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Angelopoulou E, Bougea A, Hatzimanolis A, Stefanis L, Scarmeas N, Papageorgiou S. Mild Behavioral Impairment in Parkinson's Disease: An Updated Review on the Clinical, Genetic, Neuroanatomical, and Pathophysiological Aspects. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:115. [PMID: 38256375 PMCID: PMC10820007 DOI: 10.3390/medicina60010115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 12/30/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024]
Abstract
Neuropsychiatric symptoms (NPS), including depression, anxiety, apathy, visual hallucinations, and impulse control disorders, are very common during the course of Parkinson's disease (PD), occurring even at the prodromal and premotor stages. Mild behavioral impairment (MBI) represents a recently described neurobehavioral syndrome, characterized by the emergence of persistent and impactful NPS in later life, reflecting arisk of dementia. Accumulating evidence suggests that MBI is highly prevalent in non-demented patients with PD, also being associated with an advanced disease stage, more severe motor deficits, as well as global and multiple-domain cognitive impairment. Neuroimaging studies have revealed that MBI in patients with PD may be related todistinct patterns of brain atrophy, altered neuronal connectivity, and distribution of dopamine transporter (DAT) depletion, shedding more light on its pathophysiological background. Genetic studies in PD patients have also shown that specific single-nucleotide polymorphisms (SNPs) may be associated with MBI, paving the way for future research in this field. In this review, we summarize and critically discuss the emerging evidence on the frequency, associated clinical and genetic factors, as well as neuroanatomical and neurophysiological correlates of MBI in PD, aiming to elucidate the underlying pathophysiology and its potential role as an early "marker" of cognitive decline, particularly in this population. In addition, we aim to identify research gaps, and propose novel relative areas of interest that could aid in our better understanding of the relationship of this newly defined diagnostic entity with PD.
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Affiliation(s)
- Efthalia Angelopoulou
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.A.); (L.S.); (N.S.); (S.P.)
| | - Anastasia Bougea
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.A.); (L.S.); (N.S.); (S.P.)
| | - Alexandros Hatzimanolis
- Department of Psychiatry, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Leonidas Stefanis
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.A.); (L.S.); (N.S.); (S.P.)
| | - Nikolaos Scarmeas
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.A.); (L.S.); (N.S.); (S.P.)
- Department of Neurology, Columbia University, New York, NY 10032, USA
| | - Sokratis Papageorgiou
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.A.); (L.S.); (N.S.); (S.P.)
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Weintraub D, Picillo M, Cho HR, Caspell‐Garcia C, Blauwendraat C, Brown EG, Chahine LM, Coffey CS, Dobkin RD, Foroud T, Galasko D, Kieburtz K, Marek K, Merchant K, Mollenhauer B, Poston KL, Simuni T, Siderowf A, Singleton A, Seibyl J, Tanner CM. Impact of the Dopamine System on Long-Term Cognitive Impairment in Parkinson Disease: An Exploratory Study. Mov Disord Clin Pract 2023; 10:943-955. [PMID: 37332638 PMCID: PMC10272925 DOI: 10.1002/mdc3.13751] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/09/2023] [Accepted: 04/02/2023] [Indexed: 06/20/2023] Open
Abstract
Background Little is known about the impact of the dopamine system on development of cognitive impairment (CI) in Parkinson disease (PD). Objectives We used data from a multi-site, international, prospective cohort study to explore the impact of dopamine system-related biomarkers on CI in PD. Methods PD participants were assessed annually from disease onset out to 7 years, and CI determined by applying cut-offs to four measures: (1) Montreal Cognitive Assessment; (2) detailed neuropsychological test battery; (3) Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) cognition score; and (4) site investigator diagnosis of CI (mild cognitive impairment or dementia). The dopamine system was assessed by serial Iodine-123 Ioflupane dopamine transporter (DAT) imaging, genotyping, and levodopa equivalent daily dose (LEDD) recorded at each assessment. Multivariate longitudinal analyses, with adjustment for multiple comparisons, determined the association between dopamine system-related biomarkers and CI, including persistent impairment. Results Demographic and clinical variables associated with CI were higher age, male sex, lower education, non-White race, higher depression and anxiety scores and higher MDS-UPDRS motor score. For the dopamine system, lower baseline mean striatum dopamine transporter values (P range 0.003-0.005) and higher LEDD over time (P range <0.001-0.01) were significantly associated with increased risk for CI. Conclusions Our results provide preliminary evidence that alterations in the dopamine system predict development of clinically-relevant, cognitive impairment in Parkinson's disease. If replicated and determined to be causative, they demonstrate that the dopamine system is instrumental to cognitive health status throughout the disease course. TRIAL REGISTRATION Parkinson's Progression Markers Initiative is registered with ClinicalTrials.gov (NCT01141023).
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Affiliation(s)
- Daniel Weintraub
- Department of PsychiatryPerelman School of Medicine at the University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Marina Picillo
- Assistant Professor in Neurology at the Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”University of SalernoItaly
| | - Hyunkeun Ryan Cho
- Department of Biostatistics, College of Public HealthUniversity of IowaIowa CityIowaUSA
| | | | - Cornelis Blauwendraat
- Center for Alzheimer's and Related Dementias, and the Integrative Neurogenomics Unit, Laboratory of NeurogeneticsNational Institute on Aging, National Institutes of HealthBethesdaMarylandUSA
| | - Ethan G. Brown
- Department of NeurologyWeill Institute for Neurosciences, University of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Lana M. Chahine
- Department of NeurologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Christopher S. Coffey
- Department of Biostatistics, College of Public HealthUniversity of IowaIowa CityIowaUSA
| | - Roseanne D. Dobkin
- Department of PsychiatryRutgers University, Robert Wood Johnson Medical SchoolPiscatawayNew JerseyUSA
| | - Tatiana Foroud
- Department of Medical and Molecular GeneticsIndiana UniversityIndianapolisIndianaUSA
| | - Doug Galasko
- Department of NeurologyUniversity of CaliforniaSan DiegoCaliforniaUSA
| | - Karl Kieburtz
- Department of NeurologyUniversity of Rochester Medical CenterRochesterNew YorkUSA
| | - Kenneth Marek
- Institute for Neurodegenerative DisordersNew HavenConnecticutUSA
| | - Kalpana Merchant
- Department of NeurologyNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Brit Mollenhauer
- Department of NeurologyUniversity Medical Center GoettingenGoettingenGermany
| | - Kathleen L. Poston
- Department of Neurology and Neurological SciencesStanford UniversityStanfordCaliforniaUSA
| | - Tanya Simuni
- Department of NeurologyNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Andrew Siderowf
- Department of NeurologyPerelman School of Medicine, University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Andrew Singleton
- Center for Alzheimer's and Related Dementias, and the Molecular Genetics SectionLaboratory of Neurogenetics, National Institute on Aging, National Institutes of HealthBethesdaMarylandUSA
| | - John Seibyl
- Institute for Neurodegenerative DisordersNew HavenConnecticutUSA
| | - Caroline M. Tanner
- Department of NeurologyWeill Institute for Neurosciences, University of California, San FranciscoSan FranciscoCaliforniaUSA
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Xu Y, Peremans K, Salden S, Audenaert K, Dobbeleir A, Van Eeckhaut A, De Bundel D, Saunders JH, Baeken C. Accelerated high frequency rTMS induces time-dependent dopaminergic alterations: a DaTSCAN brain imaging study in healthy beagle dogs. Front Vet Sci 2023; 10:1154596. [PMID: 37261109 PMCID: PMC10228829 DOI: 10.3389/fvets.2023.1154596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/03/2023] [Indexed: 06/02/2023] Open
Abstract
Aim The neurobiological effects of repetitive transcranial magnetic stimulation are believed to run in part through the dopaminergic system. Accelerated high frequency rTMS (aHF-rTMS), a new form of stimuli delivery, is currently being tested for its usefulness in treating human and canine mental disorders. However, the short-and long-term neurobiological effects are still unclear, including the effects on the dopaminergic system. In aHF-rTMS, multiple sessions are delivered within 1 day instead of one session per day, not only to accelerate the time to response but also to increase clinical efficacy. To gain more insight into the neurobiology of aHF-rTMS, we investigated whether applying five sessions in 1 day has direct and/or delayed effects on the dopamine transporter (DAT), and on dopamine metabolites of cerebrospinal fluid (CSF) in beagles. Materials and methods Thirteen beagles were randomly divided into two groups: five active stimulation sessions (n = 9), and 5 sham stimulation sessions (n = 4). Using DaTSCAN, DAT binding indices (BI) were obtained at baseline, after 1 day, 1 month, and 3 months post stimulation. CSF samples were collected after each scan. Results Active aHF-rTMS significantly reduced striatal DAT BI 1 day post-active stimulation session (p < 0.01), and the effect lasted to 1 month (p < 0.01). No significant DAT BI change was found in sham group. No significant changes in dopamine metabolites of CSF were found. Conclusion Although no significant effects on CSF dopamine metabolites were observed, five sessions of active aHF-rTMS significantly decreased striatal DAT BI after 1 day and up to 1 month post stimulation, indicating immediate and delayed effects on the brain dopaminergic system. Our findings in healthy beagles further substantiate the assumption that (a)HF-rTMS affects the brain dopaminergic system and it may pave the way to apply (a)HF-rTMS treatment in behaviorally disturbed dogs.
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Affiliation(s)
- Yangfeng Xu
- Department of Head and Skin, Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Kathelijne Peremans
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Sofie Salden
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Kurt Audenaert
- Department of Head and Skin, Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium
| | - Andre Dobbeleir
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Ann Van Eeckhaut
- Department of Pharmaceutical Chemistry, Drug Analysis and Drug Information (FASC), Research Group Experimental Pharmacology, Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium
| | - Dimitri De Bundel
- Department of Pharmaceutical Chemistry, Drug Analysis and Drug Information (FASC), Research Group Experimental Pharmacology, Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium
| | - Jimmy H Saunders
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Chris Baeken
- Department of Head and Skin, Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium
- Department of Psychiatry, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel (UZBrussel), Brussels, Belgium
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
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Palermo G, Giannoni S, Bellini G, Siciliano G, Ceravolo R. Dopamine Transporter Imaging, Current Status of a Potential Biomarker: A Comprehensive Review. Int J Mol Sci 2021; 22:11234. [PMID: 34681899 PMCID: PMC8538800 DOI: 10.3390/ijms222011234] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 11/16/2022] Open
Abstract
A major goal of current clinical research in Parkinson's disease (PD) is the validation and standardization of biomarkers enabling early diagnosis, predicting outcomes, understanding PD pathophysiology, and demonstrating target engagement in clinical trials. Molecular imaging with specific dopamine-related tracers offers a practical indirect imaging biomarker of PD, serving as a powerful tool to assess the status of presynaptic nigrostriatal terminals. In this review we provide an update on the dopamine transporter (DAT) imaging in PD and translate recent findings to potentially valuable clinical practice applications. The role of DAT imaging as diagnostic, preclinical and predictive biomarker is discussed, especially in view of recent evidence questioning the incontrovertible correlation between striatal DAT binding and nigral cell or axon counts.
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Affiliation(s)
- Giovanni Palermo
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.P.); (S.G.); (G.B.); (G.S.)
| | - Sara Giannoni
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.P.); (S.G.); (G.B.); (G.S.)
- Unit of Neurology, San Giuseppe Hospital, 50053 Empoli, Italy
| | - Gabriele Bellini
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.P.); (S.G.); (G.B.); (G.S.)
| | - Gabriele Siciliano
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.P.); (S.G.); (G.B.); (G.S.)
| | - Roberto Ceravolo
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.P.); (S.G.); (G.B.); (G.S.)
- Center for Neurodegenerative Diseases, Unit of Neurology, Parkinson’s Disease and Movement Disorders, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
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Pontone GM, Mills KA. Optimal Treatment of Depression and Anxiety in Parkinson's Disease. Am J Geriatr Psychiatry 2021; 29:530-540. [PMID: 33648830 DOI: 10.1016/j.jagp.2021.02.037] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 12/21/2022]
Abstract
Depression and anxiety are highly prevalent and have major adverse effects on function and quality of life in Parkinson's disease (PD). Optimal management requires that motor symptoms and psychiatric symptoms be simultaneously addressed. While there is fairly robust evidence for the treatment of motor symptoms, there are no completed randomized controlled trials to guide pharmacological treatment of anxiety in PD and no nonpharmacologic interventions have proven efficacious. Several high-quality trials for depression in PD suggest a number of antidepressants and cognitive behavioral therapy may help, but there is no data on rates of recurrence, comparative efficacy, or augmentation strategies. In order to address the gaps in knowledge, the authors provide a summary of the current evidence for treating depression and anxiety in PD and offer an algorithm that extends beyond the current literature based on clinical experience working in a multidisciplinary specialty center.
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Affiliation(s)
- Gregory M Pontone
- Department of Psychiatry and Behavioral Sciences (GMP), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (GMP, KAM), Johns Hopkins University School of Medicine, Baltimore, MD.
| | - Kelly A Mills
- Department of Neurology (GMP, KAM), Johns Hopkins University School of Medicine, Baltimore, MD
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Positron emission computed tomography/single photon emission computed tomography in Parkinson disease. Chin Med J (Engl) 2021; 133:1448-1455. [PMID: 32404694 PMCID: PMC7339301 DOI: 10.1097/cm9.0000000000000836] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Parkinson disease (PD) is the second-most common neurodegenerative disorder. Its main pathological mechanism is the selective degeneration and deletion of dopaminergic neurons in the dense part of the substantia nigra and the damage of dopaminergic neurons caused by the abnormal deposition of a Lewy body, leading to a decreased dopamine level. Positron emission computed tomography (PET)/single photon emission computed tomography (SPECT) is a molecular imaging technology that can directly or indirectly reflect changes in molecular levels by using a specific tracer. With the research and development on the tracers of related enzymes for labeling dopamine transporter and dopamine receptor and for being involved in dopamine formation, this imaging technology has been applied to all aspects of PD research. It not only contributes to clinical work but also provides an important theoretical basis for exploring the pathological mechanism of PD at a molecular level. Therefore, this review discusses the application value of PET/SPECT in PD in terms of early diagnosis, disease severity evaluation, clinical manifestations, differential diagnosis, and pathological mechanism.
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Upneja A, Paul BS, Jain D, Choudhary R, Paul G. Anxiety in Parkinson's Disease: Correlation with Depression and Quality of Life. J Neurosci Rural Pract 2021; 12:323-328. [PMID: 33986584 PMCID: PMC8110433 DOI: 10.1055/s-0041-1722840] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction Anxiety is common in patients with Parkinson's disease (PD). Its prevalence ranges from 20 to 40% but despite that, the high prevalence anxiety in PD is often undiagnosed and untreated. This research was aimed to study the pattern of anxiety with regard to its prevalence and risk factors and to establish the association of anxiety with depression and quality of life (QOL) in patients with PD. Methods A total of 105 patients with PD were prospectively observed. Demographic and clinical variables were recorded and patients were assessed for anxiety (the Parkinson anxiety scale [PAS]), depression (geriatric depression scale [GDS]), and QOL (Parkinson's Disease Questionnaire-39 [PDQ-39]). Multiple forward logistic regression analysis was done for parameters showing association with anxiety. Pearson's correlation was used to calculate the strength of association of depression and QOL with anxiety. Results Anxiety was present in 56 PD patients (53.3%). Episodic anxiety was noted in 50%, avoidance behavior in 35%, and persistent anxiety in 15% of these patients. There was significant association of anxiety with duration of disease ( p = 0.001), severity ( p < 0.005), levodopa equivalent dose (LED; p = 0.001), and tremor phenotype of PD ( p = 0.004). Anxiety coexisted with depression in 50 patients (79.4%), which was statistically significant in our cohort ( p = 0.001). There was significant linear relationship between the PAS and PDQ-39. Conclusion Anxiety exerts a negative impact on the QOL as revealed by proportionately worsening PDQ-39 and PAS scores. Screening for anxiety will allow efficient delivery of support and treatment to patients with PD and their families.
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Affiliation(s)
- Ankush Upneja
- Department of Internal Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Birinder S. Paul
- Department of Neurology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Dinesh Jain
- Department of Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Rupesh Choudhary
- Department of Psychiatry, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Gunchan Paul
- Department of Critical Care Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Carey G, Görmezoğlu M, de Jong JJ, Hofman PA, Backes WH, Dujardin K, Leentjens AF. Neuroimaging of Anxiety in Parkinson's Disease: A Systematic Review. Mov Disord 2021; 36:327-339. [PMID: 33289195 PMCID: PMC7984351 DOI: 10.1002/mds.28404] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/02/2020] [Accepted: 10/26/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The aim of this systematic review was (1) to identify the brain regions involved in anxiety in Parkinson's disease (PD) based on neuroimaging studies and (2) to interpret the findings against the background of dysfunction of the fear circuit and limbic cortico-striato-thalamocortical circuit. METHODS Studies assessing anxiety symptoms in PD patients and studies using magnetic resonance imaging, positron emission tomography, or single-photon emission computed tomography were included. RESULTS The severity of anxiety was associated with changes in the fear circuit and the cortico-striato-thalamocortical limbic circuit. In the fear circuit, a reduced gray-matter volume of the amygdala and the anterior cingulate cortex (ACC); an increased functional connectivity (FC) between the amygdala and orbitofrontal cortex (OFC) and hippocampus and between the striatum and the medial prefrontal cortex (PFC), temporal cortex, and insula; and a reduced FC between the lateral PFC and the OFC, hippocampus, and amygdala were reported. In the cortico-striato-thalamocortical limbic circuit, a reduced FC between the striatum and ACC; a reduced dopaminergic and noradrenergic activity in striatum, thalamus, and locus coeruleus; and a reduced serotoninergic activity in the thalamus were reported. CONCLUSION To conclude, anxiety is associated with structural and functional changes in both the hypothesized fear and the limbic cortico-striato-thalamocortical circuits. These circuits overlap and may well constitute parts of a more extensive pathway, of which different parts play different roles in anxiety. The neuropathology of PD may affect these circuits in different ways, explaining the high prevalence of anxiety in PD and also the associated cognitive, motor, and psychiatric symptoms. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Guillaume Carey
- School for Mental Health and Neurosciences (MHeNS)Maastricht UniversityMaastrichtthe Netherlands
- Université de Lille, Inserm, CHU Lille, Lille Neurosciences and CognitionLilleFrance
| | - Meltem Görmezoğlu
- Department of PsychiatryMaastricht University Medical CenterMaastrichtthe Netherlands
- Department of Psychiatry, Ondokuz Mayis University HospitalOndokuz Mayıs UniversitySamsunTurkey
| | - Joost J.A. de Jong
- School for Mental Health and Neurosciences (MHeNS)Maastricht UniversityMaastrichtthe Netherlands
- Department of Radiology and Nuclear MedicineMaastricht University Medical CenterMaastrichtthe Netherlands
| | - Paul A.M. Hofman
- School for Mental Health and Neurosciences (MHeNS)Maastricht UniversityMaastrichtthe Netherlands
- Department of Radiology and Nuclear MedicineMaastricht University Medical CenterMaastrichtthe Netherlands
| | - Walter H. Backes
- School for Mental Health and Neurosciences (MHeNS)Maastricht UniversityMaastrichtthe Netherlands
- Department of Radiology and Nuclear MedicineMaastricht University Medical CenterMaastrichtthe Netherlands
| | - Kathy Dujardin
- Université de Lille, Inserm, CHU Lille, Lille Neurosciences and CognitionLilleFrance
| | - Albert F.G. Leentjens
- School for Mental Health and Neurosciences (MHeNS)Maastricht UniversityMaastrichtthe Netherlands
- Department of PsychiatryMaastricht University Medical CenterMaastrichtthe Netherlands
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Mood and emotional disorders associated with parkinsonism, Huntington disease, and other movement disorders. HANDBOOK OF CLINICAL NEUROLOGY 2021; 183:175-196. [PMID: 34389117 DOI: 10.1016/b978-0-12-822290-4.00015-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This chapter provides a review of mood, emotional disorders, and emotion processing deficits associated with diseases that cause movement disorders, including Parkinson's disease, Lewy body dementia, multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration, frontotemporal dementia with parkinsonism, Huntington's disease, essential tremor, dystonia, and tardive dyskinesia. For each disorder, a clinical description of the common signs and symptoms, disease progression, and epidemiology is provided. Then the mood and emotional disorders associated with each of these diseases are described and discussed in terms of clinical presentation, incidence, prevalence, and alterations in quality of life. Alterations of emotion communication, such as affective speech prosody and facial emotional expression, associated with these disorders are also discussed. In addition, if applicable, deficits in gestural and lexical/verbal emotion are reviewed. Throughout the chapter, the relationships among mood and emotional disorders, alterations of emotional experiences, social communication, and quality of life, as well as treatment, are emphasized.
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Oh YS, Kim JH, Yoo SW, Hwang EJ, Lyoo CH, Lee KS, Kim JS. Neuropsychiatric symptoms and striatal monoamine availability in early Parkinson’s disease without dementia. Neurol Sci 2020; 42:711-718. [DOI: 10.1007/s10072-020-04859-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/24/2020] [Indexed: 10/23/2022]
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Kerstens VS, Varrone A. Dopamine transporter imaging in neurodegenerative movement disorders: PET vs. SPECT. Clin Transl Imaging 2020. [DOI: 10.1007/s40336-020-00386-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Abstract
Purpose
The dopamine transporter (DAT) serves as biomarker for parkinsonian syndromes. DAT can be measured in vivo with single-photon emission computed tomography (SPECT) and positron emission tomography (PET). DAT-SPECT is the current clinical molecular imaging standard. However, PET has advantages over SPECT measurements, and PET radioligands with the necessary properties for clinical applications are on the rise. Therefore, it is time to review the role of DAT imaging with SPECT compared to PET.
Methods
PubMed and Web of Science were searched for relevant literature of the previous 10 years. Four topics for comparison were used: diagnostic accuracy, quantitative accuracy, logistics, and flexibility.
Results
There are a few studies directly comparing DAT-PET and DAT-SPECT. PET and SPECT both perform well in discriminating neurodegenerative from non-neurodegenerative parkinsonism. Clinical DAT-PET imaging seems feasible only recently, thanks to simplified DAT assessments and better availability of PET radioligands and systems. The higher resolution of PET makes more comprehensive assessments of disease progression in the basal ganglia possible. Additionally, it has the possibility of multimodal target assessment.
Conclusion
DAT-SPECT is established for differentiating degenerative from non-degenerative parkinsonism. For further differentiation within neurodegenerative Parkinsonian syndromes, DAT-PET has essential benefits. Nowadays, because of wider availability of PET systems and radioligand production centers, and the possibility to use simplified quantification methods, DAT-PET imaging is feasible for clinical use. Therefore, DAT-PET needs to be considered for a more active role in the clinic to take a step forward to a more comprehensive understanding and assessment of Parkinson’s disease.
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Moguel-Cobos G, Saldivar C, Goslar PW, Shill HA. The Relationship Between Social Anxiety Disorder and Motor Symptoms of Parkinson Disease: A Pilot Study. PSYCHOSOMATICS 2020; 61:321-326. [PMID: 32386770 DOI: 10.1016/j.psym.2020.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 03/17/2020] [Accepted: 03/23/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND In patients with Parkinson disease (PD), motor symptoms coexist with several nonmotor neuropsychiatric symptoms. Various anxiety subtypes (generalized anxiety disorder, panic disorder, and social anxiety disorder [SAD]) are more prevalent in patients with PD than in the general population. OBJECTIVE We estimated the prevalence of SAD in early patients with PD and the relationship between severity of SAD and PD symptoms. METHODS The Liebowitz Social Anxiety Scale (LSAS) and Unified Parkinson's Disease Rating Scale (UPDRS) III, which assess function impairment, were used to grade symptom severity among 41 patients with early PD. Ratings were compared and analyzed in relation to UPDRS subdivisions. RESULTS UPDRS III and LSAS scores were not significantly correlated (r = 0.23, P = 0.14), but LSAS and UPDRS I, which evaluate nonanxiety psychiatric symptoms, were significantly correlated (r = 0.44; P = 0.004) and were stronger in the group not treated for PD (r = 0.82) but were in the group treated for PD (r = 0.28), although this difference did not reach statistical significance (P = 0.07 using the Fisher r-to-z transformation). LSAS also correlated with total UPDRS and UPDRS II (P ≤ 0.04). CONCLUSIONS Results suggest that SAD symptoms in patients with PD correlate with PD symptoms as evaluated by the total UPDRS and UPDRS I and II. In our pilot study, this correlation was higher in levodopa-untreated patients with PD but was not statistically significant. Because the UPDRS III and LSAS were not statistically significantly correlated, a direct motor correlation with SAD symptoms cannot be suggested. Further investigation is needed to clarify the relationship of SAD in patients with PD and potential treatment options.
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Affiliation(s)
- Guillermo Moguel-Cobos
- Muhammad Ali Parkinson Center, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ.
| | | | - Pamela W Goslar
- Muhammad Ali Parkinson Center, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ
| | - Holly A Shill
- Muhammad Ali Parkinson Center, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ
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13
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Dujardin K, Sgambato V. Neuropsychiatric Disorders in Parkinson's Disease: What Do We Know About the Role of Dopaminergic and Non-dopaminergic Systems? Front Neurosci 2020; 14:25. [PMID: 32063833 PMCID: PMC7000525 DOI: 10.3389/fnins.2020.00025] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 01/10/2020] [Indexed: 12/13/2022] Open
Abstract
Besides the hallmark motor symptoms (rest tremor, hypokinesia, rigidity, and postural instability), patients with Parkinson’s disease (PD) have non-motor symptoms, namely neuropsychiatric disorders. They are frequent and may influence the other symptoms of the disease. They have also a negative impact on the quality of life of patients and their caregivers. In this article, we will describe the clinical manifestations of the main PD-related behavioral disorders (depression, anxiety disorders, apathy, psychosis, and impulse control disorders). We will also provide an overview of the clinical and preclinical literature regarding the underlying mechanisms with a focus on the role of the dopaminergic and non-dopaminergic systems.
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Affiliation(s)
- Kathy Dujardin
- Inserm U1171 Degenerative and Vascular Cognitive Disorders, Lille University Medical Center, Lille, France
| | - Véronique Sgambato
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Lyon University, Bron, France
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14
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Pontone GM, Dissanayaka N, Apostolova L, Brown RG, Dobkin R, Dujardin K, Friedman JH, Leentjens AFG, Lenze EJ, Marsh L, Mari L, Monchi O, Richard IH, Schrag A, Strafella AP, Vernaleo B, Weintraub D, Mari Z. Report from a multidisciplinary meeting on anxiety as a non-motor manifestation of Parkinson's disease. NPJ Parkinsons Dis 2019; 5:30. [PMID: 31840044 PMCID: PMC6906437 DOI: 10.1038/s41531-019-0102-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 10/17/2019] [Indexed: 12/14/2022] Open
Abstract
Anxiety is a severe problem for at least one-third of people living with Parkinson's disease (PD). Anxiety appears to have a greater adverse impact on quality of life than motor impairment. Despite its high prevalence and impact on daily life, anxiety is often undiagnosed and untreated. To better address anxiety in PD, future research must improve knowledge about the mechanism of anxiety in PD and address the lack of empirical evidence from clinical trials. In response to these challenges, the Parkinson's Foundation sponsored an expert meeting on anxiety on June 13th and 14th 2018. This paper summarizes the findings from that meeting informed by a review of the existing literature and discussions among patients, caregivers, and an international, clinician-scientist, expert panel working group. The goal is to provide recommendations to improve our understanding and treatment of anxiety in PD.
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Affiliation(s)
- Gregory M. Pontone
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Nadeeka Dissanayaka
- The University of Queensland Centre for Clinical Research, Faculty of Medicine, Brisbane, Australia
- School of Psychology, The University of Queensland, Brisbane, Australia
- Department of Neurology, Royal Brisbane & Woman’s Hospital, Brisbane, Australia
| | - Liana Apostolova
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN USA
| | - Richard G. Brown
- Department of Psychology, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Roseanne Dobkin
- Department of Psychiatry, Rutgers University, Robert Wood Johnson Medical School, Piscataway, NJ USA
| | - Kathy Dujardin
- Department of Neurology and Movement Disorders, Lille University Medical Center, Lille, France
| | - Joseph H. Friedman
- Movement Disorders Program, Butler Hospital; Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI USA
| | - Albert F. G. Leentjens
- Department of Psychiatry, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Eric J. Lenze
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO USA
| | - Laura Marsh
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX USA
- Department of Psychiatry, Baylor College of Medicine, Houston, TX USA
| | - Lynda Mari
- Person Holistic Innovation, Las Vegas, NV USA
| | - Oury Monchi
- Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Irene H. Richard
- Department of Neurology, University of Rochester Medical Center, Rochester, NY USA
| | - Anette Schrag
- Department of Clinical and Movement Neurosciences, University College London, London, UK
| | - Antonio P. Strafella
- E.J. Safra Parkinson Disease Program, Toronto Western Hospital & Krembil Research Institute, UHN; Research Imaging Centre, Campbell Family Mental Health Research Institute, CAMH; University of Toronto, Ontario, Canada
| | | | - Daniel Weintraub
- Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA USA
- Parkinson’s Disease Research, Education and Clinical Center, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA USA
| | - Zoltan Mari
- Cleveland Clinic Lou Ruvo Center for Brain Health, Movement Disorders Program, Las Vegas, NV USA
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15
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Decreased Striatal Vesicular Monoamine Transporter Type 2 Correlates With the Nonmotor Symptoms in Parkinson Disease. Clin Nucl Med 2019; 44:707-713. [PMID: 31205154 DOI: 10.1097/rlu.0000000000002664] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Nonmotor symptoms (NMS) are critical players in the patients' quality of life in Parkinson disease (PD). Vesicular monoamine transporter type 2 (VMAT2) has been reported owing to a role in affecting dopamine neurons in the striatum. Therefore, this study set out to characterize the relationship between VMAT2 distribution in the striatum in relation to the NMS in PD. METHODS Totally, 21 age-matched normal controls and 37 patients with PD in the moderate stages were included, followed by examination using F-DTBZ (F-AV133) PET/CT. The specific uptake ratio (SUR) of each striatal subregion was then determined with the occipital cortex as the reference background region. The overall NMSs of each individual patient were evaluated. Finally, the role of the striatal SURs in the clinical symptom scores were evaluated through the application of a Spearman correlation analysis as well as a multivariable stepwise regression analysis. RESULTS Patients with PD, particularly those at a more advanced stage, exhibited a more pronounced reduction in SURs in the bilateral putamen and caudate nucleus (P < 0.05, vs healthy controls). Meanwhile, patients at more advanced PD stages were found to have significantly worse scores in NMS except cognitive function. The Spearman correlation analysis demonstrated that NMS scores, with the exception of cognition scores, were correlated with striatal SURs (P < 0.05). CONCLUSION The key findings of the study identified a correlation between decreased striatal VMAT2 with a broad spectrum of NMS in patients with PD, highlighting the association between diminished dopamine supply and the development of NMS in PD.
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16
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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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17
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Navalpotro-Gomez I, Dacosta-Aguayo R, Molinet-Dronda F, Martin-Bastida A, Botas-Peñin A, Jimenez-Urbieta H, Delgado-Alvarado M, Gago B, Quiroga-Varela A, Rodriguez-Oroz MC. Nigrostriatal dopamine transporter availability, and its metabolic and clinical correlates in Parkinson's disease patients with impulse control disorders. Eur J Nucl Med Mol Imaging 2019; 46:2065-2076. [PMID: 31273436 DOI: 10.1007/s00259-019-04396-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 06/10/2019] [Indexed: 01/11/2023]
Abstract
PURPOSE Previous studies in patients with Parkinson's disease (PD) and impulse control disorders (ICDs) have produced heterogeneous results regarding striatal dopamine transporter (DaT) binding and activity in the mesocorticolimbic network. Our aim here was to study the relationship between striatal DaT availability and cortical metabolism, as well as motor, behavioural and cognitive features of PD patients with ICD. METHODS In a group of PD patients with ICD (PD-ICD, n = 16) and 16 matched PD patients without ICD (PD-noICD, n = 16), DaT single-photon emission computed tomography (SPECT) imaging (DaTSCAN) was used to study DaT availability in predefined striatal volumes of interest (VOIs): putamen, caudate nucleus and ventral striatum (VS). In addition, the specific association of striatal DaT binding with cortical limbic and associative metabolic activity was evaluated by 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in PD-ICD patients and investigated using statistical parametric mapping (SPM8). Finally, associations between DaT availability and motor, behavioural and cognitive features were assessed. RESULTS PD-ICD patients had a significantly lower DaT density in the VS than PD-noICD patients, which was inversely associated with ICD severity. Lower DaT availability in the VS was associated with lower FDG uptake in several cortical areas belonging to the limbic and associative circuits, and in other regions involved in reward and inhibition processes (p < 0.0001 uncorrected; k > 50 voxels). No significant results were observed using a higher conservative threshold (p < 0.05; FDR corrected). PD-ICD patients also displayed impairment in interference and attentional Stroop Task execution, and more anxiety, all associated with reduced DaT availability in the VS and caudate nucleus. CONCLUSIONS ICDs in PD patients are related to reduced DaT binding in the VS, which accounts for dysfunction in a complex cortico-subcortical network that involves areas of the mesolimbic and mesocortical systems, being associated with reward evaluation, salience attribution and inhibitory control processes.
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Affiliation(s)
- I Navalpotro-Gomez
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastian, Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases, CIBERNED, Madrid, Spain
| | - R Dacosta-Aguayo
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastian, Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases, CIBERNED, Madrid, Spain
| | - F Molinet-Dronda
- MicroPET Research Unit, Center for Applied Medical Research, Universidad de Navarra, Pamplona, Spain
| | - A Martin-Bastida
- Department of Neurology, Clínica Universidad de Navarra, Universidad de Navarra, Pamplona, Spain
| | - A Botas-Peñin
- Department of Biomedical Engineering, Tecnun, Universidad de Navarra, Pamplona, Spain
| | - H Jimenez-Urbieta
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastian, Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases, CIBERNED, Madrid, Spain
| | - M Delgado-Alvarado
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastian, Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases, CIBERNED, Madrid, Spain.,Neurology Department, Sierrallana Hospital, Torrelavega, Spain
| | - B Gago
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastian, Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases, CIBERNED, Madrid, Spain
| | - A Quiroga-Varela
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastian, Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases, CIBERNED, Madrid, Spain.,Neuroscience Area, Center for Applied Medical Research (CIMA), Universidad de Navarra, Pamplona, Spain
| | - Maria C Rodriguez-Oroz
- Network Center for Biomedical Research in Neurodegenerative Diseases, CIBERNED, Madrid, Spain. .,Department of Neurology, Clínica Universidad de Navarra, Universidad de Navarra, Pamplona, Spain. .,Neuroscience Area, Center for Applied Medical Research (CIMA), Universidad de Navarra, Pamplona, Spain. .,Ikerbasque (Basque Foundation of Science), Bilbao, Spain. .,Basque Center on Cognition, Brain and Language (BCBL), San Sebastian, Spain.
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18
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Abstract
In addition to motor symptoms, behavioural complications are commonly found in patients with Parkinson's disease (PD). Behavioural complications, including depression, anxiety, apathy, impulse control disorder and psychosis, together have a large impact on PD patient's quality of life. Many neuroimaging studies using PET, SPECT and MRI techniques have been conducted to study the underlying neural mechanisms of PD pathogenesis and pathophysiology in relation to its behavioural complications. This review will survey these PET, SPECT and MRI studies to describe the current understanding of the neuro-chemical, functional and structural changes associated with behavioural complications in PD patients.
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19
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Ballanger B, Bath KG, Mandairon N. Odorants: a tool to provide nonpharmacological intervention to reduce anxiety during normal and pathological aging. Neurobiol Aging 2019; 82:18-29. [PMID: 31377537 DOI: 10.1016/j.neurobiolaging.2019.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 05/23/2019] [Accepted: 06/18/2019] [Indexed: 02/07/2023]
Abstract
Anxiety disorders represent 1 of the most common classes of psychiatric disorders. In the aging population and for patients with age-related pathology, the percentage of people suffering of anxiety is significantly elevated. Furthermore, anxiety carries with it an increased risk for a variety of age-related medical conditions, including cardiovascular disease, stroke, cognitive decline, and increased severity of motor symptoms in Parkinson's disease. A variety of anxiolytic compounds are available but often carry with them disturbing side effects that impact quality of life. Among nonmedicinal approaches to reducing anxiety, odor diffusion and aromatherapy are the most popular. In this review, we highlight the emerging perspective that the use of odorants may reduce anxiety symptoms or at least potentiate the effect of other anxiolytic approaches and may serve as an alternative form of therapy to deal with anxiety symptoms. Such approaches may be particularly beneficial in aging populations with elevated risk for these disorders. We also discuss potential neural mechanisms underlying the anxiolytic effects of odorants based on work in animal models.
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Affiliation(s)
- Benedicte Ballanger
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Neuroplasticity and Neuropathology of Olfactory Perception Team, Lyon F-69000, France; University Lyon, Lyon F-69000, France; University Lyon 1, Villeurbanne, F-69000, France
| | - Kevin G Bath
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence RI 02912, United States
| | - Nathalie Mandairon
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Neuroplasticity and Neuropathology of Olfactory Perception Team, Lyon F-69000, France; University Lyon, Lyon F-69000, France; University Lyon 1, Villeurbanne, F-69000, France.
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20
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Neuropsychiatric aspects of Parkinson’s disease. J Neural Transm (Vienna) 2019; 126:889-896. [DOI: 10.1007/s00702-019-02019-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 05/22/2019] [Indexed: 12/12/2022]
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21
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Eusebi P, Romoli M, Paoletti FP, Tambasco N, Calabresi P, Parnetti L. Risk factors of levodopa-induced dyskinesia in Parkinson's disease: results from the PPMI cohort. NPJ Parkinsons Dis 2018; 4:33. [PMID: 30480086 PMCID: PMC6240081 DOI: 10.1038/s41531-018-0069-x] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 10/24/2018] [Indexed: 11/10/2022] Open
Abstract
Levodopa-induced dyskinesias (LID) negatively impact on the quality of life of patients with Parkinson's disease (PD). We assessed the risk factors for LID in a cohort of de-novo PD patients enrolled in the Parkinson's Progression Markers Initiative (PPMI). This retrospective cohort study included all PD patients enrolled in the PPMI cohort. Main outcome was the incidence rate of dyskinesia, defined as the first time the patient reported a non-zero score in the item "Time spent with dyskinesia" of the MDS-UPDRS part IV. Predictive value for LID development was assessed for clinical and demographical features, dopamine transporter imaging (DaTscan) pattern, cerebrospinal fluid (CSF) biomarkers (Aβ42, total tau, phosphorylated tau, total α synuclein) and genetic risk score for PD. Overall, data from 423 PD patients were analyzed. The cumulative incidence rate of LID was 27.4% (95% CI = 23.2-32.0%), with a mean onset time of 5.81 years from PD diagnosis. Multivariate Cox regression analysis showed several factors predicting LID development, including female gender (HR = 1.61, 95% CI = 1.05-2.47), being not completely functional independent as measured by the modified Schwab & England ADL scale (HR = 1.81, 95% CI = 0.98-3.38), higher MDS-UPDRS part III score (HR = 1.03, 95% CI = 1.00-1.05), postural instability gait disturbances or intermediate phenotypes (HR = 1.95, 95% CI = 1.28-2.96), higher DaTscan caudate asymmetry index (HR = 1.02, 95% CI = 1.00-1.03), higher polygenic genetic risk score (HR = 1.39, 95% CI = 1.08-1.78), and an anxiety trait (HR = 1.02, 95% CI = 1.00-1.04). In PD patients, cumulative levodopa exposure, female gender, severity of motor and functional impairment, non-tremor dominant clinical phenotype, genetic risk score, anxiety, and marked caudate asymmetric pattern at DaTscan at baseline represent independent risk factors for developing LID.
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Affiliation(s)
- Paolo Eusebi
- Neurology Clinic, Department of Medicine, University of Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy
| | - Michele Romoli
- Neurology Clinic, Department of Medicine, University of Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy
| | - Federico Paolini Paoletti
- Neurology Clinic, Department of Medicine, University of Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy
| | - Nicola Tambasco
- Neurology Clinic, Department of Medicine, University of Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy
| | - Paolo Calabresi
- Neurology Clinic, Department of Medicine, University of Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy
- IRCCS Santa Lucia, Rome, Italy
| | - Lucilla Parnetti
- Neurology Clinic, Department of Medicine, University of Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy
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23
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Kim R, Lee J, Kim Y, Kim A, Jang M, Kim HJ, Jeon B, Kang UJ, Fahn S. Presynaptic striatal dopaminergic depletion predicts the later development of freezing of gait in de novo Parkinson's disease: An analysis of the PPMI cohort. Parkinsonism Relat Disord 2018. [DOI: 10.1016/j.parkreldis.2018.02.047] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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24
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Trojano L, Papagno C. Cognitive and behavioral disorders in Parkinson's disease: an update. II: behavioral disorders. Neurol Sci 2017; 39:53-61. [PMID: 29038946 DOI: 10.1007/s10072-017-3155-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 10/10/2017] [Indexed: 12/11/2022]
Abstract
Patients with Parkinson's disease (PD) can experience several behavioral symptoms, such as apathy, agitation, hypersexuality, stereotypic movements, pathological gambling, abuse of antiparkinsonian drugs, and REM sleep behavioral disorders. Psychoses and hallucinations, depression and anxiety disorders, and difficulties in recognizing and experiencing emotions also impair behavior and can cause severe psychosocial problems in patients with PD. Symptoms can be present since early stages of the disease, sometimes even before the appearance of classical motor symptoms, likely in relation to dopamine depletion in basal ganglia and/or to dysfunctions of other neurotrasmitter systems, and others can develop later, in some cases in relation to dopaminergic treatment. In this paper, we review recent literature, with particular attention to the last 5 years, on the main behavioral and emotional disturbances described in PD patients as well as the hypothesized neurofunctional substrate of such impairments. Finally, we provide some suggestions on the most suitable instruments to check and assess PD-associated behavioral defects over time.
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Affiliation(s)
- Luigi Trojano
- Department of Psychology, University of Campania 'Luigi Vanvitelli', Viale Ellittico 31, 81100, Caserta, Italy.
- ICS Maugeri, IRCCS, Telese Terme, Italy.
| | - Costanza Papagno
- CIMeC, University of Trento, Trento, Italy.
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo 1, 02100, Milan, Italy.
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