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Abstract
Neurodegenerative diseases are increasingly recognised to be an important cause of brain disorders, particularly in late age. Associated with a wide range of pathologies, they lead to progressive loss of neurons in different regions of the nervous system. Although anhedonia is common in a variety of neurodegenerative diseases, to date it has not been extensively studied in most of these conditions. Here we review the current literature on studies assessing the association between anhedonia and neurodegenerative diseases including Parkinson's Disease, Dementia with Lewy Bodies, Parkinson's Plus Syndromes, Alzheimer's Disease, Vascular Dementia, Frontotemporal Dementia, Amyotrophic Lateral Sclerosis and Huntington's Disease. Much of the research has been conducted in Parkinson's disease where it is evident that there are strong links between apathy (loss of motivation) and anhedonia, although the two syndromes can be dissociated. Intriguingly, drugs that improve apathy can also lead to amelioration of anhedonia in some cases. Overlaps between the two syndromes may also exist across other neurodegenerative conditions, including Frontotemporal Dementia in which imaging has revealed atrophy of both common brain regions associated with anhedonia and apathy, as well as a set of unique brain regions associated with anhedonia. A transdiagnostic perspective might be helpful to investigate whether a common network of brain regions is dysfunctional with anhedonia across neurodegenerative conditions.
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Affiliation(s)
- Vicky Turner
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Masud Husain
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
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Cinar E, Yalcin-Cakmakli G, Saka E, Ulusoy A, Yuruker S, Elibol B, Tel BC. Modelling cognitive deficits in Parkinson's disease: Is CA2 a gateway for hippocampal synucleinopathy? Exp Neurol 2020; 330:113357. [PMID: 32437708 DOI: 10.1016/j.expneurol.2020.113357] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 04/01/2020] [Accepted: 05/05/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Cognitive dysfunction is one of the most disabling non-motor symptoms of Parkinson's disease (PD), though its pathological correlates still remain elusive. Hippocampal Lewy pathology has recently been correlated by compelling evidence from post-mortem and imaging studies. Animal models recapitulating cognitive impairment in PD are essential to better understand the underlying pathophysiology. To investigate the hippocampal involvement in cognitive dysfunction of PD, we generated an experimental model by inducing midbrain and hippocampal α-synuclein pathology simultaneously. METHODS Rats were injected either with human α-synuclein or green fluorescent protein (GFP) expressing adeno-associated viral vectors (AAV), or saline bilaterally into substantia nigra (SN) and dentate gyrus (DG). A group of untreated animals were used as naïve controls. Cognitive and behavioral changes were evaluated with tests probing for spatial learning, short-term memory, anxiety and hedonistic behavior. Immunohistochemical staining, immunoblotting and stereological analysis were performed for pathological characterization. RESULTS Bilateral α-synuclein overexpression in SN and DG led to mild but significant motor impairment as well as dysfunctions in short-term memory and spatial learning. There was no hedonistic deficit, whereas a hypo-anxious state was induced. While stereological analysis revealed no significant neuronal loss in any sectors of cornu ammonis, there was considerable decrease (43%) in TH+-neurons in SN pars compacta supporting the well-known vulnerability of nigral dopaminergic neurons to α-synuclein mediated neurodegeneration. On the other hand, synaptophysin levels decreased in similar amounts both in striatum and hippocampus, suggesting comparable synaptic loss in target areas. Interestingly, phosphorylated-S129-α-synuclein staining revealed significant expression in CA2 characterized by more mature and dense cellular accumulations compared to CA1-CA3 sub-regions displaying more diffuse grain-like aggregates, suggesting preferential susceptibility of CA2 to produce α-synuclein induced pathology. CONCLUSION Bilateral α-synuclein overexpression in DG and SN reproduced partial motor and hippocampus related cognitive deficits. Using this model, we showed a predisposition of CA2 for pathological α-synuclein accumulation, which may provide further insights for future experimental and clinical studies.
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Affiliation(s)
- Elif Cinar
- Department of Pharmacology, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey.
| | | | - Esen Saka
- Department of Neurology, Hacettepe University, Sihhiye, Ankara, Turkey
| | - Ayse Ulusoy
- German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Sinan Yuruker
- Usak University Faculty of Medicine, Department of Histology and Embryology, Usak, Turkey
| | - Bulent Elibol
- Department of Neurology, Hacettepe University, Sihhiye, Ankara, Turkey
| | - Banu C Tel
- Department of Pharmacology, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
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Assogna F, Pellicano C, Savini C, Macchiusi L, Pellicano GR, Alborghetti M, Caltagirone C, Spalletta G, Pontieri FE. Drug Choices and Advancements for Managing Depression in Parkinson's Disease. Curr Neuropharmacol 2019; 18:277-287. [PMID: 31622207 PMCID: PMC7327944 DOI: 10.2174/1570159x17666191016094857] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/27/2019] [Accepted: 10/15/2019] [Indexed: 12/21/2022] Open
Abstract
Depression is a frequent non-motor symptom of Parkinson’s disease (PD), and may even precede the onset of motor symptoms of parkinsonism. Beyond its negative influence on mood, depression in PD is frequently associated with other neuropsychiatric symptoms and with late-stage complications such as dementia. Despite its profound impact on the quality of life and cognitive functioning in PD, depression in PD is often under-recognized and poorly treated. Pathophysiological studies demonstrated that depression in PD is associated with global dysfunction of interactions between discrete brain areas rather than focal structural or functional abnormalities, and that it is sustained by pathological changes of several neurotransmitter/receptor complexes. In general, all traditional antidepressants and some dopamine agonists have been found to be safe and well-tolerated to treat depressive symptoms in PD, despite initial warning on worsening of parkinsonism. Available data suggest that the time-course of response differs among antidepressants. Efficacy results from clinical trials with antidepressant in PD are, however, rather uncertain,
although pooled analysis suggests a moderate benefit. Several issues may critically impact the
results of clinical trials with antidepressants in PD, including the correct psychiatric diagnosis, the overlap of symptoms between depression and PD, and the selection of appropriate end-points and rating scales.
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Affiliation(s)
| | - Clelia Pellicano
- Fondazione Santa Lucia, IRCCS, Via Ardeatina, 306-00179 Roma, Italy.,Neurology Unit, "Belcolle" Hospital, Str. Sammartinese-01100 Viterbo, Italy
| | - Cinzia Savini
- Fondazione Santa Lucia, IRCCS, Via Ardeatina, 306-00179 Roma, Italy
| | - Lucia Macchiusi
- Fondazione Santa Lucia, IRCCS, Via Ardeatina, 306-00179 Roma, Italy
| | - Gaia R Pellicano
- Dipartimento di Psicologia Dinamica e Clinica, "Sapienza" Università di Roma, Via degli Apuli, 1-00185 Roma, Italy
| | - Marika Alborghetti
- Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso (NESMOS), "Sapienza" Universita di Roma, Via di Grottarossa, 1035-00189 Roma, Italy
| | | | | | - Francesco E Pontieri
- Fondazione Santa Lucia, IRCCS, Via Ardeatina, 306-00179 Roma, Italy.,Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso (NESMOS), "Sapienza" Universita di Roma, Via di Grottarossa, 1035-00189 Roma, Italy
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Nagayama H, Maeda T, Uchiyama T, Hashimoto M, Nomoto N, Kano O, Takahashi T, Terashi H, Hamada S, Hasegawa T, Hatano T, Takahashi T, Baba Y, Sengoku R, Watanabe H, Inoue M, Kadowaki T, Kaneko S, Shimura H, Kubo SI. Anhedonia and its correlation with clinical aspects in Parkinson's disease. J Neurol Sci 2016; 372:403-407. [PMID: 27839720 DOI: 10.1016/j.jns.2016.10.051] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 10/10/2016] [Accepted: 10/25/2016] [Indexed: 10/20/2022]
Abstract
Anhedonia is one of the non-motor symptoms observed in the Parkinson's disease (PD). However, there is no clear relationship between anhedonia and its correlation with other symptoms of PD. The aim of this study is to evaluate the characteristics of anhedonia and its correlation with clinical aspects of PD in a relatively large cohort. We enrolled 318 patients with PD and 62 control subjects for this study. Patients and subjects were tested using the Snaith-Hamilton Pleasure Scale Japanese version and the Beck Depression Inventory 2nd edition for the assessment of anhedonia and depression. We also investigated the correlation among clinical aspects of PD, anhedonia, and depression in patients with PD. The Snaith-Hamilton Pleasure Scale Japanese version and the Beck Depression Inventory 2nd edition scores were significantly higher in patients with PD than in control subjects (p=0.03 and p=0.0006, respectively). All PD patients with anhedonia had a significantly higher score on the unified Parkinson's disease rating scale (UPDRS) parts I and II compared to PD patients without anhedonia. Additionally, all PD patients with depression scored significantly higher on UPDRS part I-IV than PD patients without depression. The patients with anhedonia and without depression had mild motor severity and their treatment was relatively low dosage. These results suggest that anhedonia and depression are slightly linked, but not the same. PD patients with only anhedonia may be closely linked apathy found in untreated early stages of PD.
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Affiliation(s)
- Hiroshi Nagayama
- Department of Neurological Science, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
| | - Tetsuya Maeda
- Department of Neurology and Movement Disorder Research, Research Institute for Brain and Blood Vessels-Akita, Akita, Japan
| | - Tsuyoshi Uchiyama
- Department of Neurology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Masaya Hashimoto
- Department of Neurology, The Jikei University Katsushika Medical Center, Tokyo, Japan
| | - Nobuatsu Nomoto
- Division of Neurology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Osamu Kano
- Division of Neurology, Department of Internal Medicine, Toho University Omori Medical Center, Tokyo, Japan
| | - Tatsuya Takahashi
- Department of Neurology, National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - Hiroo Terashi
- Department of Neurology, Tokyo Medical University, Tokyo, Japan
| | - Shinsuke Hamada
- Department of Neurology, Hokuyukai Neurological Hospital, Sapporo, Japan
| | - Takafumi Hasegawa
- Division of Neurology, Department of Neuroscience & Sensory Organs, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Taku Hatano
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Tetsuya Takahashi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Hiroshima, Japan
| | - Yasuhiko Baba
- Department of Neurology, Houei Clinic, Miyazaki, Japan
| | - Renpei Sengoku
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hirohisa Watanabe
- Brain and Mind Research Center, Nagoya Graduate School of Medicine, Nagoya, Japan
| | - Manabu Inoue
- Department of Neurology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Taro Kadowaki
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Satoshi Kaneko
- Department of Neurology, Kansai Medical University, Osaka, Japan
| | - Hideki Shimura
- Department of Neurology, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Shin-Ichiro Kubo
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
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Le Grand JN, Gonzalez-Cano L, Pavlou MA, Schwamborn JC. Neural stem cells in Parkinson's disease: a role for neurogenesis defects in onset and progression. Cell Mol Life Sci 2015; 72:773-97. [PMID: 25403878 PMCID: PMC11113294 DOI: 10.1007/s00018-014-1774-1] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 10/09/2014] [Accepted: 11/03/2014] [Indexed: 12/27/2022]
Abstract
Parkinson's disease (PD) is the second most common neurodegenerative disorder, leading to a variety of motor and non-motor symptoms. Interestingly, non-motor symptoms often appear a decade or more before the first signs of motor symptoms. Some of these non-motor symptoms are remarkably similar to those observed in cases of impaired neurogenesis and several PD-related genes have been shown to play a role in embryonic or adult neurogenesis. Indeed, animal models deficient in Nurr1, Pitx3, SNCA and PINK1 display deregulated embryonic neurogenesis and LRRK2 and VPS35 have been implicated in neuronal development-related processes such as Wnt/β-catenin signaling and neurite outgrowth. Moreover, adult neurogenesis is affected in both PD patients and PD animal models and is regulated by dopamine and dopaminergic (DA) receptors, by chronic neuroinflammation, such as that observed in PD, and by differential expression of wild-type or mutant forms of PD-related genes. Indeed, an increasing number of in vivo studies demonstrate a role for SNCA and LRRK2 in adult neurogenesis and in the generation and maintenance of DA neurons. Finally, the roles of PD-related genes, SNCA, LRRK2, VPS35, Parkin, PINK1 and DJ-1 have been studied in NSCs, progenitor cells and induced pluripotent stem cells, demonstrating a role for some of these genes in stem/progenitor cell proliferation and maintenance. Together, these studies strongly suggest a link between deregulated neurogenesis and the onset and progression of PD and present strong evidence that, in addition to a neurodegenerative disorder, PD can also be regarded as a developmental disorder.
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Affiliation(s)
- Jaclyn Nicole Le Grand
- Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, 4362 Esch-sur-Alzette, Luxembourg
| | - Laura Gonzalez-Cano
- Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, 4362 Esch-sur-Alzette, Luxembourg
| | - Maria Angeliki Pavlou
- Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, 4362 Esch-sur-Alzette, Luxembourg
| | - Jens C. Schwamborn
- Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, 4362 Esch-sur-Alzette, Luxembourg
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Grover S, Somaiya M, Kumar S, Avasthi A. Psychiatric aspects of Parkinson's disease. J Neurosci Rural Pract 2015; 6:65-76. [PMID: 25552854 PMCID: PMC4244792 DOI: 10.4103/0976-3147.143197] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Parkinson's disease (PD) is essentially characterized by the motor symptoms in the form of resting tremor, rigidity and bradykinesia. However, over the years it has been recognized that motor symptoms are just the "tip of the iceberg" of clinical manifestations of PD. Besides motor symptoms, PD characterized by many non-motor symptoms, which include cognitive decline, psychiatric disturbances (depression, psychosis and impulse control), sleep difficulties, autonomic failures (gastrointestinal, cardiovascular, urinary, thermoregulation) and pain syndrome. This review evaluates the various aspects of psychiatric disorders including cognitive decline and sleep disturbances in patients with PD. The prevalence rate of various psychiatric disorders is high in patients with PD. In terms of risk factors, various demographic, clinical and treatment-related variables have been shown to be associated with higher risk of development of psychiatric morbidity. Evidence also suggests that the presence of psychiatric morbidity is associated with poorer outcome. Randomized controlled trials, evaluating the various pharmacological and non-pharmacological treatments for management of psychiatric morbidity in patients with PD are meager. Available evidence suggests that tricyclic antidepressants like desipramine and nortriptyline are efficacious for management of depression. Among the antipsychotics, clozapine is considered to be the best choice for management of psychosis in patients with PD. Among the various cognitive enhancers, evidence suggest efficacy of rivastigmine in management of dementia in patients with PD. To conclude, this review suggests that psychiatric morbidity is highly prevalent in patients with PD. Hence, a multidisciplinary approach must be followed to improve the overall outcome of PD. Further studies are required to evaluate the efficacy of various other measures for management of psychiatric morbidity in patients with PD.
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Mansi Somaiya
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Santhosh Kumar
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajit Avasthi
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Loas G, Duru C, Godefroy O, Krystkowiak P. Hedonic deficits in Parkinson's disease: is consummatory anhedonia specific? Front Neurol 2014; 5:24. [PMID: 24653714 PMCID: PMC3948001 DOI: 10.3389/fneur.2014.00024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Accepted: 02/21/2014] [Indexed: 11/24/2022] Open
Abstract
Background: Anhedonia, the lowered ability to experience pleasure, is one of the non-motor symptoms of Parkinson’s disease (PD) that is underdiagnosed and consequently undertreated. Few studies have investigated anhedonia in PD by taking into account the influence of socio-demographic variables and versus a control group composed of patients with a pure motor neurologic disease other than PD. The aim of this study was to investigate hedonic deficits in patients with PD compared to a control group of patients with non-Parkinson motor neurologic disease (OND), matched for age, gender, level of education, and inpatient/outpatient status. Distinctions between anticipatory and consummatory anhedonia and between endogenomorphic and non-endogenomorphic depression were taken into account. Methods: The study population comprised 49 PD patients and 40 subjects with OND. Anhedonia was rated by using the anticipatory [Temporal Experience Pleasure Scale (TEPS)-ANT] and consummatory (TEPS-CONS) subscales of the TEPS and two subscales extracted from the revised Physical Anhedonia Scale (PAS), measuring physical anticipatory (PAS-ANT) and physical consummatory (PAS-CONS) anhedonias. The Snaith–Hamilton Pleasure Scale (SHAPS) and the Beck Depression Inventory-II (BDI-II) were also used together with a subscale extracted from the BDI-II (ENDO-BDI-II) for the diagnosis of endogenomorphic depression. Statistical analyses were performed on the whole group and on the PD group. Results: As hypothesized, several anhedonia scores varied with age and gender in the whole population or in the PD group. On univariate or multivariate analyses, only PAS-CONS was specific for PD and only SHAPS scores differed between depression subtypes in the whole population or the PD group. Conclusion: This study suggests that physical consummatory anhedonia could be specific to PD subjects.
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Affiliation(s)
- Gwenolé Loas
- Department of Psychiatry, Amiens University Hospital , Amiens , France ; EA 4559, Laboratoire de Neurosciences Fonctionnelles et Pathologie, University of Picardie Jules Verne , Amiens , France
| | - Cécile Duru
- EA 4559, Laboratoire de Neurosciences Fonctionnelles et Pathologie, University of Picardie Jules Verne , Amiens , France ; Department of Neurology, Amiens University Hospital , Amiens , France
| | - Olivier Godefroy
- EA 4559, Laboratoire de Neurosciences Fonctionnelles et Pathologie, University of Picardie Jules Verne , Amiens , France ; Department of Neurology, Amiens University Hospital , Amiens , France
| | - Pierre Krystkowiak
- EA 4559, Laboratoire de Neurosciences Fonctionnelles et Pathologie, University of Picardie Jules Verne , Amiens , France ; Department of Neurology, Amiens University Hospital , Amiens , France
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Matsui K, Tachibana H, Yamanishi T, Oguru M, Toda K, Okuda B, Oka N. Clinical correlates of anhedonia in patients with Parkinson's disease. Clin Neurol Neurosurg 2013; 115:2524-7. [PMID: 24252163 DOI: 10.1016/j.clineuro.2013.10.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 08/12/2013] [Accepted: 10/19/2013] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the prevalence and clinical correlates of anhedonia in patients with Parkinson's disease (PD) and to also examine the relationship between anhedonia and the QOL. METHODS One hundred and seventeen patients with PD completed the Snaith-Hamilton Pleasure Scale (SHAPS), the State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory Second Edition (BDI-II), Starkstein's Apathy Scale (AS) and a quality of life (QOL) battery. Hoehn and Yahr (HY) staging, the Unified Parkinson's Disease Rating Scale (UPDRS) and the Mini-Mental State Examination (MMSE) were administered on the same day. RESULTS Anhedonia (SHAPS score≥3) was diagnosed in 15% of the patients. The SHAPS score was found to be significantly correlated with the HY stage and the UPDRS (I, IVB, IVC, total), BDI-II, AS and STAI (State, Trait) scores. A multivariate analysis revealed that the BDI-II and STAI (Trait) scores significantly influenced the SHAPS scores. The SHAPS scores were found to be negatively correlated with the QOL. CONCLUSIONS These findings indicate that anhedonia is associated with depression and anxiety. In addition, recognizing anhedonia in patients with PD is important since it may have a negative effect on the QOL.
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Affiliation(s)
- Kiyohiro Matsui
- Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
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A Multidimensional Approach to Apathy after Traumatic Brain Injury. Neuropsychol Rev 2013; 23:210-33. [DOI: 10.1007/s11065-013-9236-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 07/26/2013] [Indexed: 12/14/2022]
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Guo X, Song W, Chen K, Chen X, Zheng Z, Cao B, Huang R, Zhao B, Wu Y, Shang HF. Disease duration-related differences in non-motor symptoms: A study of 616 Chinese Parkinson's disease patients. J Neurol Sci 2013; 330:32-7. [DOI: 10.1016/j.jns.2013.03.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 03/23/2013] [Accepted: 03/26/2013] [Indexed: 11/16/2022]
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Ho N, Sommers M. Anhedonia: a concept analysis. Arch Psychiatr Nurs 2013; 27:121-9. [PMID: 23706888 PMCID: PMC3664836 DOI: 10.1016/j.apnu.2013.02.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Revised: 02/05/2013] [Accepted: 02/08/2013] [Indexed: 10/26/2022]
Abstract
Anhedonia presents itself in a myriad of disease processes. To further develop our understanding of anhedonia and effective ways to manage it, the concept requires clear boundaries. This paper critically examined the current scientific literature and conducted a concept analysis of anhedonia to provide a more accurate and lucid understanding of the concept. As part of the concept analysis, this paper also provides model, borderline, related, and contrary examples of anhedonia.
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Affiliation(s)
- Nancy Ho
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.
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