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Wandell CJ, Torres K. Exploring the utility of process scores in elucidating the role of cognitive and affective factors that influence verbal fluency performance in Parkinson's disease. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-12. [PMID: 38828539 DOI: 10.1080/23279095.2024.2359446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
OBJECTIVES Cognitive and affective factors have been implicated in verbal fluency (VF) performance in Parkinson's disease (PD). This exploratory study aimed to investigate the relationships between cognitive and affective variables on traditional ("core") and "process" (error and interval) scores of VF and elucidate unique information these scores may provide regarding mechanisms underlying VF. METHODS Sixty-two PD patients without dementia completed clinical neuropsychological examinations consisting of attention, processing speed, language, executive functioning, visuospatial, memory, and mood measures. Hierarchical regression and negative binomial regression analyses were used to evaluate relationships between outcome and predictor variables. RESULTS Generativity results revealed that processing speed and working memory explained up to 34% of the variance of total letter fluency responses (p = <.001) and processing speed explained 24% of the variance for total semantic fluency (p = .003). For category switching generativity, only age predicted 20% of the variance (p = .01). Two executive functioning measures were negatively associated with error production over the duration (b = -.055, p = .028; b = -.062, p = .004) and final 45-second interval (b = -.072, p = .003; b = -.044, p = .033) of the category switching task. In the initial 15-second task interval, a positive predictive relationship between error production and indifference apathy (b = .616, p = .044) was demonstrated. CONCLUSIONS Findings demonstrate the potential utility of "process" scores in detecting subtle cognitive impairment in Parkinson's disease patients without dementia and tentatively evidence the role of indifference apathy in task initiation.
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Affiliation(s)
- Catie J Wandell
- Veterans Afffairs Puget Sound Healthcare System, Seattle, WA, USA
| | - Karen Torres
- Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
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Schade RN, Etheridge CB, Kenney LE, Ratajska AM, Rodriguez K, Lopez FV, Gertler J, Ray A, Santos L, Hess C, Bowers D. Greater Apathy Associated With Selective Serotonin Reuptake Inhibitor Use in Parkinson's Disease. J Geriatr Psychiatry Neurol 2024:8919887241254471. [PMID: 38780969 DOI: 10.1177/08919887241254471] [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: 05/25/2024]
Abstract
OBJECTIVE Apathy, a motivational disorder, is common in Parkinson's disease (PD) and often misdiagnosed as depression. Use of selective serotonin reuptake inhibitors (SSRIs) has been associated with increased apathy in adolescents and adults with depression. Based on observations that serotonin may downregulate dopaminergic systems, we examined the relationship between apathy and SSRI use in individuals with PD. METHODS Medications, mood/motivation scales, and clinical data were collected from a convenience sample of 400 individuals with PD. Depression and apathy were measured using the Beck Depression Inventory-II (BDI-Il) and the Apathy Scale (AS). Antidepressant medications were grouped by mechanism type. RESULTS Of the 400 PD patients, 26% were on SSRIs. On standard mood/motivation scales, 38% of the sample exceeded clinical cut-offs for apathy and 28% for depression. Results of hierarchical regression analyses revealed that SSRIs were the only antidepressant that were significantly associated with higher apathy scores (β = .1, P = .02). Less education (β = -.1, P = .01) worse cognition (β = -.1, P = .01), and greater depressive symptoms (β = .5, P < .001) were also significant predictors of apathy. CONCLUSION These findings suggest that use of SSRIs, but not other antidepressants, is associated with greater apathy in PD. Given the interactive relationship between serotonin and dopamine, the current findings highlight the importance of considering apathy when determining which antidepressants to prescribe to individuals with PD. Similarly, switching a SSRI for an alternative antidepressant in individuals with PD who are apathetic may be a potential treatment for apathy that needs further study.
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Affiliation(s)
- Rachel N Schade
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Connor B Etheridge
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Lauren E Kenney
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Adrianna M Ratajska
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Katie Rodriguez
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Francesca V Lopez
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Joshua Gertler
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Alyssa Ray
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Lauren Santos
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Christopher Hess
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida Health, Gainesville, FL, USA
| | - Dawn Bowers
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida Health, Gainesville, FL, USA
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Au-Yeung C, Penney D, Rae J, Carling H, Lassman L, Lepage M. The relationship between negative symptoms and MATRICS neurocognitive domains: A meta-analysis and systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2023; 127:110833. [PMID: 37482283 DOI: 10.1016/j.pnpbp.2023.110833] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/11/2023] [Accepted: 07/16/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Negative symptoms (NS) are a core symptom domain in schizophrenia spectrum disorders and are associated with poorer social and vocational functioning, and with increased likelihood and durations of hospital admission. NS are not well understood, limiting available interventions. However, numerous studies have reported associations between neurocognitive domains and NS severity. Thus, one promising area in understanding NS is in relation to neurocognition. Currently, the specificity of the relationship between NS and neurocognition is unknown, meaning that there is no consensus regarding which neurocognitive domain is most strongly associated with NS. There is a need to systematically examine the relationship between NS and various neurocognitive domains within study samples. METHODS A systematic search of Ovid PsycINFO, Ovid MEDLINE and Web of Science was performed for articles published since 2004 (year of MATRICS Consensus publication). Inclusion criteria were: 1) individuals with schizophrenia spectrum disorders, first episode psychosis or clinical high risk 2) assessed all six MATRICS neurocognitive domains (processing speed, attention, working memory, verbal learning & memory, visual learning & memory, reasoning & problem solving), 3) reported correlations between all six MATRICS neurocognitive domains and global NS. A three-level random effects hierarchical meta-analysis was performed to assess the relationship between NS (global, expressive, and experiential dimensions) and the six MATRICS neurocognitive domains. RESULTS 21 studies were included in the review (n = 3619). All MATRICS neurocognitive domains had small significant correlations with global NS (r = -0.16 to -0.20, p < 0.0001). This relationship was significantly moderated by diagnosis and the moderating effect of sex/ gender trended on significance. Analysis of a subset of the studies revealed that MATRICS neurocognitive domains also had small significant correlations with the two NS dimensions, expressive and experiential. Correlations were stronger with the expressive NS dimension. CONCLUSIONS This review is novel in assessing the relationship between multiple neurocognitive domains and NS within the same sample, by synthesizing close to two decades of research. Our results suggest that there is a non-specific relationship between neurocognition and NS, and that expressive NS may have a stronger relationship with neurocognitive functioning-based on the MATRICS classification of neurocognition and the neurocognitive assessments used in the included studies. This has implications on our understanding of NS and neurocognition, as well as their treatments. As we gain better understanding of the directionality of the NS-cognition relationship, it could suggest that NS, particularly in the expressive domain, could be improved by targeting cognition globally or that neurocognitive treatments could be more effective if NS are addressed first. Further implications of these results are discussed.
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Affiliation(s)
- Christy Au-Yeung
- Department of Psychology, McGill University, Montreal, Quebec, Canada; Douglas Research Centre, Montréal, Québec, Canada
| | - Danielle Penney
- Douglas Research Centre, Montréal, Québec, Canada; Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Jesse Rae
- Douglas Research Centre, Montréal, Québec, Canada
| | - Hannah Carling
- Department of Psychology, McGill University, Montreal, Quebec, Canada; Douglas Research Centre, Montréal, Québec, Canada
| | - Libby Lassman
- Douglas Research Centre, Montréal, Québec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Martin Lepage
- Douglas Research Centre, Montréal, Québec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
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Mougias M, Beratis IN, Moustaka K, Alexopoulos P, Assimakopoulos K. The Differential Role of Executive Apathy in Alzheimer's Disease Dementia, Mild Cognitive Impairment and Healthy Cognitive Ageing. Geriatrics (Basel) 2023; 8:geriatrics8020038. [PMID: 36960993 PMCID: PMC10037581 DOI: 10.3390/geriatrics8020038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023] Open
Abstract
The objective of the present work was to compare the levels of executive, emotional, and initiation apathy in individuals with mild cognitive impairment (MCI), mild Alzheimer's disease dementia (ADD), and cognitively intact healthy controls (HCs). Fifty-two patients with mild ADD, 40 individuals with MCI, and 37 cognitively intact individuals were included in the current study. The participants were consecutive visitors to the Outpatient Memory Clinic of "Nestor" Alzheimer's Center. The symptoms of apathy were measured with the dimensional apathy scale. Analyses showed that ADD patients had significantly higher degrees of executive, emotional, initiation, and overall apathy compared with both the MCI group and the HCs. Additionally, a significant difference was observed in the dimension of executive apathy between individuals with MCI and the HCs. In conclusion, the dimension of executive apathy was the most sensitive measure regarding the differentiation of individuals with mild ADD or MCI and HCs. Hence, detailed evaluation of executive apathy in older individuals referred to a memory clinic may provide useful information contributing to their diagnostic categorization and to the differentiation between neurocognitive disorders and healthy cognitive ageing.
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Affiliation(s)
- Michalis Mougias
- Alzheimer's Center, "Nestor" Greek Psychogeriatric Association, 22, Ioanni Drossopoulou Street, 112 57 Athens, Greece
- Department of Psychiatry, School of Medicine, University of Patras, 265 04 Patras, Greece
| | - Ion N Beratis
- Alzheimer's Center, "Nestor" Greek Psychogeriatric Association, 22, Ioanni Drossopoulou Street, 112 57 Athens, Greece
- Psychology Department, The American College of Greece, Deree, 6, Gravias Street, 153 42 Athens, Greece
| | - Kleio Moustaka
- Alzheimer's Center, "Nestor" Greek Psychogeriatric Association, 22, Ioanni Drossopoulou Street, 112 57 Athens, Greece
- Psychology Department, The American College of Greece, Deree, 6, Gravias Street, 153 42 Athens, Greece
| | - Panagiotis Alexopoulos
- Department of Psychiatry, School of Medicine, University of Patras, 265 04 Patras, Greece
- Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, 21, Arcisstraße Street, 80 333 Munich, Germany
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Kinger SB, Juneau T, Kaplan RI, Pluim CF, Fox-Fuller JT, Wang T, Mukadam N, Neargarder S, Salazar RD, Cronin-Golomb A. Changes in Apathy, Depression, and Anxiety in Parkinson's Disease from before to during the COVID-19 Era. Brain Sci 2023; 13:199. [PMID: 36831742 PMCID: PMC9954738 DOI: 10.3390/brainsci13020199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/26/2023] Open
Abstract
Apathy, depression, and anxiety are common non-motor symptoms of Parkinson's disease (PD). Tracking the changes in such symptoms over time would be valuable not only to determine their natural course during the disease, but also to establish the effects of unusual historical events interacting with the natural course. Having collected data on apathy (Apathy Scale), depression (Beck Depression Inventory-II), and anxiety (Parkinson's Anxiety Scale) in a large sample of persons with PD (PwPD) before the beginning of the COVID-19 era, we followed up with these individuals to investigate the changes in their prevalence of apathy, depression, and anxiety across two timepoints (T1 and T2). Of the original 347 participants, 111 responded and provided complete data at T2. The data collection at T1, before COVID-19, occurred between 2017-2018. The data collection at T2 occurred in 2021 and included the same measures, with the addition of the Coronavirus Impact Scale to assess the effects of the pandemic on the individual participants. Over this period, there was a significant increase in apathy, but not in depression or anxiety. Anxiety and depression, but not apathy, were correlated with the impact of COVID-19.
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Affiliation(s)
- Shraddha B. Kinger
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02215, USA
| | - Truley Juneau
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02215, USA
| | - Rini I. Kaplan
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02215, USA
| | - Celina F. Pluim
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02215, USA
| | - Joshua T. Fox-Fuller
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02215, USA
| | - Timothy Wang
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02215, USA
| | - Nishaat Mukadam
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02215, USA
| | - Sandy Neargarder
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02215, USA
- Department of Psychology, Bridgewater State University, Bridgewater, MA 02325, USA
| | - Robert D. Salazar
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02215, USA
| | - Alice Cronin-Golomb
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02215, USA
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Ratajska AM, Scott BM, Lopez FV, Kenney LE, Foote KD, Okun MS, Price C, Bowers D. Differential contributions of depression, apathy, and anxiety to neuropsychological performance in Parkinson's disease versus essential tremor. J Clin Exp Neuropsychol 2022; 44:651-664. [PMID: 36600515 PMCID: PMC10013508 DOI: 10.1080/13803395.2022.2157796] [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: 09/26/2022] [Accepted: 12/07/2022] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Mood symptoms are common features of Parkinson's disease (PD) and essential tremor (ET) and have been linked to worse cognition. The goals of the present study were to compare the severity of anxiety, apathy, and depressive symptoms in PD, ET, and healthy controls (HC) and to examine differential relationships between mood and cognition. METHOD Older adults with idiopathic PD (N = 448), ET (N = 128), or HC (N = 136) completed a multi-domain neuropsychological assessment consisting of memory, executive function, and attention/working memory domains. Participants also completed self-reported mood measures. Between-group differences in mood and cognition were assessed, and hierarchical regression models were conducted to examine relationships between mood and cognition in each group. RESULTS Relative to the HC group, the PD and ET groups reported more mood symptoms and scored lower across all cognitive measures. There were no differences between the two movement disorder groups. Mood variables explained 3.9-13.7% of the total variance in cognitive domains, varying by disease group. For PD, apathy was the only unique predictor of executive function (β = -.114, p = .05), and trait anxiety was the only unique predictor of attention/working memory (β = -.188, p < .05). For ET, there were no unique predictors, though the overall models significantly predicted performance in the executive function and attention/working memory domains. CONCLUSIONS In a large cohort of ET and PD, we observed that the two groups had similar self-reported mood symptoms. Mood symptoms were differentially associated with cognition in PD versus ET. In PD, increased apathy was associated with worse executive function and higher trait anxiety predicted worse attention/working memory. For ET, there were no unique predictors, though the overall mood symptom severity was related to cognition. Our study highlights the importance of considering the relationship between mood and neuropsychological performance in individuals with movement disorders.
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Affiliation(s)
- Adrianna M. Ratajska
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - Bonnie M. Scott
- Department of Neurology, Dell Medical School, The University of Texas at Austin, Austin, TX
| | - Francesca V. Lopez
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - Lauren E. Kenney
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - Kelly D. Foote
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL
| | - Michael S. Okun
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL
| | - Catherine Price
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - Dawn Bowers
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL
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De Waele S, Cras P, Crosiers D. Apathy in Parkinson's Disease: Defining the Park Apathy Subtype. Brain Sci 2022; 12:923. [PMID: 35884730 PMCID: PMC9313138 DOI: 10.3390/brainsci12070923] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/12/2022] [Accepted: 07/12/2022] [Indexed: 01/25/2023] Open
Abstract
Apathy is a neurobehavioural symptom affecting Parkinson's disease patients of all disease stages. Apathy seems to be associated with a specific underlying non-motor disease subtype and reflects dysfunction of separate neural networks with distinct neurotransmitter systems. Due to the complicated neuropsychiatric aetiology of apathy, clinical assessment of this invalidating non-motor symptom remains challenging. We aim to summarize the current findings on apathy in Parkinson's disease and highlight knowledge gaps. We will discuss the prevalence rates across the different disease stages and suggest screening tools for clinically relevant apathetic symptoms. We will approach the fundamental knowledge on the neural networks implicated in apathy in a practical manner and formulate recommendations on patient-tailored treatment. We will discuss the Park apathy phenotype in detail, shedding light on different clinical manifestations and implications for prognosis. With this review, we strive to distil the vast available theoretical knowledge into a clinical and patient-oriented perspective.
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Affiliation(s)
- Ségolène De Waele
- Translational Neurosciences, Born-Bunge Institute, Faculty of Medicine and Health Sciences, University of Antwerp, 2650 Edegem, Belgium; (P.C.); (D.C.)
- Department of Neurology, Antwerp University Hospital, 2650 Edegem, Belgium
| | - Patrick Cras
- Translational Neurosciences, Born-Bunge Institute, Faculty of Medicine and Health Sciences, University of Antwerp, 2650 Edegem, Belgium; (P.C.); (D.C.)
- Department of Neurology, Antwerp University Hospital, 2650 Edegem, Belgium
| | - David Crosiers
- Translational Neurosciences, Born-Bunge Institute, Faculty of Medicine and Health Sciences, University of Antwerp, 2650 Edegem, Belgium; (P.C.); (D.C.)
- Department of Neurology, Antwerp University Hospital, 2650 Edegem, Belgium
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Raimo S, Trojano L, Gaita M, d'Onofrio F, Spitaleri D, Santangelo G. Relationship between apathy and cognitive dysfunctions in Multiple Sclerosis: a 4-year prospective longitudinal study. Mult Scler Relat Disord 2022; 63:103929. [DOI: 10.1016/j.msard.2022.103929] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/10/2022] [Accepted: 05/27/2022] [Indexed: 12/01/2022]
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Hattori N, Kogo Y, Koebis M, Ishida T, Suzuki I, Tsuboi Y, Nomoto M. The Effects of Safinamide Adjunct Therapy on Depression and Apathy in Patients With Parkinson's Disease: Post-hoc Analysis of a Japanese Phase 2/3 Study. Front Neurol 2022; 12:752632. [PMID: 35222225 PMCID: PMC8869178 DOI: 10.3389/fneur.2021.752632] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 12/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Purpose Neuropsychiatric symptoms in Parkinson's disease (PD) have been shown to significantly affect quality of life (QOL). We investigated the impact of safinamide on depression and apathy when administered as an adjunct to levodopa in Japanese patients with PD. Methods This was a post-hoc analysis of data from a phase 2/3 clinical study of safinamide in Japanese patients with PD experiencing wearing-off (JapicCTI-153056; https://www.clinicaltrials.jp/cti-user/trial/ShowDirect.jsp?japicId=JapicCTI-153056). Patients received placebo, safinamide 50 mg, or safinamide 100 mg as an adjunct therapy. The endpoints for this analysis were changes from baseline to Week 24 in the Unified Parkinson's Disease Rating Scale (UPDRS) Part I item 3 (depression) and item 4 (apathy) scores and the Parkinson's Disease Questionnaire (PDQ-39) “emotional well-being” domain score. Subgroup analyses investigated the relationship between neuropsychologic symptoms and improvements in motor fluctuation and assessed which patient populations might be expected to obtain neuropsychologic benefit from safinamide. Results Compared with placebo, safinamide (both doses) significantly improved UPDRS Part I item 3 scores in the overall analysis population, and the 100-mg dose improved UPDRS Part I item 4 scores in the population with apathy at baseline. Changes in the PDQ-39 “emotional well-being” score showed numerical, but not significant, dose-related improvements. Notable reductions in depression were associated with a change in daily ON-time ≥1 h, pain during OFF-time at baseline, and female sex. Conclusions The results from this post-hoc analysis of the Japanese phase 2/3 study suggest that safinamide could bring benefits to patients with PD who have mild depression, pain during the OFF phase. In addition, safinamide might provide particular benefits for patients with PD who have mild apathy and female.
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Affiliation(s)
- Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Yuki Kogo
- Medical Headquarters, Eisai Co., Ltd., Tokyo, Japan
| | | | | | - Ippei Suzuki
- Medicine Development Center, Eisai Co., Ltd., Tokyo, Japan
| | - Yoshio Tsuboi
- Department of Neurology, Fukuoka University, Fukuoka, Japan
| | - Masahiro Nomoto
- Department of Neurology, Saiseikai Imabari Center for Health and Welfare, Ehime, Japan
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Pluim CF, Nakhla MZ, Split M, Filoteo JV, Litvan I, Moore RC, Lessig S, Schiehser DM. Changes in Self- and Informant-Reported Frontal Behaviors in Parkinson's Disease: A Longitudinal Study. J Geriatr Psychiatry Neurol 2022; 35:89-101. [PMID: 33030110 DOI: 10.1177/0891988720964257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Frontal behaviors (i.e., executive dysfunction, disinhibition, apathy) are common in Parkinson's disease (PD). However, it is unclear if patient and informant reports of patient frontal behaviors are in agreement over time. METHOD Sixty-two PD patients without dementia and their informants (87% spouses/partners) completed the self- and informant-versions of the Frontal Systems Behavior Scale at baseline and 2-year follow-up. Dyad ratings were compared and predictors of behavior ratings were examined. RESULTS Patient and informant reports at baseline and follow-up were in agreement, with significant increases in overall frontal behaviors, executive dysfunction, and apathy. Higher levels of baseline patient depression and caregiver burden predicted decrements in patient-reported executive function; worse patient cognition at baseline predicted worsening apathy as rated by informants. CONCLUSIONS PD patients and their informants are concordant in their ratings of worsening frontal behaviors over time. Targeting patient depression, cognition, and caregiver burden may improve decrements in frontal behaviors (executive dysfunction and apathy) in PD.
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Affiliation(s)
- Celina F Pluim
- Research and Psychology Services, 19979VA San Diego Healthcare System, San Diego, CA, USA
| | - Marina Z Nakhla
- Research and Psychology Services, 19979VA San Diego Healthcare System, San Diego, CA, USA.,464916SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Molly Split
- Research and Psychology Services, 19979VA San Diego Healthcare System, San Diego, CA, USA
| | - J Vincent Filoteo
- Research and Psychology Services, 19979VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, 8784University of California San Diego, La Jolla, CA, USA.,Department of Neurosciences, Parkinson and Other Movement Disorders Center, 8784University of California San Diego, La Jolla, CA, USA
| | - Irene Litvan
- Department of Neurosciences, Parkinson and Other Movement Disorders Center, 8784University of California San Diego, La Jolla, CA, USA
| | - Raeanne C Moore
- Department of Psychiatry, 8784University of California San Diego, La Jolla, CA, USA
| | - Stephanie Lessig
- Research and Psychology Services, 19979VA San Diego Healthcare System, San Diego, CA, USA.,Department of Neurosciences, Parkinson and Other Movement Disorders Center, 8784University of California San Diego, La Jolla, CA, USA
| | - Dawn M Schiehser
- Research and Psychology Services, 19979VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, 8784University of California San Diego, La Jolla, CA, USA
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Milani G, Demattè G, Ferioli M, Dallagà G, Lavezzi S, Basaglia N, Straudi S. Telerehabilitation in Italy During the COVID-19 Lockdown: A Feasibility and Acceptability Study. Int J Telerehabil 2021; 13:e6334. [PMID: 34345336 PMCID: PMC8287718 DOI: 10.5195/ijt.2021.6334] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
This study examined the feasibility and acceptability of a telerehabilitation program during the COVID-19 pandemic in a sample of adult patients with physical disabilities. Of the twenty-three patients enrolled, 11 agreed to participate in a video-based telerehabilitation program. Barriers and facilitators to the adoption of telerehabilitation were identified and clinical, demographic, and psychological variables were analysed as predictors of success. Age, cognitive reserve, and resilience were significant predictors of satisfaction with telerehabilitation (p<0.05). The telerehabilitation program was perceived as feasible and was well accepted by patients, despite some technology challenges. However, patients who took advantage of telerehabilitation perceived differences in the quality of service and preferred traditional in-person treatment to service delivery via telerehabilitation.
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Affiliation(s)
- Giada Milani
- IIT@UNIFE Center for Translational Neurophysiology, Istituto Italiano DI Tecnologia, Ferrara, Italy.,Doctoral Program in Translational Neurosciences and Neurotechnologies, Ferrara University, Ferrara, Italy.,Department of Neuroscience and Rehabilitation, Ferrara University Hospital, Ferrara, Italy
| | - Giulia Demattè
- School of Physiotherapy, Ferrara University, Ferrara, Italy
| | | | - Giulia Dallagà
- Department of Neuroscience and Rehabilitation, Ferrara University Hospital, Ferrara, Italy
| | - Susanna Lavezzi
- Department of Neuroscience and Rehabilitation, Ferrara University Hospital, Ferrara, Italy
| | - Nino Basaglia
- Department of Neuroscience and Rehabilitation, Ferrara University Hospital, Ferrara, Italy
| | - Sofia Straudi
- Department of Neuroscience and Rehabilitation, Ferrara University Hospital, Ferrara, Italy
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Neuropsychiatric and Cognitive Deficits in Parkinson's Disease and Their Modeling in Rodents. Biomedicines 2021; 9:biomedicines9060684. [PMID: 34204380 PMCID: PMC8234051 DOI: 10.3390/biomedicines9060684] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 11/29/2022] Open
Abstract
Parkinson’s disease (PD) is associated with a large burden of non-motor symptoms including olfactory and autonomic dysfunction, as well as neuropsychiatric (depression, anxiety, apathy) and cognitive disorders (executive dysfunctions, memory and learning impairments). Some of these non-motor symptoms may precede the onset of motor symptoms by several years, and they significantly worsen during the course of the disease. The lack of systematic improvement of these non-motor features by dopamine replacement therapy underlines their multifactorial origin, with an involvement of monoaminergic and cholinergic systems, as well as alpha-synuclein pathology in frontal and limbic cortical circuits. Here we describe mood and neuropsychiatric disorders in PD and review their occurrence in rodent models of PD. Altogether, toxin-based rodent models of PD indicate a significant but non-exclusive contribution of mesencephalic dopaminergic loss in anxiety, apathy, and depressive-like behaviors, as well as in learning and memory deficits. Gene-based models display significant deficits in learning and memory, as well as executive functions, highlighting the contribution of alpha-synuclein pathology to these non-motor deficits. Collectively, neuropsychiatric and cognitive deficits are recapitulated to some extent in rodent models, providing partial but nevertheless useful options to understand the pathophysiology of non-motor symptoms and develop therapeutic options for these debilitating symptoms of PD.
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Barekatain M, Rajabi F, Ebrahimi A, Maracy MR, Akbaripour S. Comparison of Design Fluency Test Results among Patients with Parkinson's Disease, Frontotemporal Dementia, and the Control Group. Adv Biomed Res 2021; 10:13. [PMID: 34322457 PMCID: PMC8312372 DOI: 10.4103/abr.abr_148_20] [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: 06/26/2020] [Revised: 08/31/2020] [Accepted: 09/20/2020] [Indexed: 11/21/2022] Open
Abstract
Background: Design Fluency Test (DFT) is a nonverbal frame-free, nonstructured assessment of executive function (EF). Since previous studies evaluating EF in Parkinson's disease (PD) have mainly used verbal assessments for EF, this study aims to evaluate the pattern of executive domains in PD using DFT and to compare it with behavioral variant frontotemporal dementia (FTD) as a prototype for executive dysfunction and also with normal controls (NCs). Materials and Methods: Twenty-eight patients with PD, 27 with FTD, and 27 NCs were included in the study in Ayatollah Kashani Neuropsychiatry Clinic affiliated to Isfahan University of Medical Sciences from September 2019 to February 2020. All participants were assessed via semi-structured neuropsychiatric interview, questionnaire for demographic profile (age, handedness, gender, education, and marital status), duration of illness, comorbid medical condition, comorbid psychiatric illnesses and medications, DFT, Short Parkinson's Evaluation Scale, Frontal Assessment Battery, Judgment of Line Orientation, and Neuropsychiatry Unit Cognitive Assessment Tool. Results: Fixed condition novelty score was significantly different between FTD and PD (P < 0.001), FTD and control (P < 0.001), and also between PD and control (P = 0.001). When free and fixed condition novelty scores were considered to predict diagnostic attribution, multinomial logistic regression revealed that odds ratio for free condition novelty score was 0.705 (P = 0.005, 95% confidence interval [CI] = 0.553–0.899) and 0.494 (P = 0.001, 95% CI = 0.328–0.744) in PD and FTD, respectively. The odds ratio for fixed condition novelty score was 0.772 (P = 0.011, 95% CI = 0.632–0.942) and 0.449 (P = 0.00, 95% CI = 0.292–0.691). Conclusion: DFT subscores can be helpful in diagnosis and differentiation between FTD and PD.
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Affiliation(s)
- Majid Barekatain
- Department of Psychiatry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Rajabi
- Department of Psychiatry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amrollah Ebrahimi
- Department of Health Psychology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Reza Maracy
- Department of Epidemilogy and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sahar Akbaripour
- Neuropsychiatry Unit, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
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Saredakis D, Keage HA, Corlis M, Loetscher T. Using Virtual Reality to Improve Apathy in Residential Aged Care: Mixed Methods Study. J Med Internet Res 2020; 22:e17632. [PMID: 32469314 PMCID: PMC7380990 DOI: 10.2196/17632] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 03/26/2020] [Accepted: 04/08/2020] [Indexed: 12/17/2022] Open
Abstract
Background Apathy is a common symptom in neurological disorders, including dementia, and is associated with a faster rate of cognitive decline, reduced quality of life, and high caregiver burden. There is a lack of effective pharmacological treatments for apathy, and nonpharmacological interventions are a preferred first-line approach to treatment. Virtual reality (VR) using head-mounted displays (HMDs) is being successfully used in exposure- and distraction-based therapies; however, there is limited research on using HMDs for symptoms of neurological disorders. Objective This feasibility study aimed to assess whether VR using HMDs could be used to deliver tailored reminiscence therapy and examine the willingness to participate, response rates to measures, time taken to create tailored content, and technical problems. In addition, this study aimed to explore the immediate effects between verbal fluency and apathy after exposure to VR. Methods A mixed methods study was conducted in a sample of older adults residing in aged care, and 17 participants were recruited. Apathy was measured using the Apathy Evaluation Scale (AES), and verbal fluency was used as a proxy measure of improvements in apathy and debriefing interviews to assess feedback from participants. Side effects that can occur from using HMDs were also measured. Results We recruited participants from a high socioeconomic status setting with a high education level, and the participation rate was 85% (17/20); most responses to measures were positive. Access to a wide range of freely available content and the absence of technical difficulties made the delivery of a VR reminiscence intervention highly feasible. Participants had improved semantic scores (t14=−3.27; P=.006) but not phonemic fluency scores (t14=0.55; P=.59) immediately after the intervention. Those with higher levels of apathy demonstrated the greatest cognitive improvements after a VR reminiscence experience, which was indicated by a strong positive relationship between the AES and semantic verbal fluency change scores postminus pre-VR (r=0.719; 95% CI 0.327 to 0.900; P=.003). All participants enjoyed the experience despite 35% (6/17) of participants experiencing temporary side effects. Conclusions This study provides initial evidence that it is feasible to use VR with HMDs for therapy to treat symptoms of apathy in older adults in residential aged care. However, there is a need to closely monitor the side effects of HMD use in older adults. Further research is needed using an active control group to compare the use of VR with traditional forms of reminiscence therapy.
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Effects of gender on cognitive and behavioral manifestations in multiple system atrophy. J Neural Transm (Vienna) 2020; 127:925-934. [PMID: 32172473 DOI: 10.1007/s00702-020-02169-z] [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: 12/11/2019] [Accepted: 03/05/2020] [Indexed: 12/29/2022]
Abstract
Gender differences have been described in several neurodegenerative disorders, such as Alzheimer's disease and Parkinson's disease. The effects of gender on cognitive and behavioral manifestations in multiple system atrophy and the changes of cognitive functions over time according to gender have not been investigated so far. Fifty-five patients with a diagnosis of multiple system atrophy underwent a comprehensive neuropsychological and neuropsychiatric battery at baseline and 26 of them could be re-evaluated at 1-year follow-up. At baseline women with multiple system atrophy had poorer global cognitive state and visuo-spatial abilities, and a higher prevalence of depression and apathy than males. At follow-up, female patients deteriorated more than males on attention abilities and motor functions, and had a higher prevalence of depression than men. Executive functions and visuo-spatial abilities significantly worsened over time in both groups. Mild Cognitive Impairment single domain was significantly more frequent in females than males. Cognitive and behavioral differences between genders in multiple system atrophy involve global cognition, planning, attention, visual-perceptive skills, and depression, with female patients more compromised than males. Female patients deteriorated more than men over time as for motor functions and attention. Further longitudinal studies are deserved to confirm gender differences in progression of cognitive and behavioral features of multiple system atrophy.
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Apathy as a behavioural marker of cognitive impairment in Parkinson's disease: a longitudinal analysis. J Neurol 2019; 267:214-227. [PMID: 31616991 PMCID: PMC6954881 DOI: 10.1007/s00415-019-09538-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 09/08/2019] [Accepted: 09/10/2019] [Indexed: 01/10/2023]
Abstract
Background Understanding the longitudinal course of non-motor symptoms, and finding markers to predict cognitive decline in Parkinson’s disease (PD), are priorities. Previous work has demonstrated that apathy is one of the only behavioural symptoms that differentiates people with PD and intact cognition from those with mild cognitive impairment (MCI-PD). Other psychiatric symptoms emerge as dementia in PD develops. Objective We explored statistical models of longitudinal change to detect apathy as a behavioural predictor of cognitive decline in PD. Methods We followed 104 people with PD intermittently over 2 years, undertaking a variety of motor, behavioural and cognitive measures. We applied a linear mixed effects model to explore behavioural factors associated with cognitive change over time. Our approach goes beyond conventional modelling based on a random-intercept and slope approach, and can be used to examine the variability in measures within individuals over time. Results Global cognitive scores worsened during the two-year follow-up, whereas the longitudinal evolution of self-rated apathy scores and other behavioural measures was negligible. Level of apathy was negatively (− 0.598) correlated with level of cognitive impairment and participants with higher than average apathy scores at baseline also had poorer cognition. The model indicated that departure from the mean apathy score at any point in time was mirrored by a corresponding departure from average global cognitive score. Conclusion High levels of apathy are predictive of negative cognitive and behavioural outcomes over time, suggesting that apathy may be a behavioural indicator of early cognitive decline. This has clinical and prognostic implications. Electronic supplementary material The online version of this article (10.1007/s00415-019-09538-z) contains supplementary material, which is available to authorized users.
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Branco LD, Cotrena C, Shansis FM, Fonseca RP. Cognitive abilities underlying performance on the modified card sorting test: novel and traditional scores. APPLIED NEUROPSYCHOLOGY-ADULT 2019; 28:544-555. [PMID: 31530030 DOI: 10.1080/23279095.2019.1663522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The Modified Card Sorting Test (MCST) is a widely used variation of the Wisconsin Card Sorting Test. It is faster to administer, less frustrating for respondents and less ambiguous in its scoring but has been criticized for its task impurity and low discriminability between control participants and clinical groups prone to executive dysfunction. This study aimed to examine the executive functions (EF) underlying traditional (number of categories completed, perseverative errors) and novel scores for the MCST, and compare their ability to differentiate between control and clinical samples. Novel and traditional MCST scores were compared between 94 control participants, 87 with bipolar disorder and 64 with major depression. The relationship between MCST scores and traditional EF tasks was examined through correlation and regression analyses. All MCST scores were associated with at least one measure of EF, the most common of which were the Trail Making or Hayling Tests. IQ predicted most scores on the MCST, save for nonperseverative errors and categorizing efficiency. Traditional and novel scores differentiated between clinical and control groups. These findings support the utility of the MCST in detecting executive dysfunction and highlight the importance of new scoring methods in increasing the specificity and interpretability of this task.
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Affiliation(s)
- Laura Damiani Branco
- Graduate Department of Psychology, School of Health Sciences, Pontifical Catholic University of Rio Grande Do Sul (PUCRS), Porto Alegre, Brazil
| | - Charles Cotrena
- Graduate Department of Psychology, School of Health Sciences, Pontifical Catholic University of Rio Grande Do Sul (PUCRS), Porto Alegre, Brazil
| | | | - Rochele Paz Fonseca
- Graduate Department of Psychology, School of Health Sciences, Pontifical Catholic University of Rio Grande Do Sul (PUCRS), Porto Alegre, Brazil
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Yoon EJ, Ismail Z, Hanganu A, Kibreab M, Hammer T, Cheetham J, Kathol I, Sarna JR, Martino D, Furtado S, Monchi O. Mild behavioral impairment is linked to worse cognition and brain atrophy in Parkinson disease. Neurology 2019; 93:e766-e777. [PMID: 31320470 DOI: 10.1212/wnl.0000000000007968] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 03/27/2019] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To evaluate the associations of mild behavioral impairment (MBI) with cognitive deficits and patterns of gray matter changes in Parkinson disease (PD). METHODS Sixty patients with PD without dementia and 29 healthy controls underwent a cognitive neuropsychological evaluation and structural MRI scan. MBI was evaluated with the MBI Checklist (MBI-C), a rating scale designed to elicit emergent neuropsychiatric symptoms in accordance with MBI criteria. We divided the patients with PD into 2 groups: 1 group with high MBI-C scores (PD-MBI) and the other with low MBI-C scores (PD-noMBI). RESULTS Among 60 patients with PD, 20 were categorized as having PD-MBI (33.33%). In healthy controls, no participants met the MBI cut-point threshold. The PD-MBI group had significantly lower Montreal Cognitive Assessment and z scores in all 5 domains and the global score compared to healthy controls and those with PD-noMBI. In addition, all cognitive domains except language and global cognition negatively correlated with the MBI-C total score in all patients with PD. For cortical structures, the PD-MBI group revealed middle temporal cortex thinning and decreased volume compared with the PD-noMBI group, and decreased volume in this area negatively correlated with the MBI-C total score. CONCLUSIONS The impaired cognitive function over all domains and atrophy in the temporal area in the PD-MBI group are in line with posterior cortical circuit deficits in PD, which have been associated with a faster rate of progression to dementia. These initial results suggest that MBI might be an early and important marker for incident cognitive decline and dementia in patients with PD.
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Affiliation(s)
- Eun Jin Yoon
- From the Department of Clinical Neurosciences (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.) and Departments of Psychiatry and Community Health Sciences (Z.I.), University of Calgary; Hotchkiss Brain Institute (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.), Cumming School of Medicine, Calgary, Alberta; Centre de Recherche (A.H., O.M.), Institut Universitaire de Gériatrie de Montréal; and Department of Psychology (A.H.), University of Montréal, Québec, Canada
| | - Zahinoor Ismail
- From the Department of Clinical Neurosciences (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.) and Departments of Psychiatry and Community Health Sciences (Z.I.), University of Calgary; Hotchkiss Brain Institute (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.), Cumming School of Medicine, Calgary, Alberta; Centre de Recherche (A.H., O.M.), Institut Universitaire de Gériatrie de Montréal; and Department of Psychology (A.H.), University of Montréal, Québec, Canada
| | - Alexandru Hanganu
- From the Department of Clinical Neurosciences (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.) and Departments of Psychiatry and Community Health Sciences (Z.I.), University of Calgary; Hotchkiss Brain Institute (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.), Cumming School of Medicine, Calgary, Alberta; Centre de Recherche (A.H., O.M.), Institut Universitaire de Gériatrie de Montréal; and Department of Psychology (A.H.), University of Montréal, Québec, Canada
| | - Mekale Kibreab
- From the Department of Clinical Neurosciences (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.) and Departments of Psychiatry and Community Health Sciences (Z.I.), University of Calgary; Hotchkiss Brain Institute (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.), Cumming School of Medicine, Calgary, Alberta; Centre de Recherche (A.H., O.M.), Institut Universitaire de Gériatrie de Montréal; and Department of Psychology (A.H.), University of Montréal, Québec, Canada
| | - Tracy Hammer
- From the Department of Clinical Neurosciences (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.) and Departments of Psychiatry and Community Health Sciences (Z.I.), University of Calgary; Hotchkiss Brain Institute (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.), Cumming School of Medicine, Calgary, Alberta; Centre de Recherche (A.H., O.M.), Institut Universitaire de Gériatrie de Montréal; and Department of Psychology (A.H.), University of Montréal, Québec, Canada
| | - Jenelle Cheetham
- From the Department of Clinical Neurosciences (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.) and Departments of Psychiatry and Community Health Sciences (Z.I.), University of Calgary; Hotchkiss Brain Institute (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.), Cumming School of Medicine, Calgary, Alberta; Centre de Recherche (A.H., O.M.), Institut Universitaire de Gériatrie de Montréal; and Department of Psychology (A.H.), University of Montréal, Québec, Canada
| | - Iris Kathol
- From the Department of Clinical Neurosciences (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.) and Departments of Psychiatry and Community Health Sciences (Z.I.), University of Calgary; Hotchkiss Brain Institute (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.), Cumming School of Medicine, Calgary, Alberta; Centre de Recherche (A.H., O.M.), Institut Universitaire de Gériatrie de Montréal; and Department of Psychology (A.H.), University of Montréal, Québec, Canada
| | - Justyna R Sarna
- From the Department of Clinical Neurosciences (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.) and Departments of Psychiatry and Community Health Sciences (Z.I.), University of Calgary; Hotchkiss Brain Institute (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.), Cumming School of Medicine, Calgary, Alberta; Centre de Recherche (A.H., O.M.), Institut Universitaire de Gériatrie de Montréal; and Department of Psychology (A.H.), University of Montréal, Québec, Canada
| | - Davide Martino
- From the Department of Clinical Neurosciences (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.) and Departments of Psychiatry and Community Health Sciences (Z.I.), University of Calgary; Hotchkiss Brain Institute (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.), Cumming School of Medicine, Calgary, Alberta; Centre de Recherche (A.H., O.M.), Institut Universitaire de Gériatrie de Montréal; and Department of Psychology (A.H.), University of Montréal, Québec, Canada
| | - Sarah Furtado
- From the Department of Clinical Neurosciences (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.) and Departments of Psychiatry and Community Health Sciences (Z.I.), University of Calgary; Hotchkiss Brain Institute (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.), Cumming School of Medicine, Calgary, Alberta; Centre de Recherche (A.H., O.M.), Institut Universitaire de Gériatrie de Montréal; and Department of Psychology (A.H.), University of Montréal, Québec, Canada
| | - Oury Monchi
- From the Department of Clinical Neurosciences (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.) and Departments of Psychiatry and Community Health Sciences (Z.I.), University of Calgary; Hotchkiss Brain Institute (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.), Cumming School of Medicine, Calgary, Alberta; Centre de Recherche (A.H., O.M.), Institut Universitaire de Gériatrie de Montréal; and Department of Psychology (A.H.), University of Montréal, Québec, Canada.
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Brown DS, Barrett MJ, Flanigan JL, Sperling SA. Clinical and demographic correlates of apathy in Parkinson's disease. J Neurol 2019; 266:507-514. [PMID: 30604055 DOI: 10.1007/s00415-018-9166-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/26/2018] [Accepted: 12/19/2018] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To better understand the demographic, neuropsychiatric, cognitive, and motor predictors of apathy in Parkinson's disease (PD). METHOD 112 participants (Mage = 68.53 years; Mdisease duration = 6.17 years) were administered the Apathy Scale (AS), Beck Depression Inventory-II (BDI-II), Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Trail Making Test (TMT), Wechsler Adult Intelligence Scale-IV Matrix Reasoning subtest, letter (F-A-S) and category (Animals) fluency, and Hopkins Verbal Learning Test-Revised. Psychosis was assessed. A stepwise logistic regression analysis was performed to investigate the ability of demographic factors and clinical assessments to predict nonapathetic (AS ≤ 13) versus apathetic (AS > 13) group membership. RESULTS The regression analysis yielded a robust model in which older age, less education, elevated BDI-II, current psychosis, higher MDS-UPDRS Part III (motor score), and slower TMT-B performance predicted membership in the apathetic group, with a correct classification rate of 77.5% (Nagelkerke R2 = 0.48, p < .001). Depression (OR = 9.20, p < .001) and education (OR = 0.66, p = 0.002) contributed significantly to the overall model. A linear regression with AS score as the outcome variable was similar, but TMT-B additionally contributed significantly (p = 0.02) to the overall model, F(6, 86) = 12.02, p < .001, adjusted R2 = 0.42. CONCLUSIONS Of the factors examined, depression, education, and executive functioning were the strongest correlates of apathy in PD. These results support the idea that common underlying frontosubcortical disruptions in this population contribute to apathy, depression, and executive dysfunction.
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Affiliation(s)
- Daniel S Brown
- Department of Neurology, University of Virginia, PO Box 800394, 22908-0394, Charlottesville, VA, USA
| | - Matthew J Barrett
- Department of Neurology, University of Virginia, PO Box 800394, 22908-0394, Charlottesville, VA, USA
| | - Joseph L Flanigan
- Department of Neurology, University of Virginia, PO Box 800394, 22908-0394, Charlottesville, VA, USA
| | - Scott A Sperling
- Department of Neurology, University of Virginia, PO Box 800394, 22908-0394, Charlottesville, VA, USA.
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“Pure apathy” and cognitive dysfunctions in Parkinson’s disease: A meta-analytic study. Neurosci Biobehav Rev 2018; 94:1-10. [DOI: 10.1016/j.neubiorev.2018.08.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/31/2018] [Accepted: 08/06/2018] [Indexed: 11/21/2022]
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Ang Y, Lockwood PL, Kienast A, Plant O, Drew D, Slavkova E, Tamm M, Husain M. Differential impact of behavioral, social, and emotional apathy on Parkinson's disease. Ann Clin Transl Neurol 2018; 5:1286-1291. [PMID: 30349863 PMCID: PMC6186939 DOI: 10.1002/acn3.626] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 06/12/2018] [Accepted: 07/06/2018] [Indexed: 12/17/2022] Open
Abstract
Apathy is highly prevalent in Parkinson's disease. New findings suggest the syndrome is multifaceted. Here, we investigate whether all aspects of apathy are equally affected in Parkinson's disease and whether different dimensions of apathy were associated with depression and anhedonia. On the Apathy Motivation Index, while behavioral apathy and social apathy were elevated, emotional motivation was relatively preserved in Parkinson's disease, although a few patients did show impaired emotional sensitivity. Behavioral and social, but not emotional, apathy was associated with depression and anhedonia. These findings suggest aspects of motivation can be selectively impaired in Parkinson's disease and may have implications for guiding treatment.
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Affiliation(s)
- Yuen‐Siang Ang
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
- Department of Experimental PsychologyUniversity of OxfordOxfordUnited Kingdom
- Department of Experimental PsychologyWellcome Trust Centre for Integrative NeuroimagingUniversity of OxfordOxfordUnited Kingdom
| | - Patricia L. Lockwood
- Department of Experimental PsychologyUniversity of OxfordOxfordUnited Kingdom
- Department of Experimental PsychologyWellcome Trust Centre for Integrative NeuroimagingUniversity of OxfordOxfordUnited Kingdom
| | - Annika Kienast
- Department of Experimental PsychologyUniversity of OxfordOxfordUnited Kingdom
- Department of Experimental PsychologyWellcome Trust Centre for Integrative NeuroimagingUniversity of OxfordOxfordUnited Kingdom
| | - Olivia Plant
- Department of Experimental PsychologyUniversity of OxfordOxfordUnited Kingdom
- Department of Experimental PsychologyWellcome Trust Centre for Integrative NeuroimagingUniversity of OxfordOxfordUnited Kingdom
| | - Daniel Drew
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
- Department of Experimental PsychologyWellcome Trust Centre for Integrative NeuroimagingUniversity of OxfordOxfordUnited Kingdom
| | - Elitsa Slavkova
- Department of Experimental PsychologyUniversity of OxfordOxfordUnited Kingdom
- Department of Experimental PsychologyWellcome Trust Centre for Integrative NeuroimagingUniversity of OxfordOxfordUnited Kingdom
| | - Marin Tamm
- Department of Experimental PsychologyUniversity of OxfordOxfordUnited Kingdom
- Department of Experimental PsychologyWellcome Trust Centre for Integrative NeuroimagingUniversity of OxfordOxfordUnited Kingdom
| | - Masud Husain
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
- Department of Experimental PsychologyUniversity of OxfordOxfordUnited Kingdom
- Department of Experimental PsychologyWellcome Trust Centre for Integrative NeuroimagingUniversity of OxfordOxfordUnited Kingdom
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Szymkowicz SM, Dotson VM, Jones JD, Okun MS, Bowers D. Symptom Dimensions of Depression and Apathy and Their Relationship With Cognition in Parkinson's Disease. J Int Neuropsychol Soc 2018; 24:269-282. [PMID: 29032789 PMCID: PMC5820218 DOI: 10.1017/s1355617717001011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Both depression and apathy, alone and in combination, have been shown to negatively affect cognition in patients with Parkinson's disease (PD). However, the influence of specific symptom dimensions of depression and apathy on cognition is not well understood. The current study investigated the relationship between symptom dimensions of depression and apathy, based on factors identified in Kirsch-Darrow et al. (2011), and memory and executive function in PD. METHODS A sample of 138 non-demented individuals with PD (mean age=64.51±7.43 years) underwent neuropsychological testing and completed the Beck Depression Inventory, 2nd Edition, and Apathy Scale. Separate hierarchical regression models examined the relationship between symptom dimensions of depression and apathy ("pure" depressive symptoms, "pure" apathy, loss of interest/pleasure [anhedonia], and somatic symptoms) and three cognitive domain composites: immediate verbal memory, delayed verbal memory, and executive function. RESULTS After adjusting for general cognitive status and the influence of the other symptom dimensions, "pure" depressive symptoms were negatively associated with the delayed verbal memory composite (p<.034) and somatic symptoms were positively associated with the executive function composite (p<.026). No symptom dimensions were significantly related to the immediate verbal memory composite. CONCLUSIONS Findings suggest that specific mood symptoms are associated with delayed verbal memory and executive function performance in non-demented patients with PD. Further research is needed to better understand possible mechanisms through which specific symptom dimensions of depression and apathy are associated with cognition in PD. (JINS, 2018, 24, 269-282).
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Affiliation(s)
- Sarah M. Szymkowicz
- Department of Clinical & Health Psychology, College of Public Health & Health Professions, University of Florida, Gainesville, FL, USA
| | - Vonetta M. Dotson
- Department of Clinical & Health Psychology, College of Public Health & Health Professions, University of Florida, Gainesville, FL, USA
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Jacob D. Jones
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California - Los Angeles, Los Angeles, CA, USA
| | - Michael S. Okun
- Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, USA
- Center for Movement Disorders & Neurorestoration, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Dawn Bowers
- Department of Clinical & Health Psychology, College of Public Health & Health Professions, University of Florida, Gainesville, FL, USA
- Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, USA
- Center for Movement Disorders & Neurorestoration, College of Medicine, University of Florida, Gainesville, FL, USA
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23
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Fishman KN, Ashbaugh AR, Lanctôt KL, Cayley ML, Herrmann N, Murray BJ, Sicard M, Lien K, Sahlas DJ, Swartz RH. Apathy, not depressive symptoms, as a predictor of semantic and phonemic fluency task performance in stroke and transient ischemic attack. J Clin Exp Neuropsychol 2017; 40:449-461. [DOI: 10.1080/13803395.2017.1371282] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Keera N. Fishman
- Department of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Andrea R. Ashbaugh
- Department of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Krista L. Lanctôt
- Department of Medicine (Psychiatry), Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Megan L. Cayley
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Nathan Herrmann
- Department of Medicine (Psychiatry), Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Brian J. Murray
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Michelle Sicard
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Karen Lien
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Demetrios J. Sahlas
- Department of Medicine (Neurology), Hamilton Health Sciences, Hamilton General Hospital, McMaster University, Hamilton, ON, Canada
| | - Richard H. Swartz
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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24
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Hatz F, Meyer A, Zimmermann R, Gschwandtner U, Fuhr P. Apathy in Patients with Parkinson's Disease Correlates with Alteration of Left Fronto-Polar Electroencephalographic Connectivity. Front Aging Neurosci 2017; 9:262. [PMID: 28860987 PMCID: PMC5559507 DOI: 10.3389/fnagi.2017.00262] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 07/24/2017] [Indexed: 01/03/2023] Open
Abstract
Introduction: Quantitative electroencephalography (QEEG) brain frequency and network analyses are known to differentiate between disease stages in Parkinson's disease (PD) and are possible biomarkers. They correlate with cognitive decline. Little is known about changes in brain networks in relation to apathy. Objective/Aims: To analyze changes in brain network connectivities related to apathy. Methods: 40 PD patients (14 PD with mild cognitive deficits and 26 PD with normal cognition) were included. All patients had extensive neuropsychological testing; apathy was evaluated using the apathy evaluation score (AES, median 24.5, range 18–39). Resting state EEG was recorded with 256 electrodes and analyzed using fully automated Matlab® code (TAPEEG). For estimation of the connectivities between brain regions, PLI (phase lag index) was used, enhanced by a microstates segmentation. Results: After correction for multiple comparisons, significant correlations were found for single alpha2-band connectivities with the AES (p-values < 0.05). Lower connectivities, mainly involving the left fronto-polar region, were related to higher apathy scores. Conclusions: In our sample of patients with PD, apathy correlates with a network alteration mainly involving the left fronto-polar region. This might be due to dysfunction of the cortico-basal loop, modulating motivation.
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Affiliation(s)
- Florian Hatz
- Department of Neurology, Hospitals of University of BaselBasel, Switzerland
| | - Antonia Meyer
- Department of Neurology, Hospitals of University of BaselBasel, Switzerland
| | - Ronan Zimmermann
- Department of Neurology, Hospitals of University of BaselBasel, Switzerland
| | - Ute Gschwandtner
- Department of Neurology, Hospitals of University of BaselBasel, Switzerland
| | - Peter Fuhr
- Department of Neurology, Hospitals of University of BaselBasel, Switzerland
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25
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Cognitive Control, Learning, and Clinical Motor Ratings Are Most Highly Associated with Basal Ganglia Brain Volumes in the Premanifest Huntington's Disease Phenotype. J Int Neuropsychol Soc 2017; 23:159-170. [PMID: 28205498 PMCID: PMC5803794 DOI: 10.1017/s1355617716001132] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Huntington's disease (HD) is a debilitating genetic disorder characterized by motor, cognitive and psychiatric abnormalities associated with neuropathological decline. HD pathology is the result of an extended chain of CAG (cytosine, adenine, guanine) trinucleotide repetitions in the HTT gene. Clinical diagnosis of HD requires the presence of an otherwise unexplained extrapyramidal movement disorder in a participant at risk for HD. Over the past 15 years, evidence has shown that cognitive, psychiatric, and subtle motor dysfunction is evident decades before traditional motor diagnosis. This study examines the relationships among subcortical brain volumes and measures of emerging disease phenotype in prodromal HD, before clinical diagnosis. METHODS The dataset includes 34 cognitive, motor, psychiatric, and functional variables and five subcortical brain volumes from 984 prodromal HD individuals enrolled in the PREDICT HD study. Using cluster analyses, seven distinct clusters encompassing cognitive, motor, psychiatric, and functional domains were identified. Individual cluster scores were then regressed against the subcortical brain volumetric measurements. RESULTS Accounting for site and genetic burden (the interaction of age and CAG repeat length) smaller caudate and putamen volumes were related to clusters reflecting motor symptom severity, cognitive control, and verbal learning. CONCLUSIONS Variable reduction of the HD phenotype using cluster analysis revealed biologically related domains of HD and are suitable for future research with this population. Our cognitive control cluster scores show sensitivity to changes in basal ganglia both within and outside the striatum that may not be captured by examining only motor scores. (JINS, 2017, 23, 159-170).
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26
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Dias AE, Limongi JCP, Hsing WT, Barbosa ER. Telerehabilitation in Parkinson's disease: Influence of cognitive status. Dement Neuropsychol 2016; 10:327-332. [PMID: 29213477 PMCID: PMC5619273 DOI: 10.1590/s1980-5764-2016dn1004012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
Background The need for efficacy in voice rehabilitation in patients with Parkinson's
disease is well established. Given difficulties traveling from home to
treatment centers, the use of telerehabilitation may represent an invaluable
tool for many patients. Objective To analyze the influence of cognitive performance on acceptance of
telerehabilitation. Methods Fifty patients at stages 2-4 on the Hoehn-Yahr scale, aged 45-87 years old,
with cognitive scores of19-30 on the Mini-Mental State Examination, and 4-17
years of education were enrolled. All patients were submitted to evaluation
of voice intensity pre and post in-person treatment with the Lee Silverman
Voice Treatment (LSVT) and were asked to fill out a questionnaire regarding
their preferences between two options of treatment and evaluating basic
technological competence. Results Comparisons between pre and post-treatment values showed a mean increase of
14dBSPL in vocal intensity. When asked about potential acceptance to
participate in future telerehabilitation, 38 subjects agreed to take part
and 12 did not. For these two groups, 26% and 17% self-reported
technological competence, respectively. Agreement to engage in remote
therapy was positively associated with years of education and cognitive
status. Conclusion Responses to the questionnaire submitted after completion of traditional
in-person LSVT showed that the majority of patients (76%) were willing to
participate in future telerehabilitation. Age, gender, disease stage and
self-reported basic technological skills appeared to have no influence on
the decision, whereas other factors such as cognitive status and higher
school education were positively associated with acceptance of the new
therapy approach.
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Affiliation(s)
- Alice Estevo Dias
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, SP, Brazil
| | | | - Wu Tu Hsing
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, SP, Brazil
| | - Egberto Reis Barbosa
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, SP, Brazil
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27
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Assessment of apathy independent of physical disability: validation of the Dimensional Apathy Scale in Italian healthy sample. Neurol Sci 2016; 38:303-309. [DOI: 10.1007/s10072-016-2766-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Accepted: 11/08/2016] [Indexed: 12/30/2022]
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28
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Fitts W, Massimo L, Lim N, Grossman M, Dahodwala N. Computerized assessment of goal-directed behavior in Parkinson's disease. J Clin Exp Neuropsychol 2016; 38:1015-25. [PMID: 27270271 PMCID: PMC4979569 DOI: 10.1080/13803395.2016.1184232] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Apathy is a syndrome characterized by a reduction in goal-directed behavior. Neurodegenerative diseases frequently exhibit apathy. However, we lack an objective measure of apathy. The Philadelphia Apathy Computerized Task (PACT) measures impairments in goal-directed behavior that contribute to apathy, including initiation, planning, and motivation. We sought to examine these mechanisms in Parkinson's disease (PD) patients. METHOD PD patients and healthy controls with a caregiver were recruited for the study. Participants were administered the PACT, a novel computerized assessment of goal-directed behavior based on reaction times, and the Starkstein Apathy Scale (AS). Care partners completed the Neuropsychiatric Inventory (NPI). Baseline demographic characteristics of PD and control participants were compared using t tests and Wilcoxon rank sum tests. Linear regressions were used to compare PD patients to controls on each of the three PACT subtasks (initiation, planning, and motivation) while controlling for motor slowing. We then compared performance on each PACT subtask between PD subjects defined as apathetic using the NPI and Starkstein Apathy Scale and controls. RESULTS We included 30 PD and 15 control participants in the analysis. When controlling for motor slowing, both all PD and PD apathetic subjects were significantly slower than controls on the planning task and on the initiation task. There were no significant differences between PD patients and controls on the motivation tasks. CONCLUSIONS PD patients showed specific initiation and planning deficits compared to control participants. After using traditional scales to define apathy, PD apathetic patients still exhibited impaired initiation and planning behaviors. These results suggest that the PACT measures aspects of impaired goal-directed behavior that may contribute to apathy in PD.
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Affiliation(s)
- Whitney Fitts
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania
| | - Lauren Massimo
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania
| | - Nicholas Lim
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania
| | - Murray Grossman
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania
| | - Nabila Dahodwala
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania
- Institute on Aging, Perelman School of Medicine, University of Pennsylvania
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29
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Narme P, Roussel M, Mouras H, Krystkowiak P, Godefroy O. Does impaired socioemotional functioning account for behavioral dysexecutive disorders? Evidence from a transnosological study. AGING NEUROPSYCHOLOGY AND COGNITION 2016; 24:80-93. [PMID: 27054957 DOI: 10.1080/13825585.2016.1171291] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Behavioral dysexecutive disorders are highly prevalent in patients with neurological diseases but cannot be explained by cognitive dysexecutive impairments. In fact, the underlying mechanisms are poorly understood. Given that socioemotional functioning underlies appropriate behavior, socioemotional impairments may contribute to the appearance of behavioral disorders. To investigate this issue, we performed a transnosological study. Seventy-five patients suffering from various neurological diseases (Alzheimer's disease (AD), Parkinson's disease (PD), frontotemporal lobar degeneration, and stroke) were included in the study. The patients were comprehensively assessed in terms of cognitive and behavioral dysexecutive disorders and socioemotional processes (facial emotion recognition and theory of mind). As was seen for cognitive and behavioral dysexecutive impairments, the prevalence of socioemotional impairments varied according to the diagnosis. Stepwise logistic regressions showed that (i) only cognitive executive indices predicted hypoactivity with apathy/abulia, (ii) theory of mind impairments predicted hyperactivity-distractibility-impulsivity and stereotyped/perseverative behaviors, and (iii) impaired facial emotion recognition predicted social behavior disorders. Several dysexecutive behavioral disorders are associated with an underlying impairment in socioemotional processes but not with cognitive indices of executive functioning (except for apathy). These results strongly suggest that some dysexecutive behavioral disorders are the outward signs of an underlying impairment in socioemotional processes.
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Affiliation(s)
- Pauline Narme
- a Laboratoire de Neurosciences Fonctionnelles et Pathologies (EA 4559), Département de médecine , Université de Picardie Jules Verne , Amiens , France.,b Equipe Neuropsychologie du Vieillissement (EA 4468), Institut de Psychologie , Université Paris Descartes , Boulogne-Billancourt , France
| | - Martine Roussel
- a Laboratoire de Neurosciences Fonctionnelles et Pathologies (EA 4559), Département de médecine , Université de Picardie Jules Verne , Amiens , France.,c Service de Neurologie , Centre Hospitalier Universitaire d'Amiens-Nord , Amiens , France
| | - Harold Mouras
- a Laboratoire de Neurosciences Fonctionnelles et Pathologies (EA 4559), Département de médecine , Université de Picardie Jules Verne , Amiens , France.,d Centre de recherche en psychologie: Cognition, psychisme et organisations, Département de Psychologie , Université de Picardie Jules Verne , Amiens , France
| | - Pierre Krystkowiak
- a Laboratoire de Neurosciences Fonctionnelles et Pathologies (EA 4559), Département de médecine , Université de Picardie Jules Verne , Amiens , France.,c Service de Neurologie , Centre Hospitalier Universitaire d'Amiens-Nord , Amiens , France
| | - Olivier Godefroy
- a Laboratoire de Neurosciences Fonctionnelles et Pathologies (EA 4559), Département de médecine , Université de Picardie Jules Verne , Amiens , France.,c Service de Neurologie , Centre Hospitalier Universitaire d'Amiens-Nord , Amiens , France
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30
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Menéndez-González M, Álvarez-Avellón T. Editorial: Neuropsychology and Neuropsychiatry of Neurodegenerative Disorders. Front Aging Neurosci 2015; 7:227. [PMID: 26733862 PMCID: PMC4679848 DOI: 10.3389/fnagi.2015.00227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 11/23/2015] [Indexed: 12/13/2022] Open
Affiliation(s)
- Manuel Menéndez-González
- Unidad de Neurología, Hospital Álvarez-BuyllaMieres, Spain; Departamento de Morfología y Biología Celular, Universidad de OviedoOviedo, Spain; Instituto de Neurociencias del Principado de Asturias, Universidad de OviedoOviedo, Spain; Facultad de Ciencias de la Salud, Universidad Autónoma de ChileTalca, Chile
| | - Tania Álvarez-Avellón
- Departamento de Psicología, Universidad de OviedoOviedo, Spain; Neuropsicología, VitalAsturGijón, Spain
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Abstract
With the growing awareness of the presence of non-motor symptoms in Parkinson's disease (PD) has come the realization that these non-motor features play a tremendously important, and sometimes dominant, role in the management and even the diagnosis of the disorder. Despite this, a reluctance to formally address and treat the non-motor symptoms of PD remains and quality of life for PD patients suffers. This review provides an overview of the impact non-motor symptoms have on persons with PD, along with a brief description of some of the more common non-motor features of PD.
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