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Velescu DR, Marc MS, Traila D, Pescaru CC, Hogea P, Suppini N, Crisan AF, Wellmann N, Oancea C. A Narrative Review of Self-Reported Scales to Evaluate Depression and Anxiety Symptoms in Adult Obstructive Sleep Apnea Patients. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:261. [PMID: 38399548 PMCID: PMC10889932 DOI: 10.3390/medicina60020261] [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: 12/02/2023] [Revised: 01/14/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: Obstructive sleep apnea (OSA) is a prevalent chronic condition that has been associated with mental disorders like depression and anxiety. This study intends to provide a practical overview of the most relevant self-reported and self-rating scales that assess depression and anxiety in OSA patients. Materials and Methods: A search for articles was performed using PubMed, Google Scholar, and Semantic Scholar using a combination of words for obstructive sleep apnea, depression, anxiety, and scales. The tools were ordered by type (screening and rating) and arranged chronologically according to the year of publication. Results: Three scales were identified for assessing depression, which were the Center for Epidemiologic Studies Depression Scale (CES-D), the Hospital Anxiety and Depression Scale (HADS-D), and the Patient Health Questionnaire-9 (PHQ-9). For rating depression, two scales were discussed: the Zung Self-Rating Depression Scale (SDS) and the Beck Depression Inventory (BDI), which has three versions (the BDI, the BDI-II, and the Fast Screen (BDI-FS)). For assessing anxiety, the Generalized Anxiety Disorder-7 (GAD-7) scale was identified. Two scales were reviewed for rating anxiety: the State-Trait Anxiety Inventory (STAI) and the Beck Anxiety Inventory (BAI). Each scale is accompanied by a brief description of its practicality and psychometric qualities and an analysis of its strengths and limitations. Conclusions: The findings of this review will contribute to the understanding of the importance of assessing mental health comorbidities in the context of OSA, ultimately guiding clinical practice and future research in this area.
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Affiliation(s)
- Diana Raluca Velescu
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Monica Steluta Marc
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Daniel Traila
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Camelia Corina Pescaru
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Patricia Hogea
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Noemi Suppini
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Alexandru Florian Crisan
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Research Center for the Assessment of Human Motion, Functionality and Disability (CEMFD), “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Norbert Wellmann
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Cristian Oancea
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (D.R.V.); (D.T.); (C.C.P.); (P.H.); (N.S.); (A.F.C.); (C.O.)
- Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
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Firouzi M, Baetens K, Swinnen E, Baeken C, Van Overwalle F, Deroost N. Does transcranial direct current stimulation of the primary motor cortex improve implicit motor sequence learning in Parkinson's disease? J Neurosci Res 2024; 102:e25311. [PMID: 38400585 DOI: 10.1002/jnr.25311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024]
Abstract
Implicit motor sequence learning (IMSL) is a cognitive function that is known to be associated with impaired motor function in Parkinson's disease (PD). We previously reported positive effects of transcranial direct current stimulation (tDCS) over the primary motor cortex (M1) on IMSL in 11 individuals with PD with mild cognitive impairments (MCI), with the largest effects occurring during reacquisition. In the present study, we included 35 individuals with PD, with (n = 15) and without MCI (n = 20), and 35 age- and sex-matched controls without PD, with (n = 13) and without MCI (n = 22). We used mixed-effects models to analyze anodal M1 tDCS effects on acquisition (during tDCS), short-term (five minutes post-tDCS) and long-term reacquisition (one-week post-tDCS) of general and sequence-specific learning skills, as measured by the serial reaction time task. At long-term reacquisition, anodal tDCS resulted in smaller general learning effects compared to sham, only in the PD group, p = .018, possibly due to floor effects. Anodal tDCS facilitated the acquisition of sequence-specific learning (M = 54.26 ms) compared to sham (M = 38.98 ms), p = .003, regardless of group (PD/controls). Further analyses revealed that this positive effect was the largest in the PD-MCI group (anodal: M = 69.07 ms; sham: M = 24.33 ms), p < .001. Although the observed effect did not exceed the stimulation period, this single-session tDCS study confirms the potential of tDCS to enhance IMSL, with the largest effects observed in patients with lower cognitive status. These findings add to the body of evidence that anodal tDCS can beneficially modulate the abnormal basal ganglia network activity that occurs in PD.
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Affiliation(s)
- Mahyar Firouzi
- Brain, Body and Cognition Research Group, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Elsene, Belgium
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Jette, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Elsene, Belgium
| | - Kris Baetens
- Brain, Body and Cognition Research Group, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Elsene, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Elsene, Belgium
| | - Eva Swinnen
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Jette, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Elsene, Belgium
| | - Chris Baeken
- Brain, Body and Cognition Research Group, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Elsene, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Elsene, Belgium
- Department of Psychiatry and Medical Psychology, Ghent University, University Hospital Ghent (UZ Ghent), Ghent, Belgium
- Department of Psychiatry, Vrije Universiteit Brussel (VUB), Faculty of Medicine and Pharmacy, University Hospital Brussel (UZ Brussel), Brussels, Belgium
| | - Frank Van Overwalle
- Brain, Body and Cognition Research Group, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Elsene, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Elsene, Belgium
| | - Natacha Deroost
- Brain, Body and Cognition Research Group, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Elsene, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Elsene, Belgium
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Podlewska AM, Batzu L, Soukup T, Sevdalis N, Bakolis I, Derbyshire-Fox F, Hartley A, Healey A, Woods A, Crane N, Pariante C, Ray Chaudhuri K. The PD-Ballet study: study protocol for a randomised controlled single-blind hybrid type 2 clinical trial evaluating the effects of ballet dancing on motor and non-motor symptoms in Parkinson's disease. BMC Complement Med Ther 2024; 24:41. [PMID: 38233784 PMCID: PMC10792796 DOI: 10.1186/s12906-023-04296-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 12/06/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND To date, beneficial effects of multimodal exercise programmes on Parkinson's disease (PD) have focused on motor symptoms and little attention has been paid to the potential effects of such programmes on the non-motor symptoms of PD, which are now universally known as one of the key drivers of quality of life and a key unmet need. We aim to explore clinical effectiveness of a ballet-based dance programme in addressing non-motor and motor symptoms of Parkinson's disease across all stages of progression. METHODS A randomised, single-blind, controlled trial of 160 people with Parkinson's across all motor stages (Participants will be stratified into three groups of motor advancement: Hoehn and Yahr (HY) stages I and II being Mild Group, HY Stage III being Moderate Group and HY Stages IV and V being Severe Group) will be randomly allocated to either an intervention or a control group using an independent randomisation body. The primary outcome is an improvement in non-motor symptoms as measured by the Movement Disorders Society Non-Motor Scale (MDS-NMS). The intervention protocol consists of 12 one-weekly dance sessions led by English National Ballet. Each session is followed by a 'tea and biscuit' social time. Control group follows standard clinical pathway and joins the 'tea and biscuit' to control for any positive effects of social interactions. All participants are assessed at baseline, immediately after completion of the intervention and 3-6 months later to explore any potential longitudinal effects. DISCUSSION To our knowledge, no adequately powered study has explored the effects of a dance-based intervention on non-motor symptoms of Parkinson's disease, assessing these on both holistic and granular levels. We also aim to stratify participants in accordance with their motor state as assessed by. HY staging to explore specific effects on the symptoms at the initial, moderate and complex stages of the disease. If successful, this trial provides first evidence on clinical effectiveness of a ballet-based dance intervention for symptoms of Parkinson's disease, assessed in a robust, rigorous manner. TRIAL REGISTRATION NCT04719468.
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Affiliation(s)
- Aleksandra M Podlewska
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
- Parkinson's Foundation Centre of Excellence at King's College Hospital, London, UK.
| | - Lucia Batzu
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- Parkinson's Foundation Centre of Excellence at King's College Hospital, London, UK
| | - Tayana Soukup
- Imperial College London, Faculty of Medicine, London, UK
| | - Nick Sevdalis
- National University of Singapore, Yong Loo Lin School of Medicine, Singapore, Singapore
| | - Ioannis Bakolis
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | | | | | - Andy Healey
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Anthony Woods
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Nikki Crane
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Carmine Pariante
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - K Ray Chaudhuri
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- Parkinson's Foundation Centre of Excellence at King's College Hospital, London, UK
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Nuic D, van de Weijer S, Cherif S, Skrzatek A, Zeeboer E, Olivier C, Corvol J, Foulon P, Pastor JZ, Mercier G, Lau B, Bloem BR, De Vries NM, Welter M. Home-based exergaming to treat gait and balance disorders in patients with Parkinson's disease: A phase II randomized controlled trial. Eur J Neurol 2024; 31:e16055. [PMID: 37691341 PMCID: PMC11236010 DOI: 10.1111/ene.16055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 07/26/2023] [Accepted: 08/21/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Exergaming has been proposed to improve gait and balance disorders in Parkinson's disease (PD) patients. We aimed to assess the efficacy of a home-based, tailored, exergaming training system designed for PD patients with dopa-resistant gait and/or balance disorders in a controlled randomized trial. METHODS We recruited PD patients with dopa-resistant gait and/or balance disorders. Patients were randomly assigned (1:1 ratio) to receive 18 training sessions at home by playing a tailored exergame with full-body movements using a motion capture system (Active group), or by playing the same game with the computer's keyboard (Control group). The primary endpoint was the between-group difference in the Stand-Walk-Sit Test (SWST) duration change after training. Secondary outcomes included parkinsonian clinical scales, gait recordings, and safety. RESULTS Fifty PD patients were enrolled and randomized. After training, no significant difference in SWST change was found between groups (mean change SWST duration [SD] -3.71 [18.06] s after Active versus -0.71 [3.41] s after Control training, p = 0.61). Some 32% of patients in the Active and 8% in the Control group were considered responders to the training program (e.g., SWST duration change ≥2 s, p = 0.03). The clinical severity of gait and balance disorders also significantly decreased after Active training, with a between-group difference in favor of the Active training (p = 0.0082). Home-based training induced no serious adverse events. CONCLUSIONS Home-based training using a tailored exergame can be performed safely by PD patients and could improve gait and balance disorders. Future research is needed to investigate the potential of exergaming.
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Affiliation(s)
- Dijana Nuic
- Paris Brain InstituteCNRS UMR 7225INSERM 1127Sorbonne UniversityParisFrance
- LabCom Brain e‐NovationParis Brain InstituteParisFrance
| | - Sjors van de Weijer
- Donders Institute for Brain, Cognition, and Behavior and Department of NeurologyCenter of Expertise for Parkinson and MovementRadboud University Medical CenterNijmegenThe Netherlands
- Department of NeurologyMaastricht University Medical CenterMaastrichtThe Netherlands
| | - Saoussen Cherif
- Paris Brain InstituteCNRS UMR 7225INSERM 1127Sorbonne UniversityParisFrance
- LabCom Brain e‐NovationParis Brain InstituteParisFrance
| | - Anna Skrzatek
- Paris Brain InstituteCNRS UMR 7225INSERM 1127Sorbonne UniversityParisFrance
| | - Eline Zeeboer
- Donders Institute for Brain, Cognition, and Behavior and Department of NeurologyCenter of Expertise for Parkinson and MovementRadboud University Medical CenterNijmegenThe Netherlands
| | - Claire Olivier
- Paris Brain InstituteCNRS UMR 7225INSERM 1127Sorbonne UniversityParisFrance
- PANAM core facilityINSERM 1127Paris Brain InstituteParisFrance
| | - Jean‐Christophe Corvol
- Paris Brain InstituteCNRS UMR 7225INSERM 1127Sorbonne UniversityParisFrance
- Clinical Investigation CenterAssistance Publique Hôpitaux de ParisParisFrance
| | - Pierre Foulon
- LabCom Brain e‐NovationParis Brain InstituteParisFrance
- GENIOUS HealthcareMontpellierFrance
| | | | - Gregoire Mercier
- Biostatistics DepartmentCHU de MontpellierMontpellierFrance
- IDESP UA11Université de MontpellierINSERMMontpellierFrance
| | - Brian Lau
- Paris Brain InstituteCNRS UMR 7225INSERM 1127Sorbonne UniversityParisFrance
| | - Bastiaan R. Bloem
- Donders Institute for Brain, Cognition, and Behavior and Department of NeurologyCenter of Expertise for Parkinson and MovementRadboud University Medical CenterNijmegenThe Netherlands
| | - Nienke M. De Vries
- Donders Institute for Brain, Cognition, and Behavior and Department of NeurologyCenter of Expertise for Parkinson and MovementRadboud University Medical CenterNijmegenThe Netherlands
| | - Marie‐Laure Welter
- Paris Brain InstituteCNRS UMR 7225INSERM 1127Sorbonne UniversityParisFrance
- LabCom Brain e‐NovationParis Brain InstituteParisFrance
- PANAM core facilityINSERM 1127Paris Brain InstituteParisFrance
- CHU RouenNeurophysiology DepartmentRouen UniversityRouenFrance
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Sujith P, Arjunan P, Iype T, Natarajan V. Depression in Patients With Parkinson's Disease: A Hospital-Based Cross-Sectional Study. Cureus 2023; 15:e47214. [PMID: 38022066 PMCID: PMC10653116 DOI: 10.7759/cureus.47214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Depression, a common non-motor symptom in Parkinson's disease (PD), is often underdiagnosed and can significantly impact the quality of life (QOL) and treatment outcomes. Specific disease-related factors and non-specific factors may contribute to depression, and these factors should be identified early to plan the appropriate interventions that promote positive mood. The study aimed to assess the prevalence of depression in PD patients and to find out the factors associated with depression among patients with PD attending the neurology OPD of a tertiary care teaching hospital in Trivandrum. METHODS A cross-sectional study was conducted at the neurology OPD of Government Medical College Hospital, Trivandrum, from December 2021 to February 2023. We included patients with PD diagnosed according to the United Kingdom PD Society Brain Bank criteria. We collected data from 220 patients with PD by interview technique. Hospital Anxiety and Depression Scale (HADS) was used to assess depression and anxiety in this study. Staging and the severity of the motor symptoms were assessed using the Hoehn and Yahr scale and the Movement Disorder Society Unified Parkinson's Disease Rating Scale Part III (MDS UPDRS Part III), respectively. RESULTS Among 220 patients with PD, 31.8% (95% CI: 4.36-5.40) had depression. The non-specific variables, such as education, living arrangements, and gender, and disease-specific variables, such as the severity of motor symptoms (MDS UPDRS Part III score) and the Hoehn and Yahr staging of PD, had a statistically significant association with depression. Logistic regression analysis showed that the severity of motor symptoms (OR=2.69, p=0.004)) and female gender (OR=1.830, p= 0.05) were the independent factors associated with depression. CONCLUSION Depression is a common non-motor symptom of PD that is often underdiagnosed and undertreated and can significantly impact the QOL of patients and their caregivers. Hence, it should be identified early and managed by pharmacological and non-pharmacological strategies.
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Affiliation(s)
- Priya Sujith
- Medical Surgical Nursing, Government College of Nursing, Trivandrum, IND
- Nursing, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Porkodi Arjunan
- Medical Surgical Nursing, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Thomas Iype
- Neurology, Government Medical College, Trivandrum, IND
| | - Venkatesh Natarajan
- Physiotherapy, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
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Kilinc B, Cetisli-Korkmaz N, Bir LS, Marangoz AD, Senol H. The quality of life in individuals with Parkinson's Disease: is it related to functionality and tremor severity? A cross-sectional study. Physiother Theory Pract 2023:1-10. [PMID: 37515776 DOI: 10.1080/09593985.2023.2236691] [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: 04/25/2023] [Revised: 07/10/2023] [Accepted: 07/10/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Symptoms seen in Parkinson's Disease (PD) affect the quality of life (QoL) of individuals. OBJECTIVES This study aimed to examine the relationship of QoL with tremor severity and upper limb functionality in individuals with PD. METHODS Parkinson's Disease Quality of Life Questionnaire (PDQ-39) was used to examine the QoL of the participants, electromyography was used to measure the tremor amplitude, Nine-Hole Peg Test (NHPT) was used to evaluate the upper limb functionality and dynamometer was used to evaluate grip and pinch strength. Resting and postural tremor amplitudes were recorded from both sides of the hand and forearm. The relationship between QoL and other parameters was tested with Spearman Correlation Analysis. Mann-Whitney U test was used to compare individuals with and without tremor. RESULTS It was obtained that tremor amplitude was significantly related to: activities of daily living (rho = 0.597); emotional well-being (rho = 0.694); stigma (rho = 0.524); social support (rho = 0.595 and 0.559), and communication [rho = 0.532 (right forearm), 0.564 (left forearm), and 0.527 (right hand)] sub-parameters of PDQ-39 (p < .05). The relationship of the grip and pinch strength with the PDQ-39 sub-parameters was significant (p < .05), except for social support and communication. The relationship between NHPT and almost all parameters of PDQ-39 (p < .05), except bodily discomfort and social support, was significant. CONCLUSION It was concluded that future studies focusing on QoL could also consider tremor severity and grip strength as well as dexterity in individuals with PD.
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Affiliation(s)
- Buse Kilinc
- Institute of Health Sciences, Department of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Türkiye
| | | | - Levent Sinan Bir
- Faculty of Medicine, Department of Neurology, Pamukkale University, Denizli, Türkiye
| | - Ahmet Dogucem Marangoz
- Department of Geriatric Psychiatry and Psychotherapy, Klinikum Stuttgart, Stuttgart, Germany
| | - Hande Senol
- Faculty of Medicine, Department of Biostatistics, Pamukkale University, Denizli, Türkiye
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Kwok JYY, Auyeung M, Pang SYY, Ho PWL, Yu DSF, Fong DYT, Lin CC, Walker R, Wong SYS, Ho RTH. A randomized controlled trial on the effects and acceptability of individual mindfulness techniques - meditation and yoga - on anxiety and depression in people with Parkinson's disease: a study protocol. BMC Complement Med Ther 2023; 23:241. [PMID: 37461018 PMCID: PMC10351114 DOI: 10.1186/s12906-023-04049-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 06/21/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Between 40 and 50% of patients with Parkinson's disease (PD) experience anxiety and depression, associated with impaired physical function, high care dependency and mortality. Recently, the United States National Institutes of Health has urged the implementation of mindfulness practices in chronic illness care. Most research to date has examined the effects on chronically ill patients of complex interventions using a combination of mindfulness techniques. In PD patients, however, such complex modalities appear to hinder the technique mastery. Hence, the aim of this trial is to investigate the effects and underlying mechanism of individual mindfulness techniques among PD patients, as well as exploring participants' experience in using individual mindfulness techniques as a lifestyle intervention for stress and symptom management. METHODS We will conduct an assessor-blind three-arm randomized waitlist-controlled trial with a descriptive qualitative evaluation. Up to 168 PD patients will be recruited from community settings and out-patient clinics, and randomized to meditation, yoga, or usual care group. Meditation and yoga sessions of 90-minute are held weekly for 8 weeks. Primary outcomes include anxiety and depression. Secondary outcomes include PD-related motor and non-motor symptoms and quality-of-life; and level of mindfulness and biomarkers of stress and inflammatory responses will be measured as mediating variables. All outcome evaluations will be assessed at baseline, 8 weeks, and 24 weeks. Following the intention-to-treat principle, generalized estimating equation models and path analysis will be used to identify the treatment effects and the mediating mechanisms. A subsample of 30 participants from each intervention group will be invited for qualitative interviews. DISCUSSION The study would also generate important insights to enhance the patients' adaptation to debilitating disease. More specifically, symptom management and stress adaptation are highly prioritized healthcare agenda in managing PD. The research evidence will further inform the development of community-based, nurse-led compassionate care models for neurodegenerative conditions, which is complementary to existing health services. TRIAL REGISTRATION WHO Primary Registry - Chinese Clinical Trials Registry number: ChiCTR2100045939; registered on 2021/04/29 ( https://www.chictr.org.cn/showproj.html?proj=125878 ).
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Affiliation(s)
- Jojo Yan Yan Kwok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Man Auyeung
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong SAR
| | | | - Philip Wing Lok Ho
- Division of Neurology, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR
- The State Key Laboratory of Marine Pollution, City University of Hong Kong, Kowloon Tong, Hong Kong SAR
| | - Doris Sau Fung Yu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Chia-chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Richard Walker
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Newcastle, UK
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Samuel Yeung-shan Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
- CUHK Thomas Jing Centre for Mindfulness Research and Training, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Rainbow Tin Hung Ho
- Centre on Behavioral Health, The University of Hong Kong, Pokfulam, Hong Kong SAR
- Department of Social Work & Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR
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Sakai K, Kawasaki T, Kiminarita H, Ikeda Y. Longitudinal Changes in Motor Estimation Error and Motor Function in Patients with Parkinson's Disease: A Case Report. MEDICINES (BASEL, SWITZERLAND) 2023; 10:42. [PMID: 37505063 PMCID: PMC10385803 DOI: 10.3390/medicines10070042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND AND OBJECTIVES This report described two cases with clear longitudinal changes in motor estimation error (difference between the motor imagery and motor execution) and their progression and motor and activities of daily living (ADL) function changes in patients with PD. MATERIALS AND METHODS Patient 1 was a 68-year-old man (Hoehn and Yahr [H and Y] stage: IV, diagnosed with PD for 11.8 years) and patient 2 was a 68-year-old woman (H and Y stage: II, diagnosed with PD for 9.6 years). Imagined two-step test (iTST), two-step test (TST), and PD-related assessments (Unified Parkinson's Disease Rating Scale [UPDRS], and Freezing of Gait Questionnaire [FOGQ]) were assessed at baseline and after 6 months. Motor estimation error was calculated as the iTST distance minus TST distance. RESULTS In patient 1, motor estimation error was greater after 6 months (baseline: 5.7 [4.8%]/after 6 months: 25.7 cm [26.1%]). Moreover, UPDRS and FOGQ total scores deteriorated after 6 months (UPDRS total: 29/34 point, and FOGQ: 9/16 point). Conversely, in patient 2, motor estimation error did not change notably (-3.6 [7.6%]/-2.5 cm [7.0%]), while UPDRS and FOGQ total scores improved after 6 months (UPDRS total: 17/12 point, and FOGQ: 6/1 point). CONCLUSIONS This report indicated that greater motor estimation error may be associated with declining motor and ADL function and disease progression in patients with PD.
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Affiliation(s)
- Katsuya Sakai
- Department of Physical Therapy, Faculty of Health Sciences, Tokyo Metropolitan University, Tokyo 116-8551, Japan
| | - Tsubasa Kawasaki
- Department of Physical Therapy, School of Health Sciences, Tokyo International University, Kawagoe 350-1197, Japan
| | - Hiroya Kiminarita
- Department of Rehabilitation, Kirameki Visiting Nursing Rehabilistation, Kawagoe 350-0033, Japan
| | - Yumi Ikeda
- Department of Physical Therapy, Faculty of Health Sciences, Tokyo Metropolitan University, Tokyo 116-8551, Japan
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Molina-Mateo D, Valderrama BP, Zárate RV, Hidalgo S, Tamayo-Leiva J, Soto A, Guerra S, Arriagada V, Oliva C, Diez B, Campusano JM. Kanamycin treatment in the pre-symptomatic stage of a Drosophila PD model prevents the onset of non-motor alterations. Neuropharmacology 2023; 236:109573. [PMID: 37196855 DOI: 10.1016/j.neuropharm.2023.109573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 05/19/2023]
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor alterations, which is preceded by a prodromal stage where non-motor symptoms are observed. Over recent years, it has become evident that this disorder involves other organs that communicate with the brain like the gut. Importantly, the microbial community that lives in the gut plays a key role in this communication, the so-called microbiota-gut-brain axis. Alterations in this axis have been associated to several disorders including PD. Here we proposed that the gut microbiota is different in the presymptomatic stage of a Drosophila model for PD, the Pink1B9 mutant fly, as compared to that observed in control animals. Our results show this is the case: there is basal dysbiosis in mutant animals evidenced by substantial difference in the composition of midgut microbiota in 8-9 days old Pink1B9 mutant flies as compared with control animals. Further, we fed young adult control and mutant flies kanamycin and analyzed motor and non-motor behavioral parameters in these animals. Data show that kanamycin treatment induces the recovery of some of the non-motor parameters altered in the pre-motor stage of the PD fly model, while there is no substantial change in locomotor parameters recorded at this stage. On the other hand, our results show that feeding young animals the antibiotic, results in a long-lasting improvement of locomotion in control flies. Our data support that manipulations of gut microbiota in young animals could have beneficial effects on PD progression and age-dependent motor impairments.
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Affiliation(s)
- D Molina-Mateo
- Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Chile; Centro Interdisciplinario de Neurociencia UC, Pontificia Universidad Católica de Chile, Chile
| | - B P Valderrama
- Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Chile
| | - R V Zárate
- Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Chile
| | - S Hidalgo
- Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Chile
| | - J Tamayo-Leiva
- Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Chile; Center for Genome Regulation, Faculty of Science, University of Chile, Santiago, Chile
| | - A Soto
- Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Chile
| | - S Guerra
- Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Chile
| | - V Arriagada
- Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Chile
| | - C Oliva
- Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Chile
| | - B Diez
- Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Chile; Center for Genome Regulation, Faculty of Science, University of Chile, Santiago, Chile; Center for Climate and Resilience Research, University of Chile, Santiago, Chile
| | - J M Campusano
- Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Chile; Centro Interdisciplinario de Neurociencia UC, Pontificia Universidad Católica de Chile, Chile.
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10
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Huang M, Zheng B, Zhou W, Fu H, Chen X, Wu H, Zhang J, Zhou X. High-Frequency Repetitive Magnetic Stimulation at the Sacrum Alleviates Chronic Constipation in Parkinson's Patients. Ann Indian Acad Neurol 2023; 26:235-240. [PMID: 37538410 PMCID: PMC10394460 DOI: 10.4103/aian.aian_1001_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/22/2023] [Accepted: 02/16/2023] [Indexed: 08/05/2023] Open
Abstract
Objective This study was to investigate the therapeutic effect of high-frequency repetitive magnetic stimulation (HF-rMS) at the sacrum for chronic constipation in Parkinson's patients (PD). Materials and Methods Eventually 48 PD patients were enrolled from July 2019 to October 2020, and randomly divided into the HF-rMS group (the intervention group, n = 24) and the sham HF-rMS group (the control group, n = 24). The intervention group received HF-rMS at the sacrum, whereas the control group received ineffective magnetic stimulation. We performed clinical evaluation before and after HF-rMS treatment, including constipation score scale (KESS questionnaire), Unified Parkinson's Disease Rating Scale (UPDRS-III exercise examination), Hoehn-Yahr (H-Y) stage of motor function; simple mental status scale (MMSE), anxiety/depression table (HAD-A/HAD-D), the activity of daily living (ADL), and quality of life scale for patients with constipation (PAC-QOL) to evaluate symptoms and satisfaction of PD patients with chronic constipation. Results There was no significant difference in the clinical characteristics between the two groups. As compared to the control group, the HF-rMS group displayed a larger change (pre and posttreatment) in the KESS scores of PD patients with chronic constipation, suggesting a significant improvement. Moreover, HF-rMS significantly promoted the mood, activity of daily living, and quality of life of PD patients when comparing the alteration of HAD-A/HAD-D scores, ADL scores, and PAC-QOL scores between the two groups. Finally, there was no significant difference in the change of the UPDRS III score and the MMSE score between the two groups. Conclusion HF-rMS at the sacrum can improve chronic constipation in PD patients.
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Affiliation(s)
- Mei Huang
- Department of Neurology, Nursing Unit, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Bofang Zheng
- Department of Neurology, Nursing Unit, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
- Special Medical Service Center, Neuroscience Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Wanfei Zhou
- Special Medical Service Center, Neuroscience Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Huaili Fu
- Special Medical Service Center, Neuroscience Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Xinrun Chen
- Department of Clinical Medicine, The First Clinical College of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Heyong Wu
- Special Medical Service Center, Neuroscience Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Jianguo Zhang
- Special Medical Service Center, Neuroscience Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Xianju Zhou
- Department of Neurology, Nursing Unit, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
- Special Medical Service Center, Neuroscience Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
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11
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Erga AH, Alves G, Leentjens AF. The ePark study protocol: A decentralized trial of individual video-assisted cognitive behavioural therapy for depressive disorder in Parkinson's disease. Contemp Clin Trials Commun 2023; 32:101080. [PMID: 36817735 PMCID: PMC9931891 DOI: 10.1016/j.conctc.2023.101080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/06/2023] [Accepted: 01/28/2023] [Indexed: 02/05/2023] Open
Affiliation(s)
- Aleksander H. Erga
- The Norwegian Centre for Movement Disorders, Stavanger, Norway
- Institute of Social Sciences, University of Stavanger, Stavanger, Norway
- Center for Alcohol and Drug Research (KORFOR), Stavanger University Hospital, Stavanger, Norway
| | - Guido Alves
- The Norwegian Centre for Movement Disorders, Stavanger, Norway
- Department of Chemistry, Bioscience and Environmental Engineering, University of Stavanger, Stavanger, Norway
- Department of Neurology, Stavanger University Hospital, Stavanger, Norway
| | - Albert F.G. Leentjens
- Department of Psychiatry, Maastricht University Medical Center, Maastricht, the Netherlands
- School of Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
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12
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A randomized clinical trial of mindfulness meditation versus exercise in Parkinson's disease during social unrest. NPJ Parkinsons Dis 2023; 9:7. [PMID: 36681670 PMCID: PMC9862216 DOI: 10.1038/s41531-023-00452-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/06/2023] [Indexed: 01/22/2023] Open
Abstract
Clinical practice guidelines support resilience training and exercise for patients with Parkinson's disease (PD). This assessor-blinded, randomized clinical trial aimed to compare the effects of a modified mindfulness meditation program versus stretching and resistance training exercise (SRTE) in patients with mild-to-moderate PD. A total of 126 potential participants were enrolled via convenience sampling, of which 68 eligible participants were randomized 1:1 to receive eight weekly 90-min sessions of mindfulness meditation or SRTE. Compared to the SRTE group, generalized estimating equation analyses revealed that the mindfulness group had significantly better improvement in outcomes, particularly for improving depressive symptoms (d, -1.66; 95% CI, -3.31 to -0.02) at week 8 and maintaining emotional non-reactivity at week 20 (d, 2.08; 95% CI, 0.59 to 3.56). Both groups demonstrated significant immediate, small-moderate effects on cognition (effect size [d] = 0.36-0.37, p = 0.006-0.011). Compared with the SRTE, mindfulness meditation appeared to be a feasible and promising strategy for managing depressive symptoms and maintaining emotional stability, with comparable benefits on cognitive performance. To combat the psychospiritual and cognitive sequelae of social unrest and COVID-19 pandemic, the integration of mindfulness training into motor-oriented PD rehabilitation protocols is recommended to strengthen the resilience and minimize the psycho-cognitive comorbidities among patients with mild-to-moderate PD.Trial Registration: HKU Clinical Trials Registry identifier: HKUCTR-2681.
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13
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Anxiety and depression in Charcot-Marie-Tooth disease: data from the Italian CMT national registry. J Neurol 2023; 270:394-401. [PMID: 36114297 PMCID: PMC9483245 DOI: 10.1007/s00415-022-11365-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/09/2022] [Accepted: 08/30/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND There is little information about neuropsychiatric comorbidities in Charcot-Marie-Tooth disease (CMT). We assessed frequency of anxiety, depression, and general distress in CMT. METHODS We administered online the Hospital Anxiety-Depression Scale (HADS) to CMT patients of the Italian registry and controls. HADS-A and HADS-D scores ≥ 11 defined the presence of anxiety/depression and HADS total score (HADS-T) ≥ 22 of general distress. We analysed correlation with disease severity and clinical characteristics, use of anxiolytics/antidepressants and analgesic/anti-inflammatory drugs. RESULTS We collected data from 252 CMT patients (137 females) and 56 controls. CMT patient scores for anxiety (mean ± standard deviation, 6.7 ± 4.8), depression (4.5 ± 4.0), and general distress (11.5 ± 8.1) did not differ from controls and the Italian population. However, compared to controls, the percentages of subjects with depression (10% vs 2%) and general distress (14% vs 4%) were significantly higher in CMT patients. We found no association between HADS scores and disease duration or CMT type. Patients with general distress showed more severe disease and higher rate of positive sensory symptoms. Depressed patients also had more severe disease. Nineteen percent of CMT patients took antidepressants/anxiolytics (12% daily) and 70% analgesic/anti-inflammatory drugs. Patients with anxiety, depression, and distress reported higher consumption of anxiolytics/antidepressants. About 50% of patients with depression and/or general distress did not receive any specific pharmacological treatment. CONCLUSIONS An appreciable proportion of CMT patients shows general distress and depression. Both correlated with disease severity and consumption of antidepressants/anxiolytics, suggesting that the disease itself is contributing to general distress and depression.
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Sampedro F, Puig-Davi A, Martinez-Horta S, Pagonabarraga J, Horta-Barba A, Aracil-Bolaños I, Kulisevsky J. Cortical macro and microstructural correlates of cognitive and neuropsychiatric symptoms in Parkinson's disease. Clin Neurol Neurosurg 2022; 224:107531. [PMID: 36455303 DOI: 10.1016/j.clineuro.2022.107531] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cognitive and neuropsychiatric disturbances in Parkinson's disease are as common and as disabling as its well-known motor symptoms. Even though several neural substrates for these symptoms have been suggested, to which extent these symptoms reflect cortical neurodegeneration in Parkinson's disease remains to be fully elucidated. METHODS In a representative sample of 44 Parkinson's disease patients, the data about the following symptoms was recorded: cognitive performance, apathy, depression and anxiety. Surface-based vertexwise multiple regression analyses were performed to investigate the cortical macro (cortical thinning) and microstructural (increased intracortical diffusivity) correlates of each symptom. A group of 18 healthy controls with similar sociodemographics was also included to assess the disease specificity of the neuroimaging results. RESULTS Compared to healthy controls, Parkinson's disease patients showed significantly increased scores in all the considered non-motor scales (p < 0.01). Within the Parkinson's disease group, increased scores in these scales were associated with cortical macro- and microstructural neurodegeneration (p < 0.05 corrected). Each of the considered non-motor scales was associated with a specific pattern of cortical degeneration. When observing both neuroimaging techniques, intracortical diffusivity revealed similar but extensive patterns of cortical compromise than cortical thickness for each symptom, with the exception of anxiety. CONCLUSIONS Cognitive and neuropsychiatric symptoms in Parkinson's disease reflect cortical degeneration. Increases in intracortical diffusivity were able to detect symptom-specific cortical microstructural damage in the absence of cortical thinning. A better understanding of this association may contribute to characterize the brain circuitry and the neurotransmitter pathways underlying these highly prevalent and debilitating symptoms in Parkinson's disease.
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Affiliation(s)
- Frederic Sampedro
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain; Radiology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Arnau Puig-Davi
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain; Institute of Neurosciences, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Saul Martinez-Horta
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Javier Pagonabarraga
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Andrea Horta-Barba
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain; Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
| | - Ignacio Aracil-Bolaños
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Jaime Kulisevsky
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain.
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15
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Carrozzino D, Christensen KS, Patierno C, Siri C, Zecchinelli A, Pezzoli G, Cosci F. The Hopkins Symptom Checklist (SCL-90-R): A Patient-Reported Outcome Measure in Parkinson's Disease. J Geriatr Psychiatry Neurol 2022; 35:689-697. [PMID: 34971324 DOI: 10.1177/08919887211060020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: This is the first study applying Clinimetric Patient-Reported Outcome Measures (CLIPROM) criteria to evaluate the construct validity, sensitivity, and clinical utility of the SCL-90-R in patients with Parkinson's disease (PD). Methods: A Rasch analysis was conducted using a sample of 488 PD outpatients. Results: Testing for dimensionality revealed that less than 5% of t-tests were significant, indicating that the SCL-90-R subscales entailed the property of construct validity. As to the total score, a Person Separation Reliability Index of .96 was found. Conclusions: The SCL-90-R total score is a sensitive screening measure that can be used not only to differentiate healthy stress reactions from symptoms of psychological distress but also to detect PD patients with an increased risk for psychiatric complications. As to the subscales, the brief versions that did not include misfitting items should be used to assess the severity of specific symptoms of psychological distress affecting PD patients.
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Affiliation(s)
- Danilo Carrozzino
- Department of Psychology "Renzo Canestrari", 9296University of Bologna, Bologna, Italy
| | - Kaj Sparle Christensen
- Research Unit for General Practice and Section for General Medical Practice, Department of Public Health, 1006Aarhus University, Aarhus, Denmark
| | - Chiara Patierno
- Department of Psychology "Renzo Canestrari", 9296University of Bologna, Bologna, Italy
| | - Chiara Siri
- Rehabilitation Unit, 89497Moriggia Pelascini Hospital, Como, Italy
| | | | - Gianni Pezzoli
- 18605Parkinson Institute, Pini-CTO, Milan, Italy.,Fondazione Grigioni per Il Morbo di Parkinson, Milan, Italy
| | - Fiammetta Cosci
- Department of Health Sciences, 9300University of Florence, Florence, Italy.,Department of Psychiatry & Neuropsychology, Maastricht University, Maastricht, The Netherlands
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Marín‐Lahoz J, Martinez‐Horta S, Pagonabarraga J, Horta‐Barba A, Aracil‐Bolaños I, Bejr‐kasem H, Sampedro F, Campolongo A, Kulisevsky J. Predicting Impulse Control Disorders in Parkinson’s disease through incentive biomarkers. Ann Neurol 2022; 92:974-984. [DOI: 10.1002/ana.26486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Juan Marín‐Lahoz
- Neurology Department Miguel Servet University Hospital Zaragoza Spain
- Instituto de Investigación Sanitaria de Aragón Zaragoza Spain
- Universitat Autònoma de Barcelona (U.A.B.), Medicine Department Barcelona Spain
| | - Saül Martinez‐Horta
- Universitat Autònoma de Barcelona (U.A.B.), Medicine Department Barcelona Spain
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital Barcelona Spain
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
| | - Javier Pagonabarraga
- Universitat Autònoma de Barcelona (U.A.B.), Medicine Department Barcelona Spain
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital Barcelona Spain
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
| | - Andrea Horta‐Barba
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital Barcelona Spain
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
| | - Ignacio Aracil‐Bolaños
- Universitat Autònoma de Barcelona (U.A.B.), Medicine Department Barcelona Spain
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital Barcelona Spain
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
| | - Helena Bejr‐kasem
- Universitat Autònoma de Barcelona (U.A.B.), Medicine Department Barcelona Spain
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital Barcelona Spain
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
| | - Frederic Sampedro
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
| | - Antonia Campolongo
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital Barcelona Spain
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
| | - Jaime Kulisevsky
- Universitat Autònoma de Barcelona (U.A.B.), Medicine Department Barcelona Spain
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital Barcelona Spain
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
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Prange S, Klinger H, Laurencin C, Danaila T, Thobois S. Depression in Patients with Parkinson's Disease: Current Understanding of its Neurobiology and Implications for Treatment. Drugs Aging 2022; 39:417-439. [PMID: 35705848 PMCID: PMC9200562 DOI: 10.1007/s40266-022-00942-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2022] [Indexed: 12/11/2022]
Abstract
Depression is one of the most frequent and burdensome non-motor symptoms in Parkinson’s disease (PD), across all stages. Even when its severity is mild, PD depression has a great impact on quality of life for these patients and their caregivers. Accordingly, accurate diagnosis, supported by validated scales, identification of risk factors, and recognition of motor and non-motor symptoms comorbid to depression are critical to understanding the neurobiology of depression, which in turn determines the effectiveness of dopaminergic drugs, antidepressants and non-pharmacological interventions. Recent advances using in vivo functional and structural imaging demonstrate that PD depression is underpinned by dysfunction of limbic networks and monoaminergic systems, depending on the stage of PD and its associated symptoms, including apathy, anxiety, rapid eye movement sleep behavior disorder (RBD), cognitive impairment and dementia. In particular, the evolution of serotonergic, noradrenergic, and dopaminergic dysfunction and abnormalities of limbic circuits across time, involving the anterior cingulate and orbitofrontal cortices, amygdala, thalamus and ventral striatum, help to delineate the variable expression of depression in patients with prodromal, early and advanced PD. Evidence is accumulating to support the use of dual serotonin and noradrenaline reuptake inhibitors (desipramine, nortriptyline, venlafaxine) in patients with PD and moderate to severe depression, while selective serotonin reuptake inhibitors, repetitive transcranial magnetic stimulation and cognitive behavioral therapy may also be considered. In all patients, recent findings advocate that optimization of dopamine replacement therapy and evaluation of deep brain stimulation of the subthalamic nucleus to improve motor symptoms represents an important first step, in addition to physical activity. Overall, this review indicates that increasing understanding of neurobiological changes help to implement a roadmap of tailored interventions for patients with PD and depression, depending on the stage and comorbid symptoms underlying PD subtypes and their prognosis.
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Affiliation(s)
- Stéphane Prange
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, NS-PARK/FCRIN Network, 59 Boulevard Pinel, 69500, Bron, France. .,Physiopathology of the Basal Ganglia Team, Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, 67 Boulevard Pinel, 69675, Bron, France. .,Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - Hélène Klinger
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, NS-PARK/FCRIN Network, 59 Boulevard Pinel, 69500, Bron, France
| | - Chloé Laurencin
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, NS-PARK/FCRIN Network, 59 Boulevard Pinel, 69500, Bron, France.,Physiopathology of the Basal Ganglia Team, Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, 67 Boulevard Pinel, 69675, Bron, France
| | - Teodor Danaila
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, NS-PARK/FCRIN Network, 59 Boulevard Pinel, 69500, Bron, France.,Physiopathology of the Basal Ganglia Team, Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, 67 Boulevard Pinel, 69675, Bron, France
| | - Stéphane Thobois
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, NS-PARK/FCRIN Network, 59 Boulevard Pinel, 69500, Bron, France. .,Physiopathology of the Basal Ganglia Team, Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, 67 Boulevard Pinel, 69675, Bron, France. .,Faculté de Médecine et de Maïeutique Lyon Sud Charles Mérieux, Univ Lyon, Université Claude Bernard Lyon 1, Oullins, France.
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18
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Lawrie S, Coe S, Mansoubi M, Welch J, Razzaque J, Hu MT, Dawes H. Dietary Patterns and Nonmotor Symptoms in Parkinson's Disease: A Cross-Sectional Analysis. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2022; 42:393-402. [PMID: 35512773 DOI: 10.1080/07315724.2022.2056544] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Evidence-based treatment for nonmotor symptoms in Parkinson's disease (PD) is limited. Lifestyle-based improvements including dietary changes may be a potential management strategy. The intent of this research was to investigate the extent to which 3 dietary indices (Mediterranean-DASH Diet Intervention for Neurodegenerative Delay [MIND], Dietary Inflammation Index [DII], and Healthy Diet Indicator [HDI-2020]) are associated with overall and individual nonmotor symptom severity among individuals with PD. METHOD An exploratory cross-sectional analysis of dietary (food frequency questionnaire) and clinical data was undertaken, including measures of overall nonmotor symptom severity, such as fatigue, depression, anxiety, apathy, sleep problems, daytime sleepiness, and cognitive impairment. The relationship between each dietary score and symptom outcome was assessed by linear regression for continuous variables and through general linear model analysis for tertiles of dietary adherence. RESULTS None of the dietary indices significantly predicted the total nonmotor symptom severity score. The HDI predicted a significant decrease in fatigue scores as measured by the NeuroQoL fatigue item (standardized β = -.19, p = 0.022), after adjusting for age, sex, energy intake, years since diagnosis, physical activity level, education, and smoking. Self-reported depression symptoms reduced by .17 (standardized β) for each unit increase in HDI score (p = 0.035), after controlling for age, gender, energy intake, and years since diagnosis. No other significant associations were evident between dietary scores and any other nonmotor symptoms. CONCLUSIONS Our results indicate that fatigue and depression in PD may be modified by diet; however, more research is needed using a larger sample to replicate these findings. Supplemental data for this article is available online at https://doi.org/10.1080/07315724.2022.2056544 .
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Affiliation(s)
- Sophie Lawrie
- Centre for Movement, Occupational and Rehabilitation Sciences (MOReS), Oxford Brookes University, Oxford, UK
| | - Shelly Coe
- Centre for Movement, Occupational and Rehabilitation Sciences (MOReS), Oxford Brookes University, Oxford, UK
- Oxford Brookes Centre for Nutrition and Health, Oxford Brookes University, Oxford, UK
| | - Maedeh Mansoubi
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Jessica Welch
- Oxford Parkinson's Disease Centre Clinical Cohort Team, Oxford, UK
| | - Jamil Razzaque
- Oxford Parkinson's Disease Centre Clinical Cohort Team, Oxford, UK
| | - Michele T Hu
- Division of Clinical Neurology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Helen Dawes
- Centre for Movement, Occupational and Rehabilitation Sciences (MOReS), Oxford Brookes University, Oxford, UK
- College of Medicine and Health, University of Exeter, Exeter, UK
- Oxford Health BRC, University of Oxford, Oxford, UK
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19
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Cochen De Cock V, Dotov D, Lacombe S, Picot MC, Galtier F, Driss V, Giovanni C, Geny C, Abril B, Damm L, Janaqi S. Classifying Idiopathic Rapid Eye Movement Sleep Behavior Disorder, Controls, and Mild Parkinson's Disease Using Gait Parameters. Mov Disord 2022; 37:842-846. [PMID: 35040193 DOI: 10.1002/mds.28894] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/10/2021] [Accepted: 11/24/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Subtle gait changes associated with idiopathic rapid eye movement sleep behavior disorder (iRBD) could allow early detection of subjects with future synucleinopathies. OBJECTIVE The aim of this study was to create a multiclass model, using statistical learning from probability distribution of gait parameters, to distinguish between patients with iRBD, healthy control subjects (HCs), and patients with Parkinson's disease (PD). METHODS Gait parameters were collected in 21 participants with iRBD, 21 with PD, and 21 HCs, matched for age, sex, and education level. Lasso sparse linear regression explored gait features able to classify the three groups. RESULTS The final model classified iRBD from HCs and from patients with PD equally well, with 95% accuracy, 100% sensitivity, and 90% specificity. CONCLUSIONS Gait parameters and a pretrained statistical model can robustly distinguish participants with iRBD from HCs and patients with PD. This could be used to screen subjects with future synucleinopathies in the general population and to identify a conversion threshold to PD. © 2022 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Valérie Cochen De Cock
- Sleep and Neurology Department, Beau Soleil Clinic, Montpellier, France.,EuroMov Digital Health in Motion, University of Montpellier IMT Mines Ales, Montpellier, France
| | - Dobromir Dotov
- EuroMov Digital Health in Motion, University of Montpellier IMT Mines Ales, Montpellier, France
| | - Sandy Lacombe
- Department of Epidemiology and Biostatistics, Beau Soleil Clinic, Montpellier, France
| | - Marie Christine Picot
- Clinical Research & Epidemiology Unit, Medical Information Department, CHU Montpellier, University of Montpellier, Montpellier, France.,Clinical Investigation Centre 1411, University Hospital of Montpellier & Inserm, Montpellier, France
| | - Florence Galtier
- Clinical Investigation Centre 1411, University Hospital of Montpellier & Inserm, Montpellier, France
| | - Valérie Driss
- Clinical Investigation Centre 1411, University Hospital of Montpellier & Inserm, Montpellier, France
| | | | - Christian Geny
- EuroMov Digital Health in Motion, University of Montpellier IMT Mines Ales, Montpellier, France.,Department of Neurology, University Hospital of Montpellier, Montpellier, France
| | - Beatriz Abril
- Sleep Department, University Hospital of Nîmes, Nîmes, France
| | - Loic Damm
- EuroMov Digital Health in Motion, University of Montpellier IMT Mines Ales, Montpellier, France.,Department of Epidemiology and Biostatistics, Beau Soleil Clinic, Montpellier, France
| | - Stefan Janaqi
- EuroMov Digital Health in Motion, University of Montpellier IMT Mines Ales, Montpellier, France
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20
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Bhome R, Zarkali A, Thomas GEC, Iglesias JE, Cole JH, Weil RS. Thalamic white matter macrostructure and subnuclei volumes in Parkinson's disease depression. NPJ Parkinsons Dis 2022; 8:2. [PMID: 35013327 PMCID: PMC8748828 DOI: 10.1038/s41531-021-00270-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 12/20/2021] [Indexed: 12/04/2022] Open
Abstract
Depression is a common non-motor feature of Parkinson's disease (PD) which confers significant morbidity and is challenging to treat. The thalamus is a key component in the basal ganglia-thalamocortical network critical to the pathogenesis of PD and depression but the precise thalamic subnuclei involved in PD depression have not been identified. We performed structural and diffusion-weighted imaging (DWI) on 76 participants with PD to evaluate the relationship between PD depression and grey and white matter thalamic subnuclear changes. We used a thalamic segmentation method to divide the thalamus into its 50 constituent subnuclei (25 each hemisphere). Fixel-based analysis was used to calculate mean fibre cross-section (FC) for white matter tracts connected to each subnucleus. We assessed volume and FC at baseline and 14-20 months follow-up. A generalised linear mixed model was used to evaluate the relationship between depression, subnuclei volume and mean FC for each thalamic subnucleus. We found that depression scores in PD were associated with lower right pulvinar anterior (PuA) subnucleus volume. Antidepressant use was associated with higher right PuA volume suggesting a possible protective effect of treatment. After follow-up, depression scores were associated with reduced white matter tract macrostructure across almost all tracts connected to thalamic subnuclei. In conclusion, our work implicates the right PuA as a relevant neural structure in PD depression and future work should evaluate its potential as a therapeutic target for PD depression.
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Affiliation(s)
- R Bhome
- Dementia Research Centre, University College London, London, UK.
| | - A Zarkali
- Dementia Research Centre, University College London, London, UK
| | - G E C Thomas
- Dementia Research Centre, University College London, London, UK
| | - J E Iglesias
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Cambridge, USA
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, USA
| | - J H Cole
- Dementia Research Centre, University College London, London, UK
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK
| | - R S Weil
- Dementia Research Centre, University College London, London, UK
- Wellcome Centre for Human Neuroimaging, University College London, London, UK
- Movement Disorders Consortium, National Hospital for Neurology and Neurosurgery, London, UK
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21
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Isolation Related to the COVID-19 Pandemic in People Suffering from Parkinson's Disease and Activity, Self-Assessment of Physical Fitness and the Level of Affective Disorders. Healthcare (Basel) 2021; 9:healthcare9111562. [PMID: 34828608 PMCID: PMC8624023 DOI: 10.3390/healthcare9111562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/12/2021] [Accepted: 11/14/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Staying at home for long periods and limiting various types of activities and social contacts due to the COVID-19 pandemic may have negative consequences for health. This is especially true for people suffering from chronic diseases, in whom an appropriate level of activity and social contacts delay the progress of the disease. This group includes people diagnosed with Parkinson’s disease—PD. Aim: It was decided to investigate the effect of COVID-19 isolation related to self-assessment of physical fitness, physical activity, and the level of anxiety and depression in people with PD. Methods: The study included 30 patients diagnosed with Parkinson’s disease. We compared the results of the pre-pandemic questionnaire and the telephone interview with the same questions—after the period of isolation due to COVID-19. The questionnaire included questions about physical activity and fitness self-assessment. The level of affective disorders was tested using HADS. Results: There was a statistically significant decrease in the physical activity of the respondents after isolation related to COVID-19 (p < 0.05). Self-assessment of physical fitness also decreased, but the differences were not statistically significant. In the post-isolation study, only 50% of the respondents had normative values for anxiety and only 40% for depression. The analysis showed that the level of physical activity—the independent variable, explains anxiety in 30% and depression in 27%. Conclusions: Pandemic isolation has significantly reduced physical activity in PD patients. There was a certain drop in the self-esteem of physical fitness in these people. Physical fitness is an important predictor of preventing the affective disorders of anxiety and depression. The effects of isolation due to COVID-19 require further research.
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22
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Paniak I, Lewis SJG, Ehgoetz Martens KA. Measuring anxiety in Lewy Body Disease - Which scale to choose? Clin Park Relat Disord 2021; 5:100110. [PMID: 34647014 PMCID: PMC8501759 DOI: 10.1016/j.prdoa.2021.100110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 11/25/2022] Open
Abstract
Parkinson Anxiety Scale is best suited to assess anxiety in synucleinopathies. Anxiety section of the HADS shows strong convergent validity in PD and iRBD. The UPDRS anxiety item did not correlate with any of the other anxiety scales.
Background Anxiety is among the most prevalent mood disorders in Lewy Body Disease (LBD) (i.e., Parkinson’s disease (PD), Dementia with Lewy bodies DLB), and those at-risk for developing LBD (e.g. isolated REM Sleep Behaviour Disorder (iRBD)). Yet, there is little consensus on which clinical scale best evaluates anxiety across synuclein-based diseases. Objective This study compared the convergent validity of commonly used anxiety scales across PD, DLB and iRBD patients. Methods Anxiety was assessed using the Hospital Anxiety and Depression Scale (HADS-A), State-Trait Anxiety Inventory (STAI), MDS-UPDRS Anxiety item, and the Parkinson Anxiety Scale (PAS) in 57 participants (17 PD, 16 DLB, and 23 iRBD). Results Across all groups, PAS total score was significantly associated with trait anxiety (STAI-Y2), whilst HADS-A was associated with PAS total score in the PD and iRBD group. In DLB patients, HADS-A was weakly associated with PAS total score, and significantly correlated with PAS episodic anxiety. Notably, the anxiety item from the MDS-UPDRS did not correlate with any of the other anxiety outcome measures in any group. Conclusions PAS and STAI-Y2 are the most suitable scales to assess anxiety in synuclein-based diseases. HADS-A showed strong convergent validity in PD and iRBD, it had weaker convergent validity in DLB. The UPDRS anxiety item did not correlate with any of the other anxiety measures, and thus may not be sensitive at detecting anxiety symptoms. Future work should validate anxiety scales in all Lewy Body Disease groups if they are to be implemented in prospective longitudinal cohorts.
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Affiliation(s)
- Isabel Paniak
- Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, New South Wales, Australia
| | - Simon J G Lewis
- Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, New South Wales, Australia
| | - Kaylena A Ehgoetz Martens
- Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, New South Wales, Australia.,Department of Kinesiology and Health Sciences, University of Waterloo, Ontario, Canada
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23
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The contribution of cognitive behavioural factors to social anxiety in Parkinson's disease. Behav Cogn Psychother 2021; 50:57-73. [PMID: 34488922 DOI: 10.1017/s1352465821000291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Social anxiety is prevalent in idiopathic Parkinson's disease but why this is, is not yet well understood. Social cognitions, safety-seeking behaviours and internally focused attention are all known to predict social anxiety in the general population. These associated factors have not yet been explored in idiopathic Parkinson's disease, where disease severity and motor symptoms might also influence the experience of social anxiety. AIMS This study aimed to explore the relationship between cognitive behavioural factors and social anxiety in Parkinson's disease. METHOD Using a cross-sectional design, 124 people with Parkinson's disease completed self-report questionnaires including measures of Parkinson's disease severity, social anxiety, negative social cognitions, safety-seeking behaviours, internally focused attention, anxiety and depression. RESULTS The final regression model accounted for 71.6% of variance in social anxiety. Cognitive behavioural variables accounted for the largest magnitude of unique variance (43.5%). Sex, anxiety and depression accounted for 23.4%, and Parkinson non-motor symptom severity for 4.7%. Negative social cognitions and safety-seeking behaviours were statistically significant predictors, while an internal focus of attention was not. CONCLUSIONS Social anxiety in Parkinson's disease is associated with negative social cognitions and safety-seeking behaviours. Findings indicate the need for further research into cognitive behavioural approaches to social anxiety in Parkinson's disease.
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24
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Schedlich-Teufer C, Jost ST, Krack P, Witt K, Weintraub D, Baldermann JC, Sommerauer M, Amstutz D, van Eimeren T, Dafsari HS, Kalbe E, Visser-Vandewalle V, Fink GR, Kessler J, Barbe MT. Assessment of Affective-Behavioral States in Parkinson's Disease Patients: Towards a New Screening Tool. JOURNAL OF PARKINSONS DISEASE 2021; 11:1417-1430. [PMID: 33967055 DOI: 10.3233/jpd-202375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Assessment of affective-behavioral states in patients with Parkinson's disease (PD) undergoing deep brain stimulation (DBS) is essential. OBJECTIVE To analyze well-established questionnaires as a pilot-study with the long term aim to develop a screening tool evaluating affective-behavioral dysfunction, including depression, anxiety, apathy, mania, and impulse control disorders, in PD patients screened for DBS. METHODS Two hundred ninety-seven inpatients with PD underwent standardized neuropsychiatric testing including German versions of Beck Depression Inventory-II, Hospital Anxiety and Depression Scale, Apathy Evaluation Scale, Self-Report Manic Inventory, and Questionnaire for Impulsive-Compulsive Disorders in PD-Rating Scale, to assess appropriateness for DBS. Statistical item reduction was based on exploratory factor analysis, Cronbach's alpha, item-total correlations, item difficulty, and inter-item correlations. Confirmatory factor analysis was conducted to assess factorial validity. An expert rating was performed to identify clinically relevant items in the context of PD and DBS, to maintain content validity. We compared the shortened subscales with the original questionnaires using correlations. To determine cutoff points, receiver operating characteristics analysis was performed. RESULTS The items of the initial questionnaires were reduced from 129 to 38 items. Results of confirmatory factor analyses supported the validity of the shortened pool. It demonstrated high internal consistency (Cronbach's alpha = 0.72-0.83 across subscales), and the individual subscales were correlated with the corresponding original scales (rs = 0.84-0.95). Sensitivities and specificities exceeded 0.7. CONCLUSION The shortened item pool, including 38 items, provides a good basis for the development of a screening tool, capturing affective-behavioral symptoms in PD patients before DBS implantation. Confirmation of the validity of such a screening tool in an independent sample of PD patients is warranted.
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Affiliation(s)
- Charlotte Schedlich-Teufer
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Stefanie Theresa Jost
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Paul Krack
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Karsten Witt
- Department of Neurology, School of Medicine and Health Sciences, University of Oldenburg, Oldenburg, Germany.,Research Center Neurosensory Science, University of Oldenburg, Oldenburg, Germany
| | - Daniel Weintraub
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Parkinson's Disease Research, Education and Clinical Center, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - Juan Carlos Baldermann
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Michael Sommerauer
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Deborah Amstutz
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Thilo van Eimeren
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn-Cologne, Germany
| | - Haidar Salimi Dafsari
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Elke Kalbe
- Department of Medical Psychology, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Veerle Visser-Vandewalle
- Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Gereon Rudolf Fink
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany
| | - Josef Kessler
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Michael Thomas Barbe
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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25
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Khalil H, Rehan R, Al-Sharman A, El-Salem K. The clinical correlates of the chair sit to stand performance in people with multiple sclerosis. Physiother Theory Pract 2021; 38:2884-2895. [PMID: 34156901 DOI: 10.1080/09593985.2021.1931590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: This study aimed to evaluate the motor and non-motor factors associated with sit-to-stand performance in people with Multiple Sclerosis (PwMS). Design: Observational cross-sectional study. Subjects: A total of 88 individuals with MS participated in this study. Main Measures: Standing performance was measured using the five-times-sit-to-stand test (FTSTS). The Berg Balance Scale to assess balance, the 10-Meter Walking Test (10-MWT) was used to assess walking speed; the Patient Determined Disease Steps (PDDS) was used to assess disability level. Furthermore, Brief International Cognitive Assessment for MS (BICAMS) was used to assess cognitive status, Hospital Anxiety and Depression scale (HADS) to assess depression and anxiety, and the Modified Fatigue Impact scale (MFIS) to evaluate fatigue. Spearman correlation coefficient was used to determine the relationship between all these variables and the FTSTS. Furthermore, multiple linear regression was conducted to determine predictive factors of the FTSTS. Results: FTSTS score was correlated significantly with BBS, PDDS, BICAMS, 10-MWT and MFIS (r ranged from 0.3 to 0.52; P < .05). However, there was no significant correlation observed between the FTSTS and HADS-depression or HADS-anxiety. Considering the multiple regression analysis, the following factors were significantly predictive of the FTSTS: 10-MWT, MFIS and the BICAMS-z score (R2: 0.433, P < .0001). Conclusion: The study concludes that sit to stand is multifactorial and is potentially associated with walking speed, cognitive function and fatigue. These factors should be considered by healthcare professionals in interpreting the sit-to-stand performance of PwMS and in designing rehabilitation interventions.
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Affiliation(s)
- Hanan Khalil
- Faculty of Applied Medical Sciences, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Reem Rehan
- Faculty of Applied Medical Sciences, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Alham Al-Sharman
- Faculty of Applied Medical Sciences, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Khalid El-Salem
- Faculty of Medicine, Department of Neurosciences, Jordan University of Science and Technology, Irbid, Jordan
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Effect of Dynamic Balance Exercises Based on Visual Feedback on Physical Function, Balance Ability, and Depression in Women after Bilateral Total Knee Arthroplasty: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093203. [PMID: 32380679 PMCID: PMC7246741 DOI: 10.3390/ijerph17093203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/02/2020] [Accepted: 05/03/2020] [Indexed: 01/14/2023]
Abstract
The aim of this study was to compare the effects of dynamic balance exercises with and without visual feedback on recovery from total knee arthroplasty. The participants were 30 women who underwent total knee arthroplasty more than one week before the study, and were randomly allocated into two groups. The average ages of the experimental and control groups were 70.13 and 69.00 years, respectively. The dynamic balance exercise with visual feedback (VF) group practiced dynamic balance exercises using a laser pointer for five 30-min sessions over a 4-week period. The dynamic balance exercise without visual feedback (control) group practiced dynamic balance exercises for five 30 min sessions over a 4 week period. The following clinical measures were used for assessing physical function, balance ability, and depression. Compared with the control group, the VF group showed significant improvements in the physical performance test, Western Ontario and McMaster Universities Arthritis Index (WOMAC), confidence ellipse area (CEA), path length (PL), average velocity (AV), and Timed Up and Go test (TUG test) (p < 0.05). Furthermore, the VF group showed significant improvements in all post-surgery outcome measures compared with the pre-surgery values (p < 0.05). The above results indicated that the dynamic balance exercises based on visual feedback improved physical function and balance ability in patients following total knee arthroplasty, suggesting the need for effective rehabilitation programs for patients with total knee arthroplasty.
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Rosen CJ, Figueroa CA. Parkinson's disease and osteoporosis: basic and clinical implications. Expert Rev Endocrinol Metab 2020; 15:185-193. [PMID: 32336178 PMCID: PMC7250483 DOI: 10.1080/17446651.2020.1756772] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 04/14/2020] [Indexed: 12/20/2022]
Abstract
Introduction: Parkinson's disease (PD) is the second most frequent neurodegenerative disease. Lewy bodies, the hallmark of this disease due to an accumulation of α-synuclein, lead to loss of dopamine-regulated motor circuits, concomitantly progressive immobilization and a broad range of nonmotor features. PD patients have more hospitalizations, endure longer recovery time from comorbidities, and exhibit higher mortality than healthy controls. Although often overlooked, secondary osteoporosis has been reported frequently and is associated with a worse prognosis.Areas covered: In this review, we discuss the pathophysiology of PD from a systemic perspective. We searched on PubMed articles from the last 20 years in PD, both clinical features and bone health status. We discuss possible neuro/endocrine mechanisms by which PD impacts the skeleton, review available therapy for osteoporotic fractures and highlight evidence gaps in defining skeletal co-morbid events.Expert opinion: Future research is essential to understand the local and systemic effects of dopaminergic signaling on bone remodeling and to determine how pathological α-synuclein deposition in the central nervous system might impact the skeleton. It is hoped that a systematic approach to the pathogenesis of this disease and its treatment will allow the informed use of osteoporotic drugs to prevent fractures in PD patients.
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Affiliation(s)
- Clifford J Rosen
- Maine Medical Center Research Institute, 81 Research Drive, Scarborough, Maine 04074, USA
| | - Carolina A Figueroa
- Maine Medical Center Research Institute, 81 Research Drive, Scarborough, Maine 04074, USA
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28
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Marín-Lahoz J, Martínez-Horta S, Sampedro F, Pagonabarraga J, Horta-Barba A, Bejr-Kasem H, Botí MÁ, Fernández-Bobadilla R, Pascual-Sedano B, Pérez-Pérez J, Aracil-Bolaños I, Gironell A, Gómez-Ansón B, Kulisevsky J. Measuring impulsivity in Parkinson's disease: a correlational and structural neuroimaging study using different tests. Eur J Neurol 2020; 27:1478-1486. [PMID: 32250513 DOI: 10.1111/ene.14235] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 03/12/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND PURPOSE Impulsivity is an aspect of personality and a major component of multiple neuropsychiatric conditions. In Parkinson's disease, it has been associated with the expression of impulse control disorders, a highly prevalent non-motor complication. Even though multiple tests of impulsivity have been used in this context, the impact of test choice has not been addressed. The aim was to evaluate whether different impulsivity measures in Parkinson's disease share substantial inter-scale and anatomical correlations or rather mirror different underlying phenomena. METHODS In a consecutive sample of 89 Parkinson's disease patients without impulse control disorders, four common tests were evaluated assessing different aspects of impulsivity: impulsiveness trait, decisions under implicit risk with and without losses, and delay discounting. Correlations among test scores were analysed and each score was used as a regressor in a set of grey matter volume (GMV) voxel-based morphometry analyses to explore their brain structural correlates. RESULTS No significant correlations were found between the different impulsivity tests. Furthermore, their structural brain correlates were divergent. Impulsiveness trait appeared to be associated with lower GMV in dorsal-lateral prefrontal cortices, implicit risk (with losses) with higher GMV in the left nucleus accumbens and lower left insular GMV, implicit risk (without losses) with higher GMV in the left lingual gyrus and lower GMV in the gyri recti and delay discounting with higher GMV in the left nucleus accumbens. CONCLUSIONS In Parkinson's disease, different impulsivity measures reflect very dissimilar behavioural and brain structural correlates. Our results suggest that parkinsonian impulsivity is not a unitary phenomenon but rather a heterogeneous entity.
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Affiliation(s)
- J Marín-Lahoz
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain.,Institut d´Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain.,Universitat Autònoma de Barcelona (U.A.B.), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - S Martínez-Horta
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain.,Institut d´Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - F Sampedro
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain.,Institut d´Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - J Pagonabarraga
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain.,Institut d´Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain.,Universitat Autònoma de Barcelona (U.A.B.), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - A Horta-Barba
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain.,Institut d´Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - H Bejr-Kasem
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain.,Institut d´Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain.,Universitat Autònoma de Barcelona (U.A.B.), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Universitat Oberta de Catalunya, Barcelona, Spain
| | - M Á Botí
- Universitat Oberta de Catalunya, Barcelona, Spain.,Asociació Catalana per al Parkinson, Barcelona, Spain
| | | | - B Pascual-Sedano
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain.,Institut d´Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Universitat Oberta de Catalunya, Barcelona, Spain
| | - J Pérez-Pérez
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain.,Institut d´Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - I Aracil-Bolaños
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain.,Institut d´Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - A Gironell
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain.,Institut d´Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - B Gómez-Ansón
- Institut d´Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain.,Universitat Autònoma de Barcelona (U.A.B.), Barcelona, Spain.,Neuroradiology Unit, Radiology Department, Sant Pau Hospital, Barcelona, Spain
| | - J Kulisevsky
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain.,Institut d´Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain.,Universitat Autònoma de Barcelona (U.A.B.), Barcelona, Spain.,Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
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Kalyani HHN, Sullivan KA, Moyle G, Brauer S, Jeffrey ER, Kerr GK. Impacts of dance on cognition, psychological symptoms and quality of life in Parkinson's disease. NeuroRehabilitation 2020; 45:273-283. [PMID: 31561398 DOI: 10.3233/nre-192788] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND While dance may improve motor features in Parkinson's disease (PD), it is not yet clear if the benefits extend to non-motor features. OBJECTIVE To determine whether dance classes based on Dance for PD®, improve cognition, psychological symptoms and Quality of Life (QoL) in PD. METHODS Participants were allocated to a Dance Group (DG; n = 17) or Control Group (CG: n = 16). Participants had early-stage PD (Hoehn & Yahr: DG = 1.6±0.7, CG = 1.5±0.8) with no cognitive impairment (Addenbrooke's score: DG = 93.2±3.6, CG = 92.6±4.3). The DG undertook a one-hour class, twice weekly for 12 weeks, while the CG had treatment as usual. Both groups were assessed for disease severity (MDS-UPDRS), cognition (NIH Toolbox® cognition battery, Trail Making Test), psychological symptoms (Hospital Anxiety and Depression Scale, MDS-UPDRS-I) and QoL (PDQ-39, MDS-UPDRS-II). RESULTS Group comparison of pre-post change scores showed that selected cognitive skills (executive function and episodic memory), psychological symptoms (anxiety and depression) as well as QoL (PDQ-39 summary index) were significantly improved by the intervention (DG > CG, p's < 0.05, Cohen's d > 0.8). DISCUSSIONS AND CONCLUSION Dance classes had a clear benefit on psychological symptoms, QoL and a limited cognitive benefit. Follow-up assessment is required to confirm the durability of these effects.
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Affiliation(s)
- H H N Kalyani
- Movement Neuroscience Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,School of Exercise and Nutrition Science, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.,Department of Allied Health Sciences, Faculty of Medicine, University of Colombo, Sri Lanka
| | - K A Sullivan
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - G Moyle
- School of Creative Practice, Faculty of Creative Industries, Queensland University of Technology, Brisbane, QLD, Australia
| | - S Brauer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - E R Jeffrey
- Queensland Ballet, South Brisbane, QLD, Australia.,Dance for Parkinson's Australia, Brisbane, Queensland, Australia
| | - G K Kerr
- Movement Neuroscience Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,School of Exercise and Nutrition Science, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
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30
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Marín-Lahoz J, Sampedro F, Horta-Barba A, Martínez-Horta S, Aracil-Bolaños I, Camacho V, Bejr-kasem H, Pascual-Sedano B, Pérez-Pérez J, Gironell A, Pagonabarraga J, Carrió I, Kulisevsky J. Preservation of brain metabolism in recently diagnosed Parkinson’s impulse control disorders. Eur J Nucl Med Mol Imaging 2020; 47:2165-2174. [DOI: 10.1007/s00259-019-04664-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 12/16/2019] [Indexed: 12/16/2022]
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31
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Ghazi Sherbaf F, Same K, Aarabi MH. High angular resolution diffusion imaging correlates of depression in Parkinson's disease: a connectometry study. Acta Neurol Belg 2018; 118:573-579. [PMID: 29728904 DOI: 10.1007/s13760-018-0937-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 04/26/2018] [Indexed: 11/30/2022]
Abstract
Depression is a significant disabling feature in Parkinson's disease (PD). However, the neuropathology of this comorbidity is still unclear. In fact, few studies have tried to elucidate the neural correlates of depression in PD and have mostly examined specific regions of interest. In this study, we applied diffusion MRI connectometry, a powerful complementary approach to investigate alterations in whole white matter pathways regarding the severity of depressive symptoms. Using a multiple regression model, the correlation of severity of depressive symptoms assessed by the Hospital Anxiety and Depression Scale (HADS) with white matter connectivity was surveyed in 27 non-demented PD patients related to 26 age, sex, and educational level-matched healthy subjects. Results revealed areas, where white matter quantitative anisotropy (QA) was correlated with depression score in PD patients, without any significant association in healthy controls. The analysis showed a significant negative association (false discovery rate < 0.05) between scores on depression subscale of HADS in PD patients and QA of left Cingulum, Genu, and Splenium of the Corpus Callosum, and anterior and posterior limbs of the right internal capsule. This finding might improve our understanding of the neural basis of depression and its severity in PD.
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Affiliation(s)
- Farzaneh Ghazi Sherbaf
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kaveh Same
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hadi Aarabi
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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32
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Wen MC, Chan LL, Tan LCS, Tan EK. Depression, anxiety, and apathy in Parkinson's disease: insights from neuroimaging studies. Eur J Neurol 2017; 23:1001-19. [PMID: 27141858 PMCID: PMC5084819 DOI: 10.1111/ene.13002] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 03/01/2016] [Indexed: 11/28/2022]
Abstract
Depression, anxiety and apathy are common mood disturbances in Parkinson's disease (PD) but their pathophysiology is unclear. Advanced neuroimaging has been increasingly used to unravel neural substrates linked to these disturbances. A systematic review is provided of neuroimaging findings in depression, anxiety and apathy in PD. A PubMed, MEDLINE and EMBASE search of peer‐reviewed original research articles on these mood disturbances in PD identified 38 studies on depression, eight on anxiety and 14 on apathy in PD. Most of the imaging studies used either position emission tomography or single‐photon emission computed tomography techniques. These studies generally suggest increased neural activity in the prefrontal regions and decreased functional connectivity between the prefrontal−limbic networks in depressed patients. Functional imaging studies revealed an inverse correlation between dopaminergic density in the caudate and putamen with the severity of anxiety in PD. There was no consistent correlation between dopaminergic density of thalamus and anxiety. Studies demonstrated both positive and inverse correlations between apathy and metabolism or activity in the striatum, amygdalar, prefrontal, temporal and parietal regions. The clinical variability of study subjects and differences in image pre‐processing and analytical strategies may contribute to discrepant findings in these studies. Both nigrostriatal and extra‐nigrostriatal pathways (in particular the frontal region and its connecting areas) are affected in mood disorders in PD. Identifying the relative contributions of these neural pathways in PD patients with overlapping motor and mood symptoms could provide new pathophysiological clues for the development of better therapeutic targets for affected patients.
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Affiliation(s)
- M-C Wen
- Department of Research, National Neuroscience Institute, Singapore, Singapore
| | - L L Chan
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore, Singapore
| | - L C S Tan
- Duke - National University of Singapore Graduate Medical School, Singapore, Singapore.,Department of Neurology, National Neuroscience Institute, Singapore
| | - E K Tan
- Department of Research, National Neuroscience Institute, Singapore, Singapore.,Duke - National University of Singapore Graduate Medical School, Singapore, Singapore.,Department of Neurology, National Neuroscience Institute, Singapore
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33
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Ayala A, Triviño-Juárez JM, Forjaz MJ, Rodríguez-Blázquez C, Rojo-Abuin JM, Martínez-Martín P. Parkinson's Disease Severity at 3 Years Can Be Predicted from Non-Motor Symptoms at Baseline. Front Neurol 2017; 8:551. [PMID: 29163328 PMCID: PMC5674937 DOI: 10.3389/fneur.2017.00551] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 09/28/2017] [Indexed: 11/13/2022] Open
Abstract
Objective The aim of this study is to present a predictive model of Parkinson’s disease (PD) global severity, measured with the Clinical Impression of Severity Index for Parkinson’s Disease (CISI-PD). Methods This is an observational, longitudinal study with annual follow-up assessments over 3 years (four time points). A multilevel analysis and multiple imputation techniques were performed to generate a predictive model that estimates changes in the CISI-PD at 1, 2, and 3 years. Results The clinical state of patients (CISI-PD) significantly worsened in the 3-year follow-up. However, this change was of small magnitude (effect size: 0.44). The following baseline variables were significant predictors of the global severity change: baseline global severity of disease, levodopa equivalent dose, depression and anxiety symptoms, autonomic dysfunction, and cognitive state. The goodness-of-fit of the model was adequate, and the sensitive analysis showed that the data imputation method applied was suitable. Conclusion Disease progression depends more on the individual’s baseline characteristics than on the 3-year time period. Results may contribute to a better understanding of the evolution of PD including the non-motor manifestations of the disease.
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Affiliation(s)
- Alba Ayala
- Centre for Human and Social Sciences, Spanish Scientific Research Council (CCHS, CSIC) and Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
| | | | - Maria João Forjaz
- Epidemiology and Biostatistics Department, National School of Public Health, Institute of Health Carlos III and Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
| | - Carmen Rodríguez-Blázquez
- National Center of Epidemiology and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Institute of Health Carlos III, Madrid, Spain
| | - José-Manuel Rojo-Abuin
- Institute of Economics, Geography and Demography, Centre for Human and Social Sciences, Spanish National Research Council (CSIC), Madrid, Spain
| | - Pablo Martínez-Martín
- National Center of Epidemiology and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Institute of Health Carlos III, Madrid, Spain
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Wiesli D, Meyer A, Fuhr P, Gschwandtner U. Influence of Mild Cognitive Impairment, Depression, and Anxiety on the Quality of Life of Patients with Parkinson Disease. Dement Geriatr Cogn Dis Extra 2017; 7:297-308. [PMID: 29118782 PMCID: PMC5662998 DOI: 10.1159/000478849] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 06/19/2017] [Indexed: 01/03/2023] Open
Abstract
Background Neuropsychiatric symptoms (NPS) and mild cognitive impairment (MCI) are common in Parkinson disease (PD) and have a negative impact on the patient's quality of life (QoL). We aim to describe the effect of NPS and MCI on each other and on QoL. Methods Sixteen MCI and 37 non-MCI PD patients completed different self-assessment questionnaires including the Parkinson's Disease Questionnaire (PDQ-39), the Beck Depression Inventory (BD), the Beck Anxiety Inventory (BAI), and the Self-Report Manic Inventory (SRMI). Linear regression with stepwise elimination was used to select the significant predictors of QoL and to control for confounding factors. Results The significant linear regression model (R2 = 0.68, p ≤ 0.01) revealed significant effects of MCI (p = 0.03), BDI (p ≤ 0.01), BAI (p ≤ 0.01), age (p = 0.03), a trend of SRMI (p = 0.06), and disease duration (p = 0.08) on QoL. Conclusions MCI, anxiety, depression, and age decrease QoL in patients with PD. NPS has the main influence in the prediction of QoL in patients with PD, whereas MCI is only of minor importance.
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Affiliation(s)
- Daniel Wiesli
- Department of Neurology, University Hospital Basel, Basel, Switzerland
| | - Antonia Meyer
- Department of Neurology, University Hospital Basel, Basel, Switzerland
| | - Peter Fuhr
- Department of Neurology, University Hospital Basel, Basel, Switzerland
| | - Ute Gschwandtner
- Department of Neurology, University Hospital Basel, Basel, Switzerland
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35
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Mace CZ. The complexities of advance care planning in patients with idiopathic Parkinson's disease. ACTA ACUST UNITED AC 2017. [DOI: 10.12968/bjnn.2017.13.4.178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Clair Zoe Mace
- Parkinson's disease nurse specialist, Nottingham University NHS Trust
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36
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Khan MA, Quadri SA, Tohid H. A comprehensive overview of the neuropsychiatry of Parkinson's disease: A review. Bull Menninger Clin 2017; 81:53-105. [DOI: 10.1521/bumc.2017.81.1.53] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
| | - Syed A. Quadri
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Hassaan Tohid
- Center for Mind & Brain, University of California, Davis
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37
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Schrag A, Taddei RN. Depression and Anxiety in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 133:623-655. [DOI: 10.1016/bs.irn.2017.05.024] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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38
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Zhu K, van Hilten JJ, Marinus J. Onset and evolution of anxiety in Parkinson's disease. Eur J Neurol 2016; 24:404-411. [PMID: 28032408 DOI: 10.1111/ene.13217] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 11/07/2016] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND PURPOSE Anxiety is common in Parkinson's disease (PD) and has a great influence on quality of life. However, little is known about risk factors for development of anxiety in PD. We investigated which factors were associated with longitudinal changes in severity of anxiety symptoms and development of future anxiety in patients who were not anxious at baseline. METHODS Analyses were performed on data of the PROfiling PARKinson's disease (PROPARK) cohort, a 5-year hospital-based longitudinal cohort of over 400 patients with PD who have been examined annually. Linear mixed models were used to identify factors associated with longitudinal changes in Hospital Anxiety and Depression Scale - Anxiety (HADS-A) scores. Survival analysis using data of patients who were not anxious at baseline was performed to identify predictors of future anxiety (i.e. HADS-A ≥ 11). RESULTS Of 409 patients who were included at baseline, 67 (16%) had anxiety, whereas 64 (19%) of the remaining 342 non-anxious patients developed anxiety after a mean (SD) follow-up of 2.6 (1.3) years. Seventy percent of the patients with anxiety were also depressed. Female gender, cognitive impairment, depressive symptoms, dysautonomia, insomnia and excessive daytime sleepiness (EDS) at baseline were associated with higher HADS-A scores over time and, except for female gender and EDS, all of these variables were independent predictors of development of anxiety in patients who were not anxious at baseline. CONCLUSIONS Anxiety is highly prevalent in PD. Higher anxiety scores over time and future development of anxiety are associated with female gender, cognitive impairment, autonomic dysfunction, insomnia and EDS. Anxiety and depression usually coexist and share similar determinants, suggesting a common pathophysiological mechanism.
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Affiliation(s)
- K Zhu
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - J J van Hilten
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - J Marinus
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
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39
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Šumec R, Rektorová I, Jech R, Menšíková K, Roth J, Růžička E, Sochorová D, Dušek L, Kaňovský P, Rektor I, Pavlík T, Filip P, Bareš M. Motion and emotion: anxiety–axial connections in Parkinson’s disease. J Neural Transm (Vienna) 2016; 124:369-377. [DOI: 10.1007/s00702-016-1652-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 11/12/2016] [Indexed: 12/01/2022]
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40
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van de Weijer SCF, Duits AA, Bloem BR, Kessels RP, Jansen JFA, Köhler S, Tissingh G, Kuijf ML. The Parkin'Play study: protocol of a phase II randomized controlled trial to assess the effects of a health game on cognition in Parkinson's disease. BMC Neurol 2016; 16:209. [PMID: 27809791 PMCID: PMC5093943 DOI: 10.1186/s12883-016-0731-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 10/20/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Parkinson's disease (PD), cognitive impairment is an important non-motor symptom heralding the development of dementia. Effective treatments to slow down the rate of cognitive decline in PD patients with mild cognitive impairment are lacking. Here, we describe the design of the Parkin'Play study, which assesses the effects of a cognitive health game intervention on cognition in PD. METHODS/DESIGN This study is a multicentre, phase-II, open-randomized clinical trial that aims to recruit 222 PD patients with mild cognitive impairment. Eligible patients have PD, Hoehn & Yahr stages I-III, are aged between 40 and 75 years, and have cognitive impairment but no dementia. The intervention group (n = 111) will be trained using a web-based health game targeting multiple cognitive domains. The control group (n = 111) will be placed on a waiting list. In order to increase compliance the health game adapts to the subjects' performance, is enjoyable, and can be played at home. From each group, 20 patients will undergo fMRI to test for potential functional brain changes underlying treatment. The primary outcome after 12 weeks of training is cognitive function, as assessed by a standard neuropsychological assessment battery and an online cognitive assessment. The neuropsychological assessment battery covers the following domains: executive function, memory, visual perception, visuoconstruction and language. A compound score for overall cognitive function will be calculated as the mean score of all test Z-scores based on the distribution of scores for both groups taken together. Secondary outcomes at follow-up visits up to 24 weeks include various motor and non-motor symptoms, compliance, and biological endpoints (fMRI). DISCUSSION This study aims at evaluating whether a cognitive intervention among PD patients leads to an increased cognitive performance on targeted domains. Strengths of this study are a unique web-based health game intervention, the large sample size, a control group without intervention and innovations designed to increase compliance. TRIAL REGISTRATION NTR5637 on 7-jan-2016.
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Affiliation(s)
- Sjors C F van de Weijer
- Department of Neurology, Maastricht University Medical Center, Maastricht UMC+, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Annelien A Duits
- Department of Psychiatry and Psychology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bastiaan R Bloem
- Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Roy P Kessels
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Jacobus F A Jansen
- Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands.,School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Sebastian Köhler
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Gerrit Tissingh
- Department of Neurology, Zuyderland Medical Center, Heerlen, The Netherlands
| | - Mark L Kuijf
- Department of Neurology, Maastricht University Medical Center, Maastricht UMC+, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
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41
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Cognitive Function in Parkinson's Disease Patients with and without Anxiety. Neurol Res Int 2016; 2016:6254092. [PMID: 27800180 PMCID: PMC5075302 DOI: 10.1155/2016/6254092] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 09/06/2016] [Accepted: 09/18/2016] [Indexed: 01/30/2023] Open
Abstract
Research on the implications of anxiety in Parkinson's disease (PD) has been neglected despite its prevalence in nearly 50% of patients and its negative impact on quality of life. Previous reports have noted that neuropsychiatric symptoms impair cognitive performance in PD patients; however, to date, no study has directly compared PD patients with and without anxiety to examine the impact of anxiety on cognitive impairments in PD. This study compared cognitive performance across 50 PD participants with and without anxiety (17 PDA+; 33 PDA−), who underwent neurological and neuropsychological assessment. Group performance was compared across the following cognitive domains: simple attention/visuomotor processing speed, executive function (e.g., set-shifting), working memory, language, and memory/new verbal learning. Results showed that PDA+ performed significantly worse on the Digit Span forward and backward test and Part B of the Trail Making Task (TMT-B) compared to the PDA− group. There were no group differences in verbal fluency, logical memory, or TMT-A performance. In conclusion, anxiety in PD has a measurable impact on working memory and attentional set-shifting.
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Garlovsky JK, Simpson J, Grünewald RA, Overton PG. Impulse control disorders in Parkinson's disease: Predominant role of psychological determinants. Psychol Health 2016; 31:1391-1414. [PMID: 27473645 DOI: 10.1080/08870446.2016.1218879] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Impulse Control Disorders (ICDs) in Parkinson's disease (PD) have previously almost exclusively been considered to result from anti-parkinsonian medication. However, this biomedical perspective has failed to achieve a full understanding of the phenomenon and it is argued that a failure to consider psychological factors is a critical omission. DESIGN The present study examined the predictive relationship between ICDs in PD and a range of psychological measures, whilst controlling for a number of biomedical determinants. MAIN OUTCOME MEASURES One hundred participants with idiopathic PD completed questionnaires that assessed demographic and clinical characteristics, psychological measures and the presence of ICDs (QUIP-RS). RESULTS Increased use of a 'negative' coping strategy, stronger illness identity, more emotional illness representations and stress were found to be significant predictors of ICDs, and different psychological predictors were associated with different ICDs. Medication was not found to predict ICDs in the presence of psychological factors, either when total treatment levels were considered or when agonist dose was considered alone. CONCLUSIONS This study provides the first quantitative evidence of a predominant predictive relationship between psychological factors and ICDs in PD. The results suggest that psychological interventions may have useful therapeutic role to play for ICDs in PD.
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Affiliation(s)
- Jack K Garlovsky
- a Department of Psychology , University of Sheffield , Sheffield , UK
| | - Jane Simpson
- b Division of Health Research , University of Lancaster , Bailrigg , UK
| | - Richard A Grünewald
- c Department of Neurology , Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Trust , Sheffield , UK
| | - Paul G Overton
- a Department of Psychology , University of Sheffield , Sheffield , UK
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Abstract
BACKGROUND Symptoms of anxiety relating to Parkinson's disease (PD) occur commonly and include symptomatology associated with motor disability and complications arising from PD medication. However, there have been relatively few attempts to profile such disease-specific anxiety symptoms in PD. Consequently, anxiety in PD is underdiagnosed and undertreated. The present study characterizes PD-related anxiety symptoms to assist with the more accurate assessment and treatment of anxiety in PD. METHODS Ninety non-demented PD patients underwent a semi-structured diagnostic assessment targeting anxiety symptoms using relevant sections of the Mini International Neuropsychiatric Interview (MINI-plus). In addition, they were assessed for the presence of 30 PD-related anxiety symptoms derived from the literature, the clinical experience of an expert panel and the PD Anxiety-Motor Complications Questionnaire (PDAMCQ). The onset of anxiety in relation to the diagnosis of PD was determined. RESULTS Frequent (>25%) PD-specific anxiety symptoms included distress, worry, fear, agitation, embarrassment, and social withdrawal due to motor symptoms and PD medication complications, and were experienced more commonly in patients meeting DSM-IV criteria for an anxiety disorder. The onset of common anxiety disorders was observed equally before and after a diagnosis of PD. Patients in a residual group of Anxiety Not Otherwise Specified had an onset of anxiety after a diagnosis of PD. CONCLUSION Careful characterization of PD-specific anxiety symptomatology provides a basis for conceptualizing anxiety and assists with the development of a new PD-specific measure to accurately assess anxiety in PD.
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Shinmei I, Kobayashi K, Oe Y, Takagishi Y, Kanie A, Ito M, Takebayashi Y, Murata M, Horikoshi M, Dobkin RD. Cognitive behavioral therapy for depression in Japanese Parkinson's disease patients: a pilot study. Neuropsychiatr Dis Treat 2016; 12:1319-31. [PMID: 27354802 PMCID: PMC4908947 DOI: 10.2147/ndt.s104777] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES This study evaluated the feasibility of cognitive behavioral therapy (CBT) for Japanese Parkinson's disease (PD) patients with depression. To increase cultural acceptability, we developed the CBT program using manga, a type of Japanese comic novel. METHODS Participants included 19 non-demented PD patients who had depressive symptoms (GRID-Hamilton Rating Scale for Depression score ≥8). A CBT program comprising six sessions was individually administered. We evaluated the feasibility and safety of the CBT program in terms of the dropout rate and occurrence of adverse events. The primary outcome was depressive symptom reduction in the GRID-Hamilton Rating Scale for Depression upon completion of CBT. Secondary outcomes included changes in the self-report measures of depression (Beck Depression Inventory-II, Hospital Anxiety and Depression Scale-Depression), anxiety (Hospital Anxiety and Depression Scale-Anxiety, State and Trait Anxiety Inventory, Overall Anxiety Severity and Impairment Scale), functional impairment, and quality of life (Medical Outcomes Study 36-Item Short-Form Health Survey). RESULTS Of the 19 participants (mean age =63.8 years, standard deviation [SD] =9.9 years; mean Hohen-Yahr score =1.7, SD =0.8), one patient (5%) withdrew. No severe adverse event was observed. The patients reported significant improvements in depression (Hedges' g =-1.02, 95% confidence interval =-1.62 to -0.39). The effects were maintained over a 3-month follow-up period. Most of the secondary outcome measurements showed a small-to-moderate but nonsignificant effect size from baseline to post-intervention. CONCLUSION This study provides preliminary evidence that CBT is feasible among Japanese PD patients with depression. Similar approaches may be effective for people with PD from other cultural backgrounds. The results warrant replication in a randomized controlled trial.
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Affiliation(s)
- Issei Shinmei
- National Center for Cognitive Behavioral Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Neuropsychiatry, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi, Japan
| | - Kei Kobayashi
- Department of Neurology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yuki Oe
- National Center for Cognitive Behavioral Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yuriko Takagishi
- National Center for Cognitive Behavioral Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Psychology, Surugadai University, Saitama, Japan
| | - Ayako Kanie
- National Center for Cognitive Behavioral Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Masaya Ito
- National Center for Cognitive Behavioral Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yoshitake Takebayashi
- National Center for Cognitive Behavioral Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
- Risk Analysis Research Center, The Institute of Statistical Mathematics, Tokyo, Japan
| | - Miho Murata
- Department of Neurology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Masaru Horikoshi
- National Center for Cognitive Behavioral Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Roseanne D Dobkin
- Department of Psychiatry, Rutgers-Robert Wood Johnson Medical school, NJ, USA
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Broen MPG, Narayen NE, Kuijf ML, Dissanayaka NNW, Leentjens AFG. Prevalence of anxiety in Parkinson's disease: A systematic review and meta‐analysis. Mov Disord 2016; 31:1125-33. [DOI: 10.1002/mds.26643] [Citation(s) in RCA: 218] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 03/12/2016] [Accepted: 03/16/2016] [Indexed: 12/26/2022] Open
Affiliation(s)
- Martijn P. G. Broen
- Department of NeurologyMaastricht University Medical CenterMaastricht the Netherlands
| | - Nadia E. Narayen
- Department of NeurologyMaastricht University Medical CenterMaastricht the Netherlands
| | - Mark L. Kuijf
- Department of NeurologyMaastricht University Medical CenterMaastricht the Netherlands
- School for Mental Health and NeuroscienceMaastricht UniversityMaastricht the Netherlands
| | - Nadeeka N. W. Dissanayaka
- Department of NeurologyRoyal Brisbane & Women's HospitalBrisbane Australia
- The University of Queensland, UQ Centre for Clinical ResearchBrisbane Australia
- School of PsychologyThe University of QueenslandBrisbane Australia
| | - Albert F. G. Leentjens
- School for Mental Health and NeuroscienceMaastricht UniversityMaastricht the Netherlands
- Department of PsychiatryMaastricht University Medical CenterMaastricht the Netherlands
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Evaluation of severity of predominantly non-dopaminergic symptoms in Parkinson's disease: The SENS-PD scale. Parkinsonism Relat Disord 2016; 25:39-44. [PMID: 26922004 DOI: 10.1016/j.parkreldis.2016.02.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 02/11/2016] [Accepted: 02/16/2016] [Indexed: 11/23/2022]
Abstract
INTRODUCTION In spite of the multisystem nature of Parkinson's disease (PD), the formal assessment of its impairments is focused on symptoms predominantly reflecting degeneration of dopaminergic neurons. The aim of this study was to develop a valid and reliable rating scale of predominantly non-dopaminergic (PND) symptoms, which can be used as an additional measure of severity and progression of PD. METHODS Using data of the PROPARK (N = 396) and ELEP (N = 365) cohorts, three items were selected from each of six selected PND domains (cognitive impairment, depressive symptoms, excessive daytime sleepiness, psychotic symptoms, autonomic dysfunction and Postural-Instability-and-Gait-Difficulty), based on item-total correlations. Hereafter, we evaluated reliability and validity of the resulting scale. RESULTS The 18-item PND scale showed to be reliable and valid. Cronbach's alpha was 0.83. Principal component analysis using the six domain scores resulted in one factor, justifying the calculation of a sum score. Correlation coefficients of the sum score with severity of non-motor symptoms (non-motor part of MDS-UPDRS), motor symptoms (SPES/SCOPA scale), and Hoehn and Yahr stage were 0.63, 0.41 and 0.48, respectively (p < 0.001). CONCLUSION We developed a short, reliable and valid scale to evaluate severity of PND symptoms in PD. The score is expected to be largely insensitive to dopaminergic effects and may therefore more accurately reflect severity and progression of the underlying disease than currently used dopamine-sensitive measures. In combination with assessment of predominantly dopaminergic (motor) symptoms, a broad yet concise evaluation of PD is obtained, which better captures the widespread clinical consequences of the multisystem disease.
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Velseboer DC, de Bie RMA, Wieske L, Evans JR, Mason SL, Foltynie T, Schmand B, de Haan RJ, Post B, Barker RA, Williams-Gray CH. Development and external validation of a prognostic model in newly diagnosed Parkinson disease. Neurology 2016; 86:986-93. [PMID: 26888991 DOI: 10.1212/wnl.0000000000002437] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Accepted: 10/21/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To develop a prognostic model to predict disease outcomes in individual patients with Parkinson disease (PD) and perform an external validation study in an independent cohort. METHODS Model development was done in the Comorbidity and Aging in Rehabilitation Patients: The Influence on Activities (CARPA) cohort (Netherlands). External validation was performed using the Cambridgeshire Parkinson's Incidence from GP to Neurologist (CamPaIGN) cohort (UK). Both are longitudinal incident cohort studies that prospectively followed up patients with PD from the time of diagnosis. A composite outcome measure was made in which patients were classified as having an unfavorable prognosis when they had postural instability or dementia at the 5-year assessment (or at the last assessment before loss to follow-up), or had died before this time. The final model was derived with a backward selection strategy from candidate predictor variables that were measured at baseline. RESULTS In the resulting model, higher patient age, higher Unified Parkinson's Disease Rating Scale motor examination axial score, and a lower animal fluency score were all associated with a higher probability of an unfavorable outcome. External validation confirmed good discriminative ability between favorable and unfavorable outcomes with an area under the receiver operating characteristic curve of 0.85 (95% confidence interval 0.77-0.93) and a well-calibrated model with a calibration slope of 1.13 and no significant lack of fit (Hosmer-Lemeshow test: p = 0.39). CONCLUSION We constructed a model that allows individual patient prognostication at 5 years from diagnosis, using a small set of predictor variables that can easily be obtained by clinicians or research nurses.
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Affiliation(s)
- Daan C Velseboer
- From the Department of Neurology (D.C.V., R.M.A.d.B., L.W.), Department of Medical Psychology (B.S.), and Clinical Research Unit (R.J.d.H.), Academic Medical Center, Amsterdam, the Netherlands; John Van Geest Centre for Brain Repair (J.R.E., S.L.M., R.A.B., C.H.W.-G.), Department of Clinical Neurosciences, University of Cambridge; Institute of Neurology (T.F.), University College London, UK; Department of Brain and Cognition (B.S.), University of Amsterdam; and Department of Neurology (B.P.), Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Rob M A de Bie
- From the Department of Neurology (D.C.V., R.M.A.d.B., L.W.), Department of Medical Psychology (B.S.), and Clinical Research Unit (R.J.d.H.), Academic Medical Center, Amsterdam, the Netherlands; John Van Geest Centre for Brain Repair (J.R.E., S.L.M., R.A.B., C.H.W.-G.), Department of Clinical Neurosciences, University of Cambridge; Institute of Neurology (T.F.), University College London, UK; Department of Brain and Cognition (B.S.), University of Amsterdam; and Department of Neurology (B.P.), Radboud University Medical Center, Nijmegen, the Netherlands
| | - Luuk Wieske
- From the Department of Neurology (D.C.V., R.M.A.d.B., L.W.), Department of Medical Psychology (B.S.), and Clinical Research Unit (R.J.d.H.), Academic Medical Center, Amsterdam, the Netherlands; John Van Geest Centre for Brain Repair (J.R.E., S.L.M., R.A.B., C.H.W.-G.), Department of Clinical Neurosciences, University of Cambridge; Institute of Neurology (T.F.), University College London, UK; Department of Brain and Cognition (B.S.), University of Amsterdam; and Department of Neurology (B.P.), Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jonathan R Evans
- From the Department of Neurology (D.C.V., R.M.A.d.B., L.W.), Department of Medical Psychology (B.S.), and Clinical Research Unit (R.J.d.H.), Academic Medical Center, Amsterdam, the Netherlands; John Van Geest Centre for Brain Repair (J.R.E., S.L.M., R.A.B., C.H.W.-G.), Department of Clinical Neurosciences, University of Cambridge; Institute of Neurology (T.F.), University College London, UK; Department of Brain and Cognition (B.S.), University of Amsterdam; and Department of Neurology (B.P.), Radboud University Medical Center, Nijmegen, the Netherlands
| | - Sarah L Mason
- From the Department of Neurology (D.C.V., R.M.A.d.B., L.W.), Department of Medical Psychology (B.S.), and Clinical Research Unit (R.J.d.H.), Academic Medical Center, Amsterdam, the Netherlands; John Van Geest Centre for Brain Repair (J.R.E., S.L.M., R.A.B., C.H.W.-G.), Department of Clinical Neurosciences, University of Cambridge; Institute of Neurology (T.F.), University College London, UK; Department of Brain and Cognition (B.S.), University of Amsterdam; and Department of Neurology (B.P.), Radboud University Medical Center, Nijmegen, the Netherlands
| | - Thomas Foltynie
- From the Department of Neurology (D.C.V., R.M.A.d.B., L.W.), Department of Medical Psychology (B.S.), and Clinical Research Unit (R.J.d.H.), Academic Medical Center, Amsterdam, the Netherlands; John Van Geest Centre for Brain Repair (J.R.E., S.L.M., R.A.B., C.H.W.-G.), Department of Clinical Neurosciences, University of Cambridge; Institute of Neurology (T.F.), University College London, UK; Department of Brain and Cognition (B.S.), University of Amsterdam; and Department of Neurology (B.P.), Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ben Schmand
- From the Department of Neurology (D.C.V., R.M.A.d.B., L.W.), Department of Medical Psychology (B.S.), and Clinical Research Unit (R.J.d.H.), Academic Medical Center, Amsterdam, the Netherlands; John Van Geest Centre for Brain Repair (J.R.E., S.L.M., R.A.B., C.H.W.-G.), Department of Clinical Neurosciences, University of Cambridge; Institute of Neurology (T.F.), University College London, UK; Department of Brain and Cognition (B.S.), University of Amsterdam; and Department of Neurology (B.P.), Radboud University Medical Center, Nijmegen, the Netherlands
| | - Rob J de Haan
- From the Department of Neurology (D.C.V., R.M.A.d.B., L.W.), Department of Medical Psychology (B.S.), and Clinical Research Unit (R.J.d.H.), Academic Medical Center, Amsterdam, the Netherlands; John Van Geest Centre for Brain Repair (J.R.E., S.L.M., R.A.B., C.H.W.-G.), Department of Clinical Neurosciences, University of Cambridge; Institute of Neurology (T.F.), University College London, UK; Department of Brain and Cognition (B.S.), University of Amsterdam; and Department of Neurology (B.P.), Radboud University Medical Center, Nijmegen, the Netherlands
| | - Bart Post
- From the Department of Neurology (D.C.V., R.M.A.d.B., L.W.), Department of Medical Psychology (B.S.), and Clinical Research Unit (R.J.d.H.), Academic Medical Center, Amsterdam, the Netherlands; John Van Geest Centre for Brain Repair (J.R.E., S.L.M., R.A.B., C.H.W.-G.), Department of Clinical Neurosciences, University of Cambridge; Institute of Neurology (T.F.), University College London, UK; Department of Brain and Cognition (B.S.), University of Amsterdam; and Department of Neurology (B.P.), Radboud University Medical Center, Nijmegen, the Netherlands
| | - Roger A Barker
- From the Department of Neurology (D.C.V., R.M.A.d.B., L.W.), Department of Medical Psychology (B.S.), and Clinical Research Unit (R.J.d.H.), Academic Medical Center, Amsterdam, the Netherlands; John Van Geest Centre for Brain Repair (J.R.E., S.L.M., R.A.B., C.H.W.-G.), Department of Clinical Neurosciences, University of Cambridge; Institute of Neurology (T.F.), University College London, UK; Department of Brain and Cognition (B.S.), University of Amsterdam; and Department of Neurology (B.P.), Radboud University Medical Center, Nijmegen, the Netherlands
| | - Caroline H Williams-Gray
- From the Department of Neurology (D.C.V., R.M.A.d.B., L.W.), Department of Medical Psychology (B.S.), and Clinical Research Unit (R.J.d.H.), Academic Medical Center, Amsterdam, the Netherlands; John Van Geest Centre for Brain Repair (J.R.E., S.L.M., R.A.B., C.H.W.-G.), Department of Clinical Neurosciences, University of Cambridge; Institute of Neurology (T.F.), University College London, UK; Department of Brain and Cognition (B.S.), University of Amsterdam; and Department of Neurology (B.P.), Radboud University Medical Center, Nijmegen, the Netherlands
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Boel JA, Odekerken VJJ, Geurtsen GJ, Schmand BA, Cath DC, Figee M, van den Munckhof P, de Haan RJ, Schuurman PR, de Bie RMA. Psychiatric and social outcome after deep brain stimulation for advanced Parkinson's disease. Mov Disord 2015; 31:409-13. [PMID: 26660279 DOI: 10.1002/mds.26468] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 09/21/2015] [Accepted: 10/05/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The aim of this study was to assess psychiatric and social outcome 12 months after bilateral deep brain stimulation (DBS) of the globus pallidus pars interna (GPi) and subthalamic nucleus (STN) for advanced Parkinson's disease (PD). METHODS We randomly assigned patients to receive GPi DBS (n = 65) or STN DBS (n = 63). Standardized psychiatric and social questionnaires were assessed at baseline and after 12 months. RESULTS No differences were found between GPi DBS and STN DBS on psychiatric evaluation. Within-group comparisons showed small but statistically significant changes on several measures in both groups. Descriptive statistics indicated slight changes in social functioning. Marital satisfaction of patients and partners remained relatively stable after GPi and STN DBS. CONCLUSIONS We found neither differences in psychiatric and social outcome between GPi DBS and STN DBS nor any relevant within-group differences. The decision for GPi DBS or STN DBS cannot be based on expected psychiatric or social effects.
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Affiliation(s)
- Judith A Boel
- Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands.,Department of Psychology, University of Amsterdam, The Netherlands
| | | | - Gert J Geurtsen
- Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands
| | - Ben A Schmand
- Department of Psychology, University of Amsterdam, The Netherlands.,Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands
| | - Danielle C Cath
- Altrecht Academic Anxiety Center, Utrecht, The Netherlands; Department of Clinical and Health Psychology, Utrecht University, The Netherlands
| | - Martijn Figee
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | | | - Rob J de Haan
- Clinical Research Unit, Academic Medical Center, Amsterdam, The Netherlands
| | - P Richard Schuurman
- Department of Neurosurgery, Academic Medical Center, Amsterdam, The Netherlands
| | - Rob M A de Bie
- Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands
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Caudal D, Alvarsson A, Björklund A, Svenningsson P. Depressive-like phenotype induced by AAV-mediated overexpression of human α-synuclein in midbrain dopaminergic neurons. Exp Neurol 2015; 273:243-52. [DOI: 10.1016/j.expneurol.2015.09.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 08/18/2015] [Accepted: 09/03/2015] [Indexed: 01/10/2023]
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Abstract
BACKGROUND Assessing anxiety in Parkinson's disease (PD) has been a recent focus, and a number of studies have extensively investigated the validity of anxiety rating scales in PD. The present review aims to provide an overview of anxiety scales widely used and/or validated in PD, and to highlight recommendations for future research required in this area. METHODS A literature search was performed using terms such as Parkinson* disease, psychiatric, depress*, anxiety, assessment, scales, and valid* in PsycInfo, PubMed, and Web of Science databases. Validation studies and reviews focussed on assessment of anxiety in PD were included. RESULTS The literature search identified nine anxiety rating scales. The new Parkinson's Anxiety Scale (PAS) showed good psychometric properties. Having a simple design appropriate for older adults and items focussed on cognitive anxiety, the Geriatric Anxiety Inventory (GAI) also appeared promising for use in PD. The Beck Anxiety Inventory (BAI), Hospital Anxiety and Depression Scale, and Hamilton Anxiety Rating Scale (HAM-A) did not demonstrate satisfactory psychometric characteristics when used in PD, while other scales had limited or no evidence of validity or reliability to infer judgments. CONCLUSIONS PAS and GAI are can be recommended for use in PD without dementia. Usefulness of these scales to assess anxiety in dementia should be examined in the future. Moreover, the complex symptomatology of anxiety relating to "off" PD medication states were not addressed in these scales. Further research is required to develop an anxiety scale tailored for PD.
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