODS The PubMed database was searched for articles published in English before April 2011 using the terms Parkinson's disease, depression, anxiety, psychotherapy, cognitive therapy, behavioral treatment, behavioral therapy, nonpharmacologic treatment, psychoeducation, education, psychosocial treatment, and stress management. Articles included were prospective clinical trials utilizing specific depression or anxiety assessments as primary or secondary outcomes in patients with PD. RESULTS Nine reports derived from 8 separate studies fit the inclusion criteria and were included in this review. All studies were published between 1997 and 2011, and all but 3 had small sample sizes (<40 patients). Interventions included cognitive behavioral therapy (CBT), psychodrama, education, and behavior therapy as well as multidisciplinary rehabilitation. Cognitive behavioral therapy was the most studied and was shown to decrease depressive and anxiety symptoms in patients with PD. Other individual and group therapies may improve depression and anxiety in patients with PD, but the general paucity of studies and study methods limit the interpretation of these results. CONCLUSIONS There have been few studies on psychosocial treatments that specifically assess change in depression and anxiety among patients with PD. While results for CBT and other modes of therapy are promising for acute management of depression and anxiety, longer term effects after treatment have been variable. There is a need for additional studies on psychosocial interventions in people with PD.
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Affiliation(s)
- Sarah Yang
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
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van der Hoek TC, Bus BAA, Matui P, van der Marck MA, Esselink RA, Tendolkar I. Prevalence of depression in Parkinson's disease: effects of disease stage, motor subtype and gender. J Neurol Sci 2011; 310:220-4. [PMID: 21802694 DOI: 10.1016/j.jns.2011.07.007] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 06/22/2011] [Accepted: 07/05/2011] [Indexed: 12/29/2022]
Abstract
Depression is one of the most common non-motor symptoms of Parkinson's disease (PD) with a large negative impact on the quality of life. Factors such as disease stage, subtype of PD and gender might play an important role in the prevalence of depression, but a large study investigating all these factors in a within-subject design is lacking. Therefore we studied a homogeneous group of 256 Dutch PD patients (60% men, mean age=65.12 (±9.6) years). In total, 36.3% of the subjects had a BDI-score indicative for a minor depression, while 12.9% had a major depression. Notably, only 8.6% of the minor depressed patients and 30.3% of the major depressed patients were taking antidepressants. A higher prevalence of depression was observed in the later stages of the disease. However, this finding was absent in a smaller subsample after correction for cognitive impairment. Our data did not show a difference in the prevalence of depression between the motor subtypes and showed a trend towards higher prevalence of depression in the tremor dominant group. There was no significant difference in the prevalence of depression between men and women. We will discuss the relevance of these results in relation to the findings of other studies.
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Affiliation(s)
- Take C van der Hoek
- Radboud University Nijmegen Medical Centre, Department of Psychiatry, Nijmegen, The Netherlands.
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Spottke A, Schneider F, Dodel R. [Benchmarking in patient care: depression in Parkinson's disease]. ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2011; 105:383-8. [PMID: 21767798 DOI: 10.1016/j.zefq.2011.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Depression is the most common mental disorder in patients suffering from Parkinson's disease (PD) with an average prevalence of about 40% to 50%. Depression in PD has a major impact on the patient's health-related quality of life and caregivers' distress. Although common depressive symptoms in PD are under-diagnosed and therefore often untreated in clinical practice. The aim of this study was to evaluate the current status of treatment in PD patients with depression in Germany and to develop approaches to improve awareness and therapy. The study was divided into three parts: 1. a pre-study to evaluate treatment patterns in a registry of PD patients with and without depressive symptoms, 2. a pilot trial to establish a valid and feasible questionnaire for patients with PD and depression, 3. main study: quality measurement by benchmarking in 14 centres followed by a final phase for developing an integrated algorithm for the treatment of PD patients with depression. In the main study only 27.6% of the patients received antidepressant therapy, and only 55% with moderate to severe depression were treated. Only seven patients received behavioural therapy. There were two groups: one with and the other without training and benchmark information. No significant difference could be detected between the two treatment arms. This study provided important data on the treatment of patients with PD and depression in Germany. There are a number of reasons for the observed lack of efficacy in this study. More studies are needed to develop an appropriate approach to performing benchmarking for the treatment of neurological disease.
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Affiliation(s)
- Annika Spottke
- Neurologische Klinik, Rheinische Friedrich-Wilhelms-Universität Bonn
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Charidimou A, Seamons J, Selai C, Schrag A. The role of cognitive-behavioural therapy for patients with depression in Parkinson's disease. PARKINSONS DISEASE 2011; 2011:737523. [PMID: 21766001 PMCID: PMC3135065 DOI: 10.4061/2011/737523] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Accepted: 02/25/2011] [Indexed: 11/20/2022]
Abstract
Depression is a common complication of Parkinson's disease (PD) with considerable impact on patients' quality of life. However, at present the most appropriate treatment approach is unclear. There are limited data on antidepressant medications in PD-associated depression (dPD) and those available suggest limited efficacy and tolerability of these drugs. Cognitive behavioural therapy (CBT) has been shown to be an effective treatment of depressive disorders. Treatment of dPD with CBT may pose particular challenges, including possible different pathophysiology, physical and mental comorbidities, and barriers to treatment through disability, which do not allow simple transfer of these results to patients with dPD. However, a number of case reports, case series, and small pilot studies suggest that this is a promising treatment for patients with PD. We here summarise the published evidence on this treatment in dPD.
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Affiliation(s)
- Andreas Charidimou
- Institute of Neurology, The National Hospital for Neurology and Neurosurgery, University College London (UCL), Queen Square, London WC1N 3BG, UK
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Abstract
Although diagnosed by characteristic motor features, Parkinson's disease may be preceded, and is frequently accompanied by, a wide range of cognitive and neuropsychiatric features. In addition to the most commonly studied disorders of dementia, depression, and psychosis, other relatively common and clinically significant psychiatric complications include impulse control disorders, anxiety symptoms, disorders of sleep and wakefulness, and apathy. These problems may be underrecognized and are frequently undertreated. The emergent focus on nonmotor aspects of Parkinson's disease over the past quarter of a century is highlighted by a nonlinear increase in the number of articles published devoted to this topic. Although the development of newer antidepressants, atypical antipsychotics, and cholinesterase inhibitors in recent years has had a positive benefit on the management of these troublesome and distressing symptoms, responses are frequently suboptimal, and this remains an area of major unmet therapeutic need.
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Affiliation(s)
- Daniel Weintraub
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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Zampieri M, de Souza EAP. Locus of control, depression, and quality of life in Parkinson's Disease. J Health Psychol 2011; 16:980-7. [PMID: 21444732 DOI: 10.1177/1359105310397220] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
People can attribute the source of control of events that involve them either to internal or external factors. Through this view, depression can be defined as a belief that one's own behavior is not effective. In case of chronic diseases, such as Parkinson's Disease, depression is more frequent than in the general population. The present study aimed to assess locus of control orientation and its relation with depression and quality of life in 30 patients with Parkinson's Disease. Results showed positive correlation between external locus orientation and depression and quality of life scores, and negative correlation between internal orientation and depression.
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Schmitz-Hübsch T, Coudert M, Tezenas du Montcel S, Giunti P, Labrum R, Dürr A, Ribai P, Charles P, Linnemann C, Schöls L, Rakowicz M, Rola R, Zdzienicka E, Fancellu R, Mariotti C, Baliko L, Melegh B, Filla A, Salvatore E, van de Warrenburg BP, Szymanski S, Infante J, Timmann D, Boesch S, Depondt C, Kang JS, Schulz JB, Klopstock T, Lossnitzer N, Löwe B, Frick C, Rottländer D, Schlaepfer TE, Klockgether T. Depression comorbidity in spinocerebellar ataxia. Mov Disord 2011; 26:870-6. [DOI: 10.1002/mds.23698] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Revised: 02/03/2011] [Accepted: 02/07/2011] [Indexed: 01/08/2023] Open
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A pathophysiological model of freezing of gait in Parkinson's disease. Parkinsonism Relat Disord 2009; 15:333-8. [DOI: 10.1016/j.parkreldis.2008.08.006] [Citation(s) in RCA: 228] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2008] [Revised: 08/11/2008] [Accepted: 08/19/2008] [Indexed: 11/22/2022]
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Abstract
Parkinson's disease (PD) is a neurodegenerative disorder which is often reduced to a mere dysfunction of motor performance. Non-motor symptoms, however, are frequent impairments in PD and result in a major impact on the patients and their caregivers. The major neuropsychiatric comorbidities depression, anxiety, and psychotic symptoms are briefly discussed. Additionally, a brief outlook on deep brain stimulation and its effect on psychiatric symptoms is provided. Several studies did show that neuropsychiatric symptoms are underdiagnosed and consecutively treated inadequately. All in all more attention should be directed to the detection and treatment of psychiatric symptoms in PD patients in routine clinical settings.
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Strzelczyk A, Möller J, Stamelou M, Matusch A, Oertel W. Atypische Parkinson-Syndrome. DER NERVENARZT 2008; 79:1203-20; quiz 1221-2. [DOI: 10.1007/s00115-008-2559-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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