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Swinnen BEKS, Hoy CW, Pegolo E, Matzilevich EU, Sun J, Ishihara B, Morgante F, Pereira E, Baig F, Hart M, Tan H, Sawacha Z, Beudel M, Wang S, Starr P, Little S, Ricciardi L. Basal ganglia theta power indexes trait anxiety in people with Parkinson's disease. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.04.24308449. [PMID: 38883720 PMCID: PMC11177918 DOI: 10.1101/2024.06.04.24308449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Background Neuropsychiatric symptoms are common and disabling in Parkinson's disease (PD), with troublesome anxiety occurring in one-third of patients. Management of anxiety in PD is challenging, hampered by insufficient insight into underlying mechanisms, lack of objective anxiety measurements, and largely ineffective treatments.In this study, we assessed the intracranial neurophysiological correlates of anxiety in PD patients treated with deep brain stimulation (DBS) in the laboratory and at home. We hypothesized that low-frequency (theta-alpha) activity would be associated with anxiety. Methods We recorded local field potentials (LFP) from the subthalamic nucleus (STN) or the globus pallidus pars interna (GPi) DBS implants in three PD cohorts: 1) patients with recordings (STN) performed in hospital at rest via perioperatively externalized leads, without active stimulation, both ON or OFF dopaminergic medication; 2) patients with recordings (STN or GPi) performed at home while resting, via a chronically implanted commercially available sensing-enabled neurostimulator (Medtronic Percept™ device), ON dopaminergic medication, with stimulation both ON or OFF; 3) patients with recordings performed at home while engaging in a behavioral task via STN and GPi leads and electrocorticography paddles (ECoG) over premotor cortex connected to an investigational sensing-enabled neurostimulator, ON dopaminergic medication, with stimulation both ON or OFF.Trait anxiety was measured with validated clinical scales in all participants, and state anxiety was measured with momentary assessment scales at multiple time points in the two at-home cohorts. Power in theta (4-8 Hz) and alpha (8-12 Hz) ranges were extracted from the LFP recordings, and their relation with anxiety ratings was assessed using linear mixed-effects models. Results In total, 33 PD patients (59 hemispheres) were included. Across three independent cohorts, with stimulation OFF, basal ganglia theta power was positively related to trait anxiety (all p<0.05). Also in a naturalistic setting, with individuals at home at rest with stimulation and medication ON, basal ganglia theta power was positively related to trait anxiety (p<0.05). This relationship held regardless of the hemisphere and DBS target. There was no correlation between trait anxiety and premotor cortical theta-alpha power. There was no within-patient association between basal ganglia theta-alpha power and state anxiety. Conclusion We showed that basal ganglia theta activity indexes trait anxiety in PD. Our data suggest that theta could be a possible physiomarker of neuropsychiatric symptoms and specifically of anxiety in PD, potentially suitable for guiding advanced DBS treatment tailored to the individual patient's needs, including non-motor symptoms.
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Affiliation(s)
- Bart E K S Swinnen
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
- Department of Neurology, Amsterdam University Medical Centers, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Colin W Hoy
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Elena Pegolo
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
- Neurosciences and Cell Biology Institute, Neuromodulation and Motor Control Section, St George's University of London, London, United Kingdom
- Department of Information Engineering, University of Padova, Padova, Italy
| | | | - Julia Sun
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Bryony Ishihara
- Neurosciences and Cell Biology Institute, Neuromodulation and Motor Control Section, St George's University of London, London, United Kingdom
| | - Francesca Morgante
- Neurosciences and Cell Biology Institute, Neuromodulation and Motor Control Section, St George's University of London, London, United Kingdom
| | - Erlick Pereira
- Neurosciences and Cell Biology Institute, Neuromodulation and Motor Control Section, St George's University of London, London, United Kingdom
| | - Fahd Baig
- Neurosciences and Cell Biology Institute, Neuromodulation and Motor Control Section, St George's University of London, London, United Kingdom
| | - Michael Hart
- Neurosciences and Cell Biology Institute, Neuromodulation and Motor Control Section, St George's University of London, London, United Kingdom
| | - Huiling Tan
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Zimi Sawacha
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Martijn Beudel
- Department of Neurology, Amsterdam University Medical Centers, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Sarah Wang
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Philip Starr
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Simon Little
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Lucia Ricciardi
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
- Neurosciences and Cell Biology Institute, Neuromodulation and Motor Control Section, St George's University of London, London, United Kingdom
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2
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Cardoso VSL, Valente-Amaral A, Monteiro RFM, Meira CLS, de Meira NS, da Silva MN, Pinheiro JDJV, Bastos GDNT, Felício JS, Yamada ES. Aqueous extract of Swietenia macrophylla leaf exerts an anti-inflammatory effect in a murine model of Parkinson's disease induced by 6-OHDA. Front Neurosci 2024; 18:1351718. [PMID: 38449740 PMCID: PMC10914943 DOI: 10.3389/fnins.2024.1351718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/05/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction Parkinson's disease affects 2% of the population aged over 65 years and is the second most common neurodegenerative disorder in the general population. The appearance of motor symptoms is associated with the degeneration of dopaminergic neurons in the nigrostriatal pathway. Clinically significant nonmotor symptoms are also important for severe disability with disease progression. Pharmacological treatment with levodopa, which involves dopamine restitution, results in a temporary improvement in motor symptoms. Among the mechanisms underlying the pathogenesis of the disease are exacerbated oxidative stress, mitochondrial dysfunction, and neuroinflammation. A phytochemical prospecting study showed that the aqueous extract of the leaves from Swietenia macrophylla (Melineaceae), known as mahogany, has polyphenols with antioxidant and anti-inflammatory capacity in a significantly higher percentage than leaf extracts from other Amazonian plants. Furthermore, the antioxidant and anti-inflammatory capacity of aqueous extract of mahogany leaf has already been demonstrated in an in vitro model. In this study, we hypothesized that the aqueous extract of mahogany leaf (AEML) has a neuroprotective effect in a murine model of Parkinson's disease induced by 6-hydroxidopamine (6-OHDA), due to antioxidant and anti-inflammatory properties of its phenolic compounds. Methods Mice were treated daily with the mahogany extract at a dose of 50 mg/kg, starting 7 days before 6-OHDA infusion until post-surgery day 7. Results and discussion The animals from the 6-OHDA/mahogany group, which corresponds to animals injected with the toxin and treated with aqueous extract of the mahogany leaf, presented distinct behavioral phenotypes after apomorphine challenge and were therefore subdivided into 2 groups, 6-OHDA/mahogany F1 and 6-OHDA/mahogany F2. The F1 group showed a significant increase in contralateral rotations, whereas the F2 group did not show rotations after the apomorphine stimulus. In the F1 group, there was an increase, although not significant, in motor performance in the open field and elevated plus maze tests, whereas in the F2 group, there was significant improvement, which may be related to the lesser degree of injury to the nigrostriatal dopaminergic pathway. The TH+ histopathological analysis, a dopaminergic neuron marker, confirmed that the lesion to the nigrostriatal dopaminergic pathway was more pronounced in 6-OHDA/mahogany F1 than in 6-OHDA/mahogany F2. Our main result consisted of signs of improvement in the inflammatory profile in both the F1 and F2 6-OHDA/mahogany groups, such as a lower number of IBA-1+ microglial cells in the ventral striatum and substantia nigra pars compacta and a reduction in GFAP+ expression, an astrocyte marker, in the dorsal striatum. In this study, several bioactive compounds in the aqueous extract of mahogany leaf may have contributed to the observed beneficial effects. Further studies are necessary to better characterize their applicability for treating chronic degenerative diseases with inflammatory and oxidative bases, such as Parkinson's disease.
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Affiliation(s)
- Váldina Solimar Lopes Cardoso
- Experimental Neuropathology Laboratory, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
- Oncology Research Center and Graduate Program in Oncology and Medical Sciences, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | - Anderson Valente-Amaral
- Experimental Neuropathology Laboratory, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
- Graduate Program in Neuroscience and Cellular Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Rayan Fidel Martins Monteiro
- Graduate Program in Neuroscience and Cellular Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Neuroinflammation Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Clarina Loius Silva Meira
- Experimental Neuropathology Laboratory, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | - Natália Silva de Meira
- Experimental Neuropathology Laboratory, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | - Milton Nascimento da Silva
- Liquid Chromatography Laboratory, Institute of Exact and Natural Science, Federal University of Pará, Belém, Brazil
| | - João de Jesus Viana Pinheiro
- Oncology Research Center and Graduate Program in Oncology and Medical Sciences, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
- Laboratory of Pathological Anatomy and Immunohistochemistry, School of Dentistry, Federal University of Pará, Belém, Brazil
| | - Gilmara de Nazareth Tavares Bastos
- Graduate Program in Neuroscience and Cellular Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Neuroinflammation Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - João Soares Felício
- Oncology Research Center and Graduate Program in Oncology and Medical Sciences, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Belém, Brazil
| | - Elizabeth Sumi Yamada
- Experimental Neuropathology Laboratory, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
- Oncology Research Center and Graduate Program in Oncology and Medical Sciences, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
- Graduate Program in Neuroscience and Cellular Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
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Stuber A, Cavaccini A, Manole A, Burdina A, Massoud Y, Patriarchi T, Karayannis T, Nakatsuka N. Interfacing Aptamer-Modified Nanopipettes with Neuronal Media and Ex Vivo Brain Tissue. ACS MEASUREMENT SCIENCE AU 2024; 4:92-103. [PMID: 38404490 PMCID: PMC10885324 DOI: 10.1021/acsmeasuresciau.3c00047] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 02/27/2024]
Abstract
Aptamer-functionalized biosensors exhibit high selectivity for monitoring neurotransmitters in complex environments. We translated nanoscale aptamer-modified nanopipette sensors to detect endogenous dopamine release in vitro and ex vivo. These sensors employ quartz nanopipettes with nanoscale pores (ca. 10 nm diameter) that are functionalized with aptamers that enable the selective capture of dopamine through target-specific conformational changes. The dynamic behavior of aptamer structures upon dopamine binding leads to the rearrangement of surface charge within the nanopore, resulting in measurable changes in ionic current. To assess sensor performance in real time, we designed a fluidic platform to characterize the temporal dynamics of nanopipette sensors. We then conducted differential biosensing by deploying control sensors modified with nonspecific DNA alongside dopamine-specific sensors in biological milieu. Our results confirm the functionality of aptamer-modified nanopipettes for direct measurements in undiluted complex fluids, specifically in the culture media of human-induced pluripotent stem cell-derived dopaminergic neurons. Moreover, sensor implantation and repeated measurements in acute brain slices was possible, likely owing to the protected sensing area inside nanoscale DNA-filled orifices, minimizing exposure to nonspecific interferents and preventing clogging. Further, differential recordings of endogenous dopamine released through electrical stimulation in the dorsolateral striatum demonstrate the potential of aptamer-modified nanopipettes for ex vivo recordings with unprecedented spatial resolution and reduced tissue damage.
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Affiliation(s)
- Annina Stuber
- Laboratory
of Biosensors and Bioelectronics, Institute for Biomedical Engineering, ETH Zürich, Zurich CH-8092, Switzerland
| | - Anna Cavaccini
- Laboratory
of Neural Circuit Assembly, Brain Research Institute, University of Zurich, Zurich CH-8057, Switzerland
- Neuroscience
Center Zurich, University and ETH Zurich, Zurich CH-8057, Switzerland
| | - Andreea Manole
- iXCells
Biotechnologies, Inc., San Diego, California 92131, United States
| | - Anna Burdina
- Laboratory
of Biosensors and Bioelectronics, Institute for Biomedical Engineering, ETH Zürich, Zurich CH-8092, Switzerland
| | - Yassine Massoud
- Laboratory
of Biosensors and Bioelectronics, Institute for Biomedical Engineering, ETH Zürich, Zurich CH-8092, Switzerland
| | - Tommaso Patriarchi
- Neuroscience
Center Zurich, University and ETH Zurich, Zurich CH-8057, Switzerland
- Institute
of Pharmacology and Toxicology, University
of Zurich, Zurich CH-8057, Switzerland
| | - Theofanis Karayannis
- Laboratory
of Neural Circuit Assembly, Brain Research Institute, University of Zurich, Zurich CH-8057, Switzerland
- Neuroscience
Center Zurich, University and ETH Zurich, Zurich CH-8057, Switzerland
| | - Nako Nakatsuka
- Laboratory
of Biosensors and Bioelectronics, Institute for Biomedical Engineering, ETH Zürich, Zurich CH-8092, Switzerland
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Ankar P, Arya NP, Fating T, Sasun AR. Optimizing Physiotherapeutic Approaches in Parkinson's Disease Post-spinal Fixation Surgery: A Case Report. Cureus 2024; 16:e54149. [PMID: 38496068 PMCID: PMC10940556 DOI: 10.7759/cureus.54149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/13/2024] [Indexed: 03/19/2024] Open
Abstract
Patients with Parkinson's disease (PD) exhibit both a severe neuromuscular disorder and low bone quality at presentation. These issues are made worse by inactivity and a chairbound state. Each and every pathologic and degenerative process that affects the naturally aging spine also affects these individuals. Stooped posture is a symptom of a disease and can easily cause spinal degeneration. PD is associated with many physical abnormalities that cause a unique and specific need for rehabilitation. Patients' experiences highlight the challenges doctors face in diagnosis, treatment, and rehabilitation. This case report details the rehabilitation of a 67-year-old patient with PD who underwent spinal fixation for spinal stenosis and presented with complaints of weakness in both lower limbs. An advanced rehabilitation program was devised, primarily emphasizing strength training to enhance overall functionality. Pre- and post-intervention assessments were conducted, encompassing range of motion (ROM), manual muscle testing (MMT), Oswestry Disability Index, Functional Independence Measure, Lower Limb Functional Scale, and Berg Balance Scale, all of which demonstrated noteworthy improvements in joints ROM, strength, functional independence, balance, and lower limb function. This case report underscores the significance of rehabilitation programs in such cases, highlighting their important role in enhancing overall functioning.
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Affiliation(s)
- Prajyot Ankar
- Community Health Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Neha P Arya
- Community Health Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Tejaswini Fating
- Community Health Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anam R Sasun
- Community Health Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Grotemeyer A, Kornhuber J, Spitzer P. [Treatment-resistant first-time depression in middle age]. DER NERVENARZT 2023; 94:855-858. [PMID: 37589782 PMCID: PMC10499729 DOI: 10.1007/s00115-023-01530-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/30/2023] [Indexed: 08/18/2023]
Affiliation(s)
- Alexander Grotemeyer
- Psychiatrische und Psychotherapeutische Klinik, Universitätsklinikum Erlangen, Schwabachanlage 6, 91054, Erlangen, Deutschland.
| | - Johannes Kornhuber
- Psychiatrische und Psychotherapeutische Klinik, Universitätsklinikum Erlangen, Schwabachanlage 6, 91054, Erlangen, Deutschland
| | - Philipp Spitzer
- Psychiatrische und Psychotherapeutische Klinik, Universitätsklinikum Erlangen, Schwabachanlage 6, 91054, Erlangen, Deutschland
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6
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Heimrich KG, Schönenberg A, Mühlhammer HM, Mendorf S, Santos-García D, Prell T. Longitudinal analysis of the Non-Motor Symptoms Scale in Parkinson's Disease (NMSS): An exploratory network analysis approach. Front Neurol 2023; 14:972210. [PMID: 36864919 PMCID: PMC9971229 DOI: 10.3389/fneur.2023.972210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 01/17/2023] [Indexed: 02/16/2023] Open
Abstract
Introduction Parkinson's disease (PD) is a multisystem neurodegenerative disorder characterized by motor and non-motor symptoms. In particular, non-motor symptoms have become increasingly relevant to disease progression. This study aimed to reveal which non-motor symptoms have the highest impact on the complex interacting system of various non-motor symptoms and to determine the progression of these interactions over time. Methods We performed exploratory network analyses of 499 patients with PD from the Cohort of Patients with Parkinson's Disease in Spain study, who had Non-Motor Symptoms Scale in Parkinson's Disease ratings obtained at baseline and a 2-year follow-up. Patients were aged between 30 and 75 years and had no dementia. The strength centrality measures were determined using the extended Bayesian information criterion and the least absolute shrinkage and selection operator. A network comparison test was conducted for the longitudinal analyses. Results Our study revealed that the depressive symptoms anhedonia and feeling sad had the strongest impact on the overall pattern of non-motor symptoms in PD. Although several non-motor symptoms increase in intensity over time, their complex interacting networks remain stable. Conclusion Our results suggest that anhedonia and feeling sad are influential non-motor symptoms in the network and, thus, are promising targets for interventions as they are closely linked to other non-motor symptoms.
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Affiliation(s)
- Konstantin G. Heimrich
- Department of Neurology, Jena University Hospital, Jena, Germany,*Correspondence: Konstantin G. Heimrich ✉
| | | | - Hannah M. Mühlhammer
- Department of Neurology, Jena University Hospital, Jena, Germany,Department of Geriatrics, Halle University Hospital, Halle, Germany
| | - Sarah Mendorf
- Department of Neurology, Jena University Hospital, Jena, Germany
| | | | - Tino Prell
- Department of Geriatrics, Halle University Hospital, Halle, Germany
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Maggi G, D'Iorio A, Aiello EN, Poletti B, Ticozzi N, Silani V, Amboni M, Vitale C, Santangelo G. Psychometrics and diagnostics of the Italian version of the Beck Depression Inventory-II (BDI-II) in Parkinson's disease. Neurol Sci 2023; 44:1607-1612. [PMID: 36653542 PMCID: PMC10102079 DOI: 10.1007/s10072-023-06619-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 01/09/2023] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Depression is one of the most disabling neuropsychiatric manifestations of Parkinson's disease (PD) and requires proper screening and diagnosis because it affects the overall prognosis and quality of life of patients. This study aimed to assess the psychometric and diagnostic properties of the Beck Depression Inventory-II (BDI-II) in an Italian PD cohort. MATERIALS AND METHODS Fifty consecutive outpatients with PD underwent the Italian version of the BDI-II and other questionnaires to evaluate anxiety and apathetic symptoms. Patients' caregivers completed the depression/dysphoria domain of the Neuropsychiatric Inventory (NPI-D). We evaluated the internal consistency, convergent and divergent validity, and factorial structure of BDI-II. Sensitivity, specificity, positive and negative predictive values, and likelihood ratios were computed using ROC analyses, and an optimal cutoff was defined using the Youden index. RESULTS The BDI-II proved to be internally consistent (Cronbach's α = 0.840) and substantially met the bi-factorial structure. Regarding construct validity, the BDI-II was substantially related to anxiety measures, but not to apathy. With the combination of the NPI-D and anxiety score used as the gold standard, the BDI-II overall showed good accuracy (AUC = 0.859) with adequate sensitivity (75%) and specificity (87%). The optimal cutoff point was defined at 14.50. CONCLUSIONS We provide evidence of the psychometric and diagnostic properties of the Italian version of the BDI-II as a screening tool for depression in patients with PD. The BDI-II was found to be reliable and valid for the measurement of depression in patients with PD; therefore, it is available for use in clinical research and practice.
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Affiliation(s)
- Gianpaolo Maggi
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Alfonsina D'Iorio
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Edoardo Nicolò Aiello
- Department of Neurology and Laboratory of Neuroscience, IRCCS, Istituto Auxologico Italiano, Milano, Italy.,PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience, IRCCS, Istituto Auxologico Italiano, Milano, Italy
| | - Nicola Ticozzi
- Department of Neurology and Laboratory of Neuroscience, IRCCS, Istituto Auxologico Italiano, Milano, Italy.,Department of Pathophysiology and Transplantation, "Dino Ferrari Center", Università degli Studi di Milano, Milano, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS, Istituto Auxologico Italiano, Milano, Italy.,Department of Pathophysiology and Transplantation, "Dino Ferrari Center", Università degli Studi di Milano, Milano, Italy
| | - Marianna Amboni
- Institute of Diagnosis and Health, IDC-Hermitage Capodimonte, Naples, Italy.,Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Carmine Vitale
- Institute of Diagnosis and Health, IDC-Hermitage Capodimonte, Naples, Italy.,Department of Motor Sciences and Wellness, University "Parthenope", Naples, Italy
| | - Gabriella Santangelo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy.
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Vortioxetine Improves Depressive Symptoms and Cognition in Parkinson's Disease Patients with Major Depression: An Open-Label Prospective Study. Brain Sci 2022; 12:brainsci12111466. [PMID: 36358393 PMCID: PMC9688230 DOI: 10.3390/brainsci12111466] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/15/2022] [Accepted: 10/26/2022] [Indexed: 11/17/2022] Open
Abstract
Depression is frequent in Parkinson’s disease (PD) patients, but the evidence for many antidepressant agents to treat it in PD is insufficient. The aim of the present prospective open-label single-arm study (VOPARK, an open-label study of the effectiveness and safety of VOrtioxetine in PARKinson’s disease patients with depression) was to analyze the effectiveness of vortioxetine on depressive symptoms in PD patients with major depression. The primary efficacy outcome was the change from baseline (VB) at the end of the observational period (12 weeks ± 14 days; V12w) in the 17-item Hamilton Depression Rating Scale (HAM-D17) total score. At VB, all patients had a HAM-D17 total score ≥16. A total of 30 patients (age 66.23 ± 10.27; 73.3% males) were included between February 2021 (first patient, 12/FEB/21) and March 2022 (last patient, 14/MAR/22). At 12 weeks, 27 patients completed the follow-up (90%). The total HAM-D17 total score was reduced by 52.7% (from 21.5 ± 4.75 at VB to 10.44 ± 7.54 at V12w; Cohen’s effect size = −2.5; p < 0.0001) and the response and remission rates were 50% and 43.3%, respectively. Apathy (Apathy Scale; p < 0.0001), cognition (PD-Cognitive Rating Scale; p = 0.007), fatigue (Fatigue Severity Scale; p = 0.014), and quality of life (PDQ-39 (p = 0.001) and EUROHIS-QOL8 (p < 0.0001)) improved at 3 weeks as well. A total of 11 adverse events in 10 patients (33.3%) were reported, one of which was severe (vomiting related to vortioxetine with full recovery after drug withdrawal). Vortioxetine was safe and well tolerated and improved depressive symptoms and other non-motor symptoms in PD patients.
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9
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Zhang J, Xue B, Jing B, Tian H, Zhang N, Li M, Lu L, Chen L, Diao H, Chen Y, Wang M, Li X. LPS activates neuroinflammatory pathways to induce depression in Parkinson’s disease-like condition. Front Pharmacol 2022; 13:961817. [PMID: 36278237 PMCID: PMC9582846 DOI: 10.3389/fphar.2022.961817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 09/22/2022] [Indexed: 11/13/2022] Open
Abstract
Aim: This study aimed to observe the effects of lipopolysaccharide (LPS) intraperitoneal (i.p.) injection on rats and investigate how neuroinflammation contributes to the pathogenesis of depression in Parkinson’s disease (dPD). Methods: Rats were administered LPS (0.5 mg/kg, i.p.) for either 1, 2, or 4 consecutive days to establish a rat model of dPD. The sucrose preference test (SPT), the open field test (OFT), and the rotarod test evaluated depression-like and motor behaviors. Magnetic resonance imaging was used to detect alterations in the intrinsic activity and the integrity of white matter fibers in the brain. The expression of c-Fos, ionized calcium-binding adapter molecule (Iba-1), and tyrosine hydroxylase (TH) was evaluated using immunohistochemistry. The concentration of interleukin-6 (IL-6), tumor necrosis factor (TNF-α), and interleukin-10 (IL-10) was measured using Luminex technology. Results: LPS i.p. injections decreased sucrose preference in the SPT, horizontal and center distance in the OFT, and standing time in the rotarod test. The intrinsic activities in the hippocampus (HIP) were significantly reduced in the LPS-4 d group. The integrity of white matter fibers was greatly destroyed within 4 days of LPS treatment. The expression of c-Fos and Iba-1 in the prefrontal cortex, HIP, and substantia nigra increased dramatically, and the number of TH+ neurons in the substantia nigra decreased considerably after LPS injection. The levels of IL-6, TNF-α, and IL-10 were higher in the LPS-4 d group than those in the control group. Conclusion: Injection of LPS (0.5 mg/kg, i.p.) for 4 consecutive days can activate microglia, cause the release of inflammatory cytokines, reduce intrinsic activities in the HIP, destroy the integrity of white matter fibers, induce anhedonia and behavioral despair, and finally lead to dPD. This study proved that LPS injection (0.5 mg/kg, i.p.) for 4 consecutive days could be used to successfully create a rat model of dPD.
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Affiliation(s)
- Jing Zhang
- Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Bing Xue
- Core Facility Center, Capital Medical University, Beijing, China
| | - Bin Jing
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Huiling Tian
- School of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Naiwen Zhang
- Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Mengyuan Li
- Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Lihua Lu
- Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Lin Chen
- Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Huaqiong Diao
- Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yufei Chen
- Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Min Wang
- Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaoli Li
- Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
- *Correspondence: Xiaoli Li,
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α-Synuclein at the Presynaptic Axon Terminal as a Double-Edged Sword. Biomolecules 2022; 12:biom12040507. [PMID: 35454096 PMCID: PMC9029495 DOI: 10.3390/biom12040507] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 12/12/2022] Open
Abstract
α-synuclein (α-syn) is a presynaptic, lipid-binding protein strongly associated with the neuropathology observed in Parkinson’s disease (PD), dementia with Lewy bodies (DLB), and Alzheimer’s Disease (AD). In normal physiology, α-syn plays a pivotal role in facilitating endocytosis and exocytosis. Interestingly, mutations and modifications of precise α-syn domains interfere with α-syn oligomerization and nucleation that negatively affect presynaptic vesicular dynamics, protein expressions, and mitochondrial profiles. Furthermore, the integration of the α-syn oligomers into the presynaptic membrane results in pore formations, ion influx, and excitotoxicity. Targeted therapies against specific domains of α-syn, including the use of small organic molecules, monoclonal antibodies, and synthetic peptides, are being screened and developed. However, the prospect of an effective α-syn targeted therapy is still plagued by low permeability across the blood–brain barrier (BBB), and poor entry into the presynaptic axon terminals. The present review proposes a modification of current strategies, which includes the use of novel encapsulation technology, such as lipid nanoparticles, to bypass the BBB and deliver such agents into the brain.
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11
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Yu Z, Liu G, Li Y, Arkin E, Zheng Y, Feng T. Erythrocytic α-Synuclein Species for Parkinson’s Disease Diagnosis and the Correlations With Clinical Characteristics. Front Aging Neurosci 2022; 14:827493. [PMID: 35185529 PMCID: PMC8850836 DOI: 10.3389/fnagi.2022.827493] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background Erythrocytes contain most of the peripheral α-synuclein (α-syn), which is the key pathological molecular of α-synucleinopathies including Parkinson’s disease (PD). Our objectives were to assess the efficiency of erythrocytic total and oligomeric α-syn levels as PD diagnostic biomarkers, and to identify the correlations between erythrocytic α-syn levels and physiological/psychiatrical assessment scales. Methods Home-brewed electrochemiluminescence assays were applied to assess the concentrations of erythrocytic total and oligomeric α-syn levels in a cohort including 124 patients with PD and 79 healthy controls (HCs). The correlations between erythrocytic α-syn levels and clinical measurements were assessed using Spearman’s rank test. Results Both the erythrocytic total and oligomeric α-syn levels were significantly higher in PD patients than HCs. The biomarkers adjusted for age and sex discriminated PDs from HCs well with 80% sensitivity, 89% specificity and 79% sensitivity, 83% specificity, respectively. Combining erythrocytic total and oligomeric α-syn levels by using binary logistic regression analysis with the controlling of age and sex generated a factor discriminates PDs from HCs with 88% sensitivity and 85% specificity. The erythrocytic total but not oligomeric α-syn levels adjusted for age and sex significantly correlated with anxiety scales and the MDS-UPDRS III scales in PD patients, respectively. Conclusion We showed the usefulness of erythrocytic total and oligomeric α-syn levels as biomarkers for PD. Our results also suggest the capability of erythrocytic α-syn as a potential pathological factor and therapeutic target for psychiatric symptoms in PD patients.
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Affiliation(s)
- Zhenwei Yu
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Genliang Liu
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yang Li
- Institute of Systems Biomedicine, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Ehsan Arkin
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yuanchu Zheng
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Tao Feng
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- *Correspondence: Tao Feng,
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12
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Lee S. Perceived Health, Psychological Distress, and Subjective Well-Being among Older Adults with Parkinson's Disease: A Cross-Lagged Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12566. [PMID: 34886289 PMCID: PMC8657129 DOI: 10.3390/ijerph182312566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 11/20/2021] [Accepted: 11/27/2021] [Indexed: 11/16/2022]
Abstract
A growing aging population leads to a gradual increase in the number of patients with Parkinson's disease (PD). This study examines how perceived health, psychological distress, and subjective well-being evolve in older adults with PD. A cross-lagged study design was employed using data from Waves 4 and 6 of the Survey of Health, Aging and Retirement in Europe (SHARE). In total, 421 older adults diagnosed with PD at baseline (46% women; mean age 74.98 ± 9.05 years) were included in the study and were followed up after a four-year lag. Auto-regressive and cross-lagged associations between the measured variables were examined in reciprocal models. Individual differences in perceived health, psychological distress, and subjective well-being were relatively stable over the 4-year lag. A final reciprocal model with significant cross-lagged effects explained the underlying structure of the sample data well: χ2 (49) = 101.876, p < 0.001, CFI = 0.953, NFI = 0.935, RMSEA = 0.050, and AIC = 241.876. Increased difficulties in fulfilling instrumental activities and a lowered level of subjective well-being were particularly noticeable in older adults with PD during the four-year follow-up. Additional attention should be paid to helping older patients with PD cope better with their functional limitations and improve their sense of well-being.
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Affiliation(s)
- Sunwoo Lee
- Faculty of Physical Culture, Palacký University Olomouc, Třída Míru 117, 771 11 Olomouc, Czech Republic
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13
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Hoffmeister JD, Kelm-Nelson CA, Ciucci MR. Quantification of brainstem norepinephrine relative to vocal impairment and anxiety in the Pink1-/- rat model of Parkinson disease. Behav Brain Res 2021; 414:113514. [PMID: 34358571 PMCID: PMC8393386 DOI: 10.1016/j.bbr.2021.113514] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/23/2021] [Accepted: 07/30/2021] [Indexed: 12/31/2022]
Abstract
Vocal communication impairment and anxiety are co-occurring and interacting signs of Parkinson Disease (PD) that are common, poorly understood, and under-treated. Both vocal communication and anxiety are influenced by the noradrenergic system. In light of this shared neural substrate and considering that noradrenergic dysfunction is a defining characteristic of PD, tandem investigation of vocal impairment and anxiety in PD relative to noradrenergic mechanisms is likely to yield insights into the underlying disease-specific causes of these impairments. In order to address this gap in knowledge, we assessed vocal impairment and anxiety behavior relative to brainstem noradrenergic markers in a genetic rat model of early-onset PD (Pink1-/-) and wild type controls (WT). We hypothesized that 1) brainstem noradrenergic markers would be disrupted in Pink1-/-, and 2) brainstem noradrenergic markers would be associated with vocal acoustic changes and anxiety level. Rats underwent testing of ultrasonic vocalization and anxiety (elevated plus maze) at 4, 8, and 12 months of age. At 12 months, brainstem norepinephrine markers were quantified with immunohistochemistry. Results demonstrated that vocal impairment and anxiety were increased in Pink1-/- rats, and increased anxiety was associated with greater vocal deficit in this model of PD. Further, brainstem noradrenergic markers including TH and α1 adrenoreceptor immunoreactivity in the locus coeruleus, and β1 adrenoreceptor immunoreactivity in vagal nuclei differed by genotype, and were associated with vocalization and anxiety behavior. These findings demonstrate statistically significant relationships among vocal impairment, anxiety, and brainstem norepinephrine in the Pink1-/- rat model of PD.
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Affiliation(s)
- Jesse D Hoffmeister
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, 1975 Willow Drive, Madison, WI, 53706, USA; Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792-7375, USA.
| | - Cynthia A Kelm-Nelson
- Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792-7375, USA.
| | - Michelle R Ciucci
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, 1975 Willow Drive, Madison, WI, 53706, USA; Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792-7375, USA; Neuroscience Training Program, University of Wisconsin-Madison, 9531 WIMR II, 1111 Highland Avenue, Madison, WI, 53705, USA.
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14
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Antidepressant-Like Properties of Intrastriatal Botulinum Neurotoxin-A Injection in a Unilateral 6-OHDA Rat Model of Parkinson's Disease. Toxins (Basel) 2021; 13:toxins13070505. [PMID: 34357977 PMCID: PMC8310221 DOI: 10.3390/toxins13070505] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/09/2021] [Accepted: 07/14/2021] [Indexed: 12/14/2022] Open
Abstract
Parkinson’s patients often suffer from depression and anxiety, for which there are no optimal treatments. Hemiparkinsonian (hemi-PD) rats were used to test whether intrastriatal Botulinum neurotoxin-A (BoNT-A) application could also have antidepressant-like properties in addition to the known improvement of motor performance. To quantify depression- and anxiety-like behavior, the forced swim test, tail suspension test, open field test, and elevated plus maze test were applied to hemi-PD rats injected with BoNT-A or vehicle. Furthermore, we correlated the results in the forced swim test, open field test, and elevated plus maze test with the rotational behavior induced by apomorphine and amphetamine. Hemi-PD rats did not show significant anxiety-like behavior as compared with Sham 6-OHDA- + Sham BoNT-A-injected as well as with non-injected rats. However, hemi-PD rats demonstrated increased depression-like behaviors compared with Sham- or non-injected rats; this was seen by increased struggling frequency and increased immobility frequency. Hemi-PD rats intrastriatally injected with BoNT-A exhibited reduced depression-like behavior compared with the respective vehicle-receiving hemi-PD animals. The significant effects of intrastriatally applied BoNT-A seen in the forced swim test are reminiscent of those found after various antidepressant drug therapies. Our data correspond with the efficacy of BoNT-A treatment of glabellar frown lines in treating patients with major depression and suggest that also intrastriatal injected BoNT-A may have some antidepressant-like effect on hemi-PD.
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15
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Lovegrove CJ, Bannigan K. What is the lived experience of anxiety for people with Parkinson's? A phenomenological study. PLoS One 2021; 16:e0249390. [PMID: 33831029 PMCID: PMC8031398 DOI: 10.1371/journal.pone.0249390] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 03/17/2021] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Anxiety is a common non-motor symptom of Parkinson's and there is no specific pharmacological intervention for people with Parkinson's who experience anxiety. Yet there is little specific research documenting how individuals with this condition experience anxiety. It is important to explore the experiences of people with Parkinson's to identify potential issues in developing future non-pharmacological interventions. This study explored the lived experience of anxiety for people with Parkinson's. MATERIALS AND METHODS Six participants were recruited into a descriptive phenomenological study, through the charity Parkinson's UK, using a maximum variation sampling strategy. Face to face interviews were conducted. Data analysis employed thematic analysis. RESULTS Three key themes encapsulated the data: Finding ways to cope to "Try not to let it rule your life", Amplifies symptoms "It's emotionally draining it it's also physically draining" and "Anxiety is a funny thing" experienced in myriad ways. A model of the experience of PWP experience of anxiety is proposed. CONCLUSIONS Anxiety is a complex experience constructed of interlinked parts affecting people with Parkinson's in myriad ways. Researchers and healthcare professionals should take these findings into account when designing future studies and interventions.
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Affiliation(s)
- Christopher J. Lovegrove
- Royal Devon & Exeter NHS Foundation Trust, Exeter, United Kingdom
- School of Health Professions, Faculty of Health & Human Sciences, University of Plymouth, Plymouth, United Kingdom
| | - Katrina Bannigan
- Department of Occupational Therapy and Human Nutrition and Dietetics, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom
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16
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Kim K, Wi S, Seo JH, Pyo S, Cho SR. Reduced Interaction of Aggregated α-Synuclein and VAMP2 by Environmental Enrichment Alleviates Hyperactivity and Anxiety in a Model of Parkinson's Disease. Genes (Basel) 2021; 12:genes12030392. [PMID: 33801790 PMCID: PMC7998569 DOI: 10.3390/genes12030392] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/22/2021] [Accepted: 03/03/2021] [Indexed: 12/15/2022] Open
Abstract
Parkinson’s disease (PD) is a prevalent motor disease caused by the accumulation of mutated α-synuclein (α-Syn); however, its early stages are also characterized by non-motor symptoms, such as olfactory loss, cognitive decline, depression, and anxiety. The therapeutic effects of environmental enrichment (EE) on motor recovery have been reported, but its effects on non-motor symptoms remain unclear. Herein, we reveal the beneficial effects of EE on PD-related non-motor symptoms and changes in synaptic plasticity in the nucleus accumbens. To investigate its therapeutic effects in the early phase of PD, we randomly assigned eight-month-old mice overexpressing human A53T (hA53T) α-Syn to either the EE or standard condition groups for two months. Next, we performed behavioral tests and biochemical and histological analyses at 10 months of age. EE significantly alleviated locomotor hyperactivity and anxiety during the early stages of PD. It normalized the levels of tyrosine hydroxylase, phosphorylated and oligomeric α-Syn, and soluble N-ethylmaleimide-sensitive factor attachment protein receptor complex-forming proteins, including synaptosomal-associated protein, 25 kDa, syntaxin1, and vesicle-associated membrane protein 2 (VAMP2). Moreover, the interactions between VAMP2 and pSer129 α-Syn were markedly reduced following EE. The restoration of synaptic vesicle transportation status may underlie the neuroprotective effects of EE in hA53T α-Syn mice.
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Affiliation(s)
- Kyungri Kim
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (K.K.); (J.H.S.); (S.P.)
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Soohyun Wi
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 03080, Korea;
| | - Jung Hwa Seo
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (K.K.); (J.H.S.); (S.P.)
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Soonil Pyo
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (K.K.); (J.H.S.); (S.P.)
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Sung-Rae Cho
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (K.K.); (J.H.S.); (S.P.)
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul 03722, Korea
- Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul 03722, Korea
- Graduate Program of Nano Science and Technology, Yonsei University College of Medicine, Seoul 03722, Korea
- Correspondence: ; Tel.: +82-2-2228-3715
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17
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Bhoopatiraju S, Grossberg G. Emerging Perspectives in the Diagnosis and Management of Depression and Psychosis in Parkinson's Disease. Neurology 2021. [DOI: 10.17925/usn.2021.17.2.97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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18
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De Micco R, Siciliano M, Sant'Elia V, Giordano A, Russo A, Tedeschi G, Tessitore A. Correlates of Psychological Distress in Patients with Parkinson's Disease During the COVID-19 Outbreak. Mov Disord Clin Pract 2021; 8:60-68. [PMID: 33426160 PMCID: PMC7780948 DOI: 10.1002/mdc3.13108] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/25/2020] [Accepted: 10/19/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Following the severe consequences of the COVID-19 outbreak, on March 9, 2020, the Italian government implemented extraordinary measures to limit viral transmission, including restrictive quarantine measures. This resulted in a rapid and profound change of people's daily lives. OBJECTIVE We assessed the psychological impact of the 40-day quarantine in a large cohort of patients with Parkinson's disease (PD) and caregivers. Moreover, we analyzed whether prelockdown clinical features may be associated with subjective response of patients with PD to this traumatic event. METHODS A total of 94 patients with PD were enrolled in the study. The Impact of Event Scale-Revised, the Kessler Psychological Distress Scale, and the 12-item Zarit Burden Inventory were obtained from patients and caregivers by email. A multivariate regression analysis was performed to determine whether prelockdown clinical motor and nonmotor features were associated with the psychological impact of lockdown. RESULTS Regression analyses showed that prelockdown levels of anxiety, treatment-related motor complications, patients' quality of life, and lockdown hours per day were significantly associated with psychological impact measures of the 40-day quarantine. In addition, we showed that caregiver burden was correlated with overall patient autonomy and attention/memory impairment. CONCLUSIONS We identified specific PD motor and nonmotor features potentially predisposing to higher psychological impact of stressful situations, such as quarantine. This may help guide postpandemic interventions and preventive strategies to avoid further impairment of psychological well-being in patients with PD.
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Affiliation(s)
- Rosa De Micco
- Department of Advanced Medical and Surgical SciencesUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Mattia Siciliano
- Department of Advanced Medical and Surgical SciencesUniversity of Campania “Luigi Vanvitelli”NaplesItaly
- Department of PsychologyUniversity of Campania “Luigi Vanvitelli”CasertaItaly
| | - Valeria Sant'Elia
- Department of Advanced Medical and Surgical SciencesUniversity of Campania “Luigi Vanvitelli”NaplesItaly
- Department of PsychologyUniversity of Campania “Luigi Vanvitelli”CasertaItaly
| | - Alfonso Giordano
- Department of Advanced Medical and Surgical SciencesUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Antonio Russo
- Department of Advanced Medical and Surgical SciencesUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Gioacchino Tedeschi
- Department of Advanced Medical and Surgical SciencesUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Alessandro Tessitore
- Department of Advanced Medical and Surgical SciencesUniversity of Campania “Luigi Vanvitelli”NaplesItaly
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19
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Zhang L, Qu Y, Jin B, Jing L, Gao Z, Liang Z. An Intelligent Mobile-Enabled System for Diagnosing Parkinson Disease: Development and Validation of a Speech Impairment Detection System. JMIR Med Inform 2020; 8:e18689. [PMID: 32936086 PMCID: PMC7527911 DOI: 10.2196/18689] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/06/2020] [Accepted: 07/26/2020] [Indexed: 11/17/2022] Open
Abstract
Background Parkinson disease (PD) is one of the most common neurological diseases. At present, because the exact cause is still unclear, accurate diagnosis and progression monitoring remain challenging. In recent years, exploring the relationship between PD and speech impairment has attracted widespread attention in the academic world. Most of the studies successfully validated the effectiveness of some vocal features. Moreover, the noninvasive nature of speech signal–based testing has pioneered a new way for telediagnosis and telemonitoring. In particular, there is an increasing demand for artificial intelligence–powered tools in the digital health era. Objective This study aimed to build a real-time speech signal analysis tool for PD diagnosis and severity assessment. Further, the underlying system should be flexible enough to integrate any machine learning or deep learning algorithm. Methods At its core, the system we built consists of two parts: (1) speech signal processing: both traditional and novel speech signal processing technologies have been employed for feature engineering, which can automatically extract a few linear and nonlinear dysphonia features, and (2) application of machine learning algorithms: some classical regression and classification algorithms from the machine learning field have been tested; we then chose the most efficient algorithms and relevant features. Results Experimental results showed that our system had an outstanding ability to both diagnose and assess severity of PD. By using both linear and nonlinear dysphonia features, the accuracy reached 88.74% and recall reached 97.03% in the diagnosis task. Meanwhile, mean absolute error was 3.7699 in the assessment task. The system has already been deployed within a mobile app called No Pa. Conclusions This study performed diagnosis and severity assessment of PD from the perspective of speech order detection. The efficiency and effectiveness of the algorithms indirectly validated the practicality of the system. In particular, the system reflects the necessity of a publicly accessible PD diagnosis and assessment system that can perform telediagnosis and telemonitoring of PD. This system can also optimize doctors’ decision-making processes regarding treatments.
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Affiliation(s)
- Liang Zhang
- International Business College, Dongbei University of Finance and Economics, Dalian, China
| | - Yue Qu
- School of Innovation and Entrepreneurship, Dalian University of Technology, Dalian, China
| | - Bo Jin
- School of Innovation and Entrepreneurship, Dalian University of Technology, Dalian, China
| | - Lu Jing
- Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Zhan Gao
- Beijing Haoyisheng Cloud Hospital Management Technology Ltd, Beijing, China
| | - Zhanhua Liang
- Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
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20
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Moraes-Ferreira R, Alves WMGDC, Brandao-Rangel MAR, Abrahin O, Pimentel CP, Correa-Sousa E, Vieira RP, Cortinhas-Alves EA. Parkinson Anxiety Scale: A Validation Study for the Brazilian Population. J Mov Disord 2020; 13:199-204. [PMID: 32713176 PMCID: PMC7502291 DOI: 10.14802/jmd.20031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 05/26/2020] [Indexed: 11/24/2022] Open
Abstract
Objective The Parkinson Anxiety Scale (PAS) was developed to measure the severity of anxiety symptoms in patients with Parkinson’s disease (PD), and it has not yet been adapted and validated in Portuguese. Thus, this study evaluated the reliability and validity of a translated and adapted version of the PAS for the Brazilian population of PD patients. Methods The Parkinson Anxiety Scale – Brazilian Version (PAS-BV) was completed by 55 patients with PD. The reliability (test-retest reliability, interrater reliability and internal consistency) and construct validity of the PAS-BV were assessed by comparing it with the Beck Anxiety Inventory (BAI), the Parkinson’s Disease Fatigue Scale (PFS) and the Unified Parkinson Disease Rating Scale (UPDRS) part III. Results Patients with PD had an average age of 64.51 ± 9.20 years and had PD for an average of 6.98 ± 5.02 years. The reliability of the PAS-BV was 0.83, and the intraclass correlation coefficient (ICC) (retest-test) was 0.88. The scale presented good convergent validity with the BAI (rs = 0.82, p < 0.05). It also presented good divergent validity with the PFS (rs = 0.24, p > 0.05) and the UPDRS part II (rs = -0.10, p > 0.05), part III (rs = -0.21, p > 0.05), and part IV (rs = 0.03, p > 0.05), as indicated by the absence of significant correlations. However, there was a significant correlation between the PAS-BV and part I of the UPDRS (rs = 0.67, p < 0.05). Conclusion The PAS-BV presents substantial reliability and validity for patients with PD without dementia.
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Affiliation(s)
- Renilson Moraes-Ferreira
- Department of Sciences of Human Movement and Rehabilitation, Federal University of São Paulo (UNIFESP), Sao Paulo, Brazil.,Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), Sao Jose dos Campos, Brazil
| | - Wilson Mateus Gomes da Costa Alves
- Department of Sciences of Human Movement and Rehabilitation, Federal University of São Paulo (UNIFESP), Sao Paulo, Brazil.,Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), Sao Jose dos Campos, Brazil
| | - Maysa Alves Rodrigues Brandao-Rangel
- Department of Sciences of Human Movement and Rehabilitation, Federal University of São Paulo (UNIFESP), Sao Paulo, Brazil.,Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), Sao Jose dos Campos, Brazil
| | | | | | | | - Rodolfo Paula Vieira
- Department of Sciences of Human Movement and Rehabilitation, Federal University of São Paulo (UNIFESP), Sao Paulo, Brazil.,Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), Sao Jose dos Campos, Brazil.,Anhembi Morumbi University, School of Medicine, Sao Jose dos Campos, Brazil.,Post-graduate Program in Bioengineering and in Biomedical Engineering Brazil University, Sao Paulo, Brazil
| | - Erik Artur Cortinhas-Alves
- Pará State University, Belém, Brazil.,Exercise Biochemistry Laboratory, Center for Biological Sciences of Health III, State University of Pará, Belém, Brazil
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21
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Yang W, Hamilton JL, Kopil C, Beck JC, Tanner CM, Albin RL, Ray Dorsey E, Dahodwala N, Cintina I, Hogan P, Thompson T. Current and projected future economic burden of Parkinson's disease in the U.S. NPJ PARKINSONS DISEASE 2020; 6:15. [PMID: 32665974 PMCID: PMC7347582 DOI: 10.1038/s41531-020-0117-1] [Citation(s) in RCA: 227] [Impact Index Per Article: 56.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 06/02/2020] [Indexed: 12/23/2022]
Abstract
Parkinson's disease (PD) is one of the world's fastest growing neurological disorders. Much is unknown about PD-associated economic burdens in the United States (U.S.) and other high-income nations. This study provides a comprehensive analysis of the economic burdens of PD in the U.S. (2017) and projections for the next two decades. Multiple data sources were used to estimate the costs of PD, including public and private administrative claims data, Medicare Current Beneficiary Survey, Medical Expenditure Panel Survey, and a primary survey (n = 4,548) designed for this study. We estimated a U.S. prevalence of approximately one million individuals with diagnosed Parkinson's disease in 2017 and a total economic burden of $51.9 billion. The total burden of PD includes direct medical costs of $25.4 billion and $26.5 billion in indirect and non-medical costs, including an indirect cost of $14.2 billion (PWP and caregiver burden combined), non-medical costs of $7.5 billion, and $4.8 billion due to disability income received by PWPs. The Medicare program bears the largest share of excess medical costs, as most PD patients are over age 65. Projected PD prevalence will be more than 1.6 million with projected total economic burden surpassing $79 billion by 2037. The economic burden of PD was previously underestimated. Our findings underscore the substantial burden of PD to society, payers, patients, and caregivers. Interventions to reduce PD incidence, delay disease progression, and alleviate symptom burden may reduce the future economic burden of PD.
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Affiliation(s)
- Wenya Yang
- The Lewin Group, Falls Church, VA 22042 USA
| | | | | | | | | | - Roger L Albin
- University of Michigan, Ann Arbor, MI 48109 USA.,VA Ann Arbor Health System, Ann Arbor, MI 48105 USA
| | - E Ray Dorsey
- University of Rochester, Rochester, NY 14642 USA
| | - Nabila Dahodwala
- Penn Parkinson's Disease and Movement's Disorders Center, Philadelphia, PA 19107 USA
| | | | - Paul Hogan
- The Lewin Group, Falls Church, VA 22042 USA
| | - Ted Thompson
- The Michael J. Fox Foundation, New York, NY 10120 USA
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Zečević I. Clinical practice guidelines based on evidence for cognitive-behavioural therapy in Parkinson's disease comorbidities: A literature review. Clin Psychol Psychother 2020; 27:504-514. [PMID: 32196842 DOI: 10.1002/cpp.2448] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/17/2020] [Accepted: 03/17/2020] [Indexed: 12/18/2022]
Abstract
The purpose of this review is to provide psychologists and other health care professional enough knowledge about available cognitive-behavioural interventions for comorbidities in Parkinson's disease that include depression, anxiety, impulsive disorder, pain, and sleep disturbances. This review has clear clinical practical suggestions how to adapt psychological interventions and techniques to the motor and/or cognitive impairments of patients with Parkinson's disease, based on earlier available research results. Every available research that could be found with the help of search engines from Medline, Springer, PsychINFO, and Google Scholar, which used cognitive-behavioural therapy to treat Parkinson's comorbidities, was cited and explained. Cognitive-behavioural interventions and techniques are presented based on available research results for Parkinson's comorbidities. It is recommended to use treatment plans and interventions that are earlier suggested as efficient in patients with Parkinson's disease. Strongest available research based recommendations are available for depression and anxiety. There are only few available research studies that used cognitive and/or behavioural interventions for pain, impulsive disorder, or sleeping disturbances, except insomnia in Parkinson's disease. Cognitive-behavioural therapy is safe to use and should be adapted to the specific needs of patients and with the scientific approved treatment interventions and techniques. Psychologists should be careful on how they adapt their treatment plan for patients.
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Affiliation(s)
- Ivan Zečević
- Department of Psychosocial Rehabilitation, Center for Rehabilitation Stančić, Zagreb, Croatia
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23
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Taguchi T, Ikuno M, Yamakado H, Takahashi R. Animal Model for Prodromal Parkinson's Disease. Int J Mol Sci 2020; 21:ijms21061961. [PMID: 32183024 PMCID: PMC7139491 DOI: 10.3390/ijms21061961] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/10/2020] [Accepted: 03/11/2020] [Indexed: 12/18/2022] Open
Abstract
Parkinson’s disease (PD) is characterized by the loss of dopaminergic neurons in the substantia nigra and subsequent motor symptoms, but various non-motor symptoms (NMS) often precede motor symptoms. Recently, NMS have attracted much attention as a clue for identifying patients in a prodromal stage of PD, which is an excellent point at which to administer disease-modifying therapies (DMTs). These prodromal symptoms include olfactory loss, constipation, and sleep disorders, especially rapid eye movement sleep behavior disorder (RBD), all of which are also important for elucidating the mechanisms of the initiation and progression of the disease. For the development of DMTs, an animal model that reproduces the prodromal stage of PD is also needed. There have been various mammalian models reported, including toxin-based, genetic, and alpha synuclein propagation models. In this article, we review the animal models that exhibit NMS as prodromal symptoms and also discuss an appropriate prodromal model and its importance for the development of DMT of PD.
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Affiliation(s)
| | | | - Hodaka Yamakado
- Correspondence: (H.Y.); (R.T.); Tel.: +81-75-751-3767 (H.Y.); Tel.: +81-75-751-4397 (R.T.); Fax: +81-75-761-9780 (H.Y.); Fax: +81-75-761-9780 (R.T.)
| | - Ryosuke Takahashi
- Correspondence: (H.Y.); (R.T.); Tel.: +81-75-751-3767 (H.Y.); Tel.: +81-75-751-4397 (R.T.); Fax: +81-75-761-9780 (H.Y.); Fax: +81-75-761-9780 (R.T.)
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Lowes H, Pyle A, Santibanez-Koref M, Hudson G. Circulating cell-free mitochondrial DNA levels in Parkinson's disease are influenced by treatment. Mol Neurodegener 2020; 15:10. [PMID: 32070373 PMCID: PMC7029508 DOI: 10.1186/s13024-020-00362-y] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 02/13/2020] [Indexed: 12/12/2022] Open
Abstract
Several studies have linked circulating cell-free mitochondrial DNA (ccf-mtDNA) to human disease. In particular, reduced ccf-mtDNA levels in the cerebrospinal fluid (CSF) of both Alzheimer's and Parkinson's disease (PD) patients have raised the hypothesis that ccf-mtDNA could be used as a biomarker for neurodegenerative disease onset and progression. However, how a reduction of CSF ccf-mtDNA levels relates to neurodegeneration remains unclear. Many factors are likely to influence ccf-mtDNA levels, such as concomitant therapeutic treatment and comorbidities. In this study we aimed to investigate these factors, quantifying CSF ccf-mtDNA from the Parkinson's Progression Markers Initiative in 372 PD patients and 159 matched controls at two time points. We found that ccf-mtDNA levels appear significantly reduced in PD cases when compared to matched controls and are associated with cognitive impairment. However, our data indicate that this reduction in ccf-mtDNA is also associated with the commencement, type and duration of treatment. Additionally, we found that ccf-mtDNA levels are associated with comorbidities such as depression and insomnia, however this was only significant if measured in the absence of treatment. We conclude that in PD, similar to reports in HIV and sepsis, comorbidities and treatment can both influence ccf-mtDNA homeostasis, raising the possibility that ccf-mtDNA may be useful as a biomarker for treatment response or the development of secondary phenotypes. Given that, clinically, PD manifests often decades after neurodegeneration begins, predicting who will develop disease is important. Also, identifying patients who will respond to existing treatments or develop secondary phenotypes will have increased clinical importance as PD incidence rises.
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Affiliation(s)
- Hannah Lowes
- Wellcome Centre for Mitochondrial Research, Biosciences Institute, Newcastle University, Newcastle upon Tyne, NE1 3BZ UK
| | - Angela Pyle
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH UK
| | | | - Gavin Hudson
- Wellcome Centre for Mitochondrial Research, Biosciences Institute, Newcastle University, Newcastle upon Tyne, NE1 3BZ UK
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25
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Dlay JK, Duncan GW, Khoo TK, Williams-Gray CH, Breen DP, Barker RA, Burn DJ, Lawson RA, Yarnall AJ. Progression of Neuropsychiatric Symptoms over Time in an Incident Parkinson's Disease Cohort (ICICLE-PD). Brain Sci 2020; 10:E78. [PMID: 32024222 PMCID: PMC7071603 DOI: 10.3390/brainsci10020078] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 01/25/2020] [Accepted: 01/31/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Cross-sectional studies have identified that the prevalence of neuropsychiatric symptoms (NPS) in Parkinson's disease (PD) ranges from 70-89%. However, there are few longitudinal studies determining the impact of NPS on quality of life (QoL) in PD patients and their caregivers. We seek to determine the progression of NPS in early PD. METHODS Newly diagnosed idiopathic PD cases (n = 212) and age-matched controls (n = 99) were recruited into a longitudinal study. NPS were assessed using the Neuropsychiatric Inventory with Caregiver Distress scale (NPI-D). Further neuropsychological and clinical assessments were completed by participants, with reassessment at 18 and 36 months. Linear mixed-effects modelling determined factors associated with NPI-D and QoL over 36 months. RESULTS Depression, anxiety, apathy and hallucinations were more frequent in PD than controls at all time points (p < 0.05). Higher motor severity at baseline was associated with worsening NPI-D scores over time (β = 0.1, p < 0.05), but not cognition. A higher NPI total score was associated with poorer QoL at any time point (β = 0.3, p < 0.001), but not changed in QoL scores. CONCLUSION NPS are significantly associated with poorer QoL, even in early PD. Screening for NPS from diagnosis may allow efficient delivery of better support and treatment to patients and their families.
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Affiliation(s)
- J. K. Dlay
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (J.K.D.); (G.W.D.); (R.A.L.)
| | - G. W. Duncan
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (J.K.D.); (G.W.D.); (R.A.L.)
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK
| | - T. K. Khoo
- School of Medicine and Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia;
- School of Medicine, University of Wollongong, New South Wales 2522, Australia
| | - C. H. Williams-Gray
- John van Geest Centre for Brain Repair, University of Cambridge, Cambridge CB2 0PY, UK; (C.H.W.-G.); (R.A.B.)
| | - D. P. Breen
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK
- Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh EH16 4SB, UK
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh EH16 4UX, UK
| | - R. A. Barker
- John van Geest Centre for Brain Repair, University of Cambridge, Cambridge CB2 0PY, UK; (C.H.W.-G.); (R.A.B.)
| | - D. J. Burn
- Faculty of Medical Sciences, Newcastle University & Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE2 4HH, UK;
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, UK
| | - R. A. Lawson
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (J.K.D.); (G.W.D.); (R.A.L.)
| | - A. J. Yarnall
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (J.K.D.); (G.W.D.); (R.A.L.)
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, UK
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26
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Vieira JCF, Bassani TB, Santiago RM, de O. Guaita G, Zanoveli JM, da Cunha C, Vital MA. Anxiety-like behavior induced by 6-OHDA animal model of Parkinson’s disease may be related to a dysregulation of neurotransmitter systems in brain areas related to anxiety. Behav Brain Res 2019; 371:111981. [DOI: 10.1016/j.bbr.2019.111981] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 05/22/2019] [Accepted: 05/25/2019] [Indexed: 12/22/2022]
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Abstract
In addition to motor symptoms, behavioural complications are commonly found in patients with Parkinson's disease (PD). Behavioural complications, including depression, anxiety, apathy, impulse control disorder and psychosis, together have a large impact on PD patient's quality of life. Many neuroimaging studies using PET, SPECT and MRI techniques have been conducted to study the underlying neural mechanisms of PD pathogenesis and pathophysiology in relation to its behavioural complications. This review will survey these PET, SPECT and MRI studies to describe the current understanding of the neuro-chemical, functional and structural changes associated with behavioural complications in PD patients.
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28
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Pinter A, Szatmari S, Horvath T, Penzlin AI, Barlinn K, Siepmann M, Siepmann T. Cardiac dysautonomia in depression - heart rate variability biofeedback as a potential add-on therapy. Neuropsychiatr Dis Treat 2019; 15:1287-1310. [PMID: 31190834 PMCID: PMC6529729 DOI: 10.2147/ndt.s200360] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 03/21/2019] [Indexed: 01/05/2023] Open
Abstract
Depressive disorders are among the most important health problems and are predicted to constitute the leading cause of disease burden by the year 2030. Aside significant impact on quality of life, psychosocial well-being and socioeconomic status of affected patients, depression is associated with impaired cardiovascular health and increased mortality. The link between affective and cardiovascular disease has largely been attributed to dysregulation of the autonomic nervous system resulting in a chronic shift toward increased sympathetic and decreased parasympathetic activity and, consecutively, cardiac dysautonomia. Among proposed surrogate parameters to capture and quantitatively analyze this shift, heart rate variability (HRV) and baroreflex sensitivity have emerged as reliable tools. Attenuation of these parameters is frequently seen in patients suffering from depression and is closely linked to cardiovascular morbidity and mortality. Therefore, diagnostic and therapeutic strategies were designed to assess and counteract cardiac dysautonomia. While psychopharmacological treatment can effectively improve affective symptoms of depression, its effect on cardiac dysautonomia is limited. HRV biofeedback is a non-invasive technique which is based on a metronomic breathing technique to increase parasympathetic tone. While some small studies observed beneficial effects of HRV biofeedback on dysautonomia in patients with depressive disorders, larger confirmatory trials are lacking. We reviewed the current literature on cardiac dysautonomia in patients suffering from depression with a focus on the underlying pathophysiology as well as diagnostic workup and treatment.
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Affiliation(s)
- Alexandra Pinter
- Division of Health Care Sciences, Dresden International University, Dresden, Germany.,Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Szabolcs Szatmari
- Division of Health Care Sciences, Dresden International University, Dresden, Germany.,Department of Neurology, Semmelweis University, Budapest, Hungary.,Janos Szentagothai Doctoral School of Neurosciences, Semmelweis University, Budapest, Hungary
| | - Tamas Horvath
- Department of Hydrodynamic Systems, Budapest University of Technology and Economics, Budapest, Hungary
| | - Ana Isabel Penzlin
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Kristian Barlinn
- Department of Neurology, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Martin Siepmann
- Department of Psychosomatic Medicine and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Timo Siepmann
- Division of Health Care Sciences, Dresden International University, Dresden, Germany.,Department of Neurology, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
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29
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Xu JJ, Yang ST, Sha Y, Ge YY, Wang JM. Hyperbaric oxygen treatment for Parkinson's disease with severe depression and anxiety: A case report. Medicine (Baltimore) 2018; 97:e0029. [PMID: 29489651 PMCID: PMC5851727 DOI: 10.1097/md.0000000000010029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
RATIONALE Patients with Parkinson's disease (PD) frequently suffer from psychiatric disorders, and treating these symptom whereas managing the motor symptoms associated with PD can be a therapeutic challenge. PATIENT CONCERNS We report a case of PD patient with severe depression and anxiety that refused to be treated with dopaminagonists or SSRIs, the most common treatments for PD patients suffering from psychiatric symptoms. DIAGNOSES Parkinson's disease with severe depression and anxiety. INTERVENTIONS This man was treated with hyperbaric oxygen treatment for 30 days. OUTCOMES Clinical assessment scores for depression and anxiety, including Unified Parkinson's Disease Rating ScaleI (UPDRS I), UPDRS II, Hanmilton Depression Rating Scale, and Hamiliton Anxiety Rating Scale, were improved following the hyperbaric oxygen treatment. LESSONS Hyperbaric oxygen treatment may be a potential therapeutic method for PD patient suffering from depression and anxiety. Further research is needed to validate this finding and explore a potential mechanism.
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30
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Wen MC, Chan LL, Tan LCS, Tan EK. Depression, anxiety, and apathy in Parkinson's disease: insights from neuroimaging studies. Eur J Neurol 2017; 23:1001-19. [PMID: 27141858 PMCID: PMC5084819 DOI: 10.1111/ene.13002] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 03/01/2016] [Indexed: 11/28/2022]
Abstract
Depression, anxiety and apathy are common mood disturbances in Parkinson's disease (PD) but their pathophysiology is unclear. Advanced neuroimaging has been increasingly used to unravel neural substrates linked to these disturbances. A systematic review is provided of neuroimaging findings in depression, anxiety and apathy in PD. A PubMed, MEDLINE and EMBASE search of peer‐reviewed original research articles on these mood disturbances in PD identified 38 studies on depression, eight on anxiety and 14 on apathy in PD. Most of the imaging studies used either position emission tomography or single‐photon emission computed tomography techniques. These studies generally suggest increased neural activity in the prefrontal regions and decreased functional connectivity between the prefrontal−limbic networks in depressed patients. Functional imaging studies revealed an inverse correlation between dopaminergic density in the caudate and putamen with the severity of anxiety in PD. There was no consistent correlation between dopaminergic density of thalamus and anxiety. Studies demonstrated both positive and inverse correlations between apathy and metabolism or activity in the striatum, amygdalar, prefrontal, temporal and parietal regions. The clinical variability of study subjects and differences in image pre‐processing and analytical strategies may contribute to discrepant findings in these studies. Both nigrostriatal and extra‐nigrostriatal pathways (in particular the frontal region and its connecting areas) are affected in mood disorders in PD. Identifying the relative contributions of these neural pathways in PD patients with overlapping motor and mood symptoms could provide new pathophysiological clues for the development of better therapeutic targets for affected patients.
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Affiliation(s)
- M-C Wen
- Department of Research, National Neuroscience Institute, Singapore, Singapore
| | - L L Chan
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore, Singapore
| | - L C S Tan
- Duke - National University of Singapore Graduate Medical School, Singapore, Singapore.,Department of Neurology, National Neuroscience Institute, Singapore
| | - E K Tan
- Department of Research, National Neuroscience Institute, Singapore, Singapore.,Duke - National University of Singapore Graduate Medical School, Singapore, Singapore.,Department of Neurology, National Neuroscience Institute, Singapore
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31
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Maiti P, Manna J, Dunbar GL. Current understanding of the molecular mechanisms in Parkinson's disease: Targets for potential treatments. Transl Neurodegener 2017; 6:28. [PMID: 29090092 PMCID: PMC5655877 DOI: 10.1186/s40035-017-0099-z] [Citation(s) in RCA: 284] [Impact Index Per Article: 40.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 10/09/2017] [Indexed: 12/21/2022] Open
Abstract
Gradual degeneration and loss of dopaminergic neurons in the substantia nigra, pars compacta and subsequent reduction of dopamine levels in striatum are associated with motor deficits that characterize Parkinson’s disease (PD). In addition, half of the PD patients also exhibit frontostriatal-mediated executive dysfunction, including deficits in attention, short-term working memory, speed of mental processing, and impulsivity. The most commonly used treatments for PD are only partially or transiently effective and are available or applicable to a minority of patients. Because, these therapies neither restore the lost or degenerated dopaminergic neurons, nor prevent or delay the disease progression, the need for more effective therapeutics is critical. In this review, we provide a comprehensive overview of the current understanding of the molecular signaling pathways involved in PD, particularly within the context of how genetic and environmental factors contribute to the initiation and progression of this disease. The involvement of molecular chaperones, autophagy-lysosomal pathways, and proteasome systems in PD are also highlighted. In addition, emerging therapies, including pharmacological manipulations, surgical procedures, stem cell transplantation, gene therapy, as well as complementary, supportive and rehabilitation therapies to prevent or delay the progression of this complex disease are reviewed.
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Affiliation(s)
- Panchanan Maiti
- Field Neurosciences Institute Laboratory for Restorative Neurology, Mt. Pleasant, MI 48859 USA.,Program in Neuroscience, Mt. Pleasant, MI 48859 USA.,Department of Psychology, Central Michigan University, Mt. Pleasant, MI 48859 USA.,Field Neurosciences Institute, St. Mary's of Michigan, Saginaw, MI 48604 USA.,Department of Biology, Saginaw Valley State University, Saginaw, MI 48604 USA
| | - Jayeeta Manna
- Department of Physiology, University of Tennessee Health Science Center, Memphis, TN 38105 USA
| | - Gary L Dunbar
- Field Neurosciences Institute Laboratory for Restorative Neurology, Mt. Pleasant, MI 48859 USA.,Program in Neuroscience, Mt. Pleasant, MI 48859 USA.,Department of Psychology, Central Michigan University, Mt. Pleasant, MI 48859 USA.,Field Neurosciences Institute, St. Mary's of Michigan, Saginaw, MI 48604 USA
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32
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Depression in Parkinson's Disease: The Contribution from Animal Studies. PARKINSONS DISEASE 2017; 2017:9124160. [PMID: 29158943 PMCID: PMC5660814 DOI: 10.1155/2017/9124160] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 09/07/2017] [Indexed: 02/06/2023]
Abstract
Besides being better known for causing motor impairments, Parkinson's disease (PD) can also cause many nonmotor symptoms, like depression and anxiety, which can cause significant loss of life quality and may not respond to regular drugs treatment. In this review, we discuss the depression in PD, based on data from studies in humans and rodents. Depression frequency seems higher in PD patients than in general population, despite high variation in data due to diagnosis disparities. Development of depression in PD seems more likely to be caused by the nigrostriatal pathway degeneration than as a consequence of the awareness of disease prognostic, and it seems to be related to dopaminergic, noradrenergic, and serotoninergic synapses deficits. The dopaminergic role could be more significant, since it can modulate the release of the others, and its depletion is progressive, due to the degenerative feature of PD. Highly regarded in major depression, serotonin can be depleted in rats after nigrostriatal damage, but data from human patients are more conflicting. Animal studies can help in understanding the neurobiological mechanisms of depression in PD and the pursuit for more effective drugs for its treatment, but they lack the complexity of the disease progression, especially the nondopaminergic degeneration.
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33
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Schrag A, Taddei RN. Depression and Anxiety in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 133:623-655. [DOI: 10.1016/bs.irn.2017.05.024] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Factor SA, Scullin MK, Freeman A, Bliwise DL, McDonald WM, Goldstein FC. Affective Correlates of Psychosis in Parkinson's Disease. Mov Disord Clin Pract 2016; 4:225-230. [PMID: 28944257 DOI: 10.1002/mdc3.12381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To examine the nature of the association between affective disorders and psychosis in Parkinson's disease (PD). BACKGROUND In PD, psychosis and affective disorders are common and independently impact quality of life and mortality. Both depression and psychosis are correlated with the occurrence of cognitive dysfunction, suggesting that they may share neurobiological substrates. Anxiety has not been examined as a correlate of psychosis. METHODS 144 PD subjects were evaluated with the Schedule for Assessment of Positive Symptoms to assess psychotic features, while depression and anxiety were examined by the Structured Clinical Interview for DSM-IV-TR (SCID) and self-assessment scales Beck Depression Inventory II (BDI-II) and Beck Anxiety Inventory (BAI). Correlational analyses assessed associations between hallucinations and delusions with depression and anxiety. RESULTS A diagnosis of anxiety (SCID) was significantly (p=.015) associated with hallucinations (OR=4.81, CI=1.36-16.99). Severity of anxiety (BAI) significantly predicted (p=.03) the presence of hallucinations (OR=1.08, CI=1.01-1.15) and delusions (OR=1.09, CR=1.01-1.17). Current depression (SCID) was significantly (p=.001) associated with the presence of hallucinations (OR=6.12, CI=2.04-18.39) and delusions (OR=7.14, CI=2.23-22.93). Multiple linear regressions revealed that severity of anxiety remained an independent predictor (p<.05) of both the number of types of hallucinations (t=3.06, p=.003) and delusions (t=2.87, p=.005). Severity of depression was a significant predictor of the total number of delusions (t=2.28, p=.024). CONCLUSIONS This study demonstrates an association between depression and psychosis and, for the first time, an association between anxiety and psychosis. These associations may have implications on pathophysiology and treatment of psychosis in PD.
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Affiliation(s)
| | | | - Alan Freeman
- Emory University School of Medicine: Department of Neurology
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35
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Ghaddar A, Fawaz M, Khazen G, Abdallah J, Milane A. Prevalence of depression in Parkinson's disease in a Lebanese tertiary clinic. J Clin Exp Neuropsychol 2015; 38:51-8. [PMID: 26588047 DOI: 10.1080/13803395.2015.1087466] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Diagnosis of Parkinson's disease can be emotionally and psychologically challenging to patients. The aim of this study is to investigate the association between Parkinson's disease and depression and the impact of the disease stage and patients' age and gender on this association. METHOD This is a cross-sectional retrospective study on 200 patients aged above 35 years old from 10 different nationalities. RESULTS Depression was diagnosed in 46% of the patients enrolled. Most of these patients were treated with an antidepressant. Young age, female gender, and moderate Parkinson's disease stage were found to be significantly associated with depression (odds ratio of 1.19, 1.23, and 1.22, respectively, p < .05). CONCLUSION This study, the first of its kind in Lebanon and the Middle East and North Africa region, highlights the importance of studying depression in Parkinson's disease and the need for identifying and treating depression symptoms when treating Parkinson's disease patients.
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Affiliation(s)
- Alissar Ghaddar
- a School of Pharmacy , Lebanese American University , Byblos , Lebanon
| | - Mohammad Fawaz
- a School of Pharmacy , Lebanese American University , Byblos , Lebanon
| | - Georges Khazen
- b School of Arts and Sciences , Lebanese American University , Byblos , Lebanon
| | - Jad Abdallah
- a School of Pharmacy , Lebanese American University , Byblos , Lebanon
| | - Aline Milane
- a School of Pharmacy , Lebanese American University , Byblos , Lebanon
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36
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Jiang SM, Yuan YS, Tong Q, Zhang L, Xu QR, Ding J, Zhang KZ. The association between clinically relevant anxiety and other non-motor symptoms in Parkinson's disease. Neurol Sci 2015; 36:2105-9. [PMID: 26152801 DOI: 10.1007/s10072-015-2320-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 07/01/2015] [Indexed: 11/25/2022]
Abstract
Anxiety disorders in patients with Parkinson's disease (PD) are often missed due to an overlap with other non-motor symptoms. The relationships between anxiety and other non-motor symptoms in PD still remain unclear. We used the Hamilton anxiety rating scale and the Non-motor Symptoms Questionnaire to measure anxiety and the complex range of non-motor symptoms in 99 PD patients. The relationships between anxiety and other PD-related non-motor symptoms were examined through regression analyses. 25 % of PD patients were diagnosed with clinically relevant anxiety. Non-motor symptoms were more prominent in patients with anxiety. Depression, urinary disorders, and sleep disruption were the factors most likely to influence anxiety in PD. Our findings have revealed a strong interplay between anxiety and other non-motor symptoms of PD and have highlighted the need for a holistic approach towards the clinical treatment of this disabling condition.
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Affiliation(s)
- Si-Ming Jiang
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Yong-Sheng Yuan
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Qing Tong
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Li Zhang
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Qin-Rong Xu
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Jian Ding
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Ke-Zhong Zhang
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China.
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37
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Coakeley S, Martens KE, Almeida QJ. Management of anxiety and motor symptoms in Parkinson’s disease. Expert Rev Neurother 2014; 14:937-46. [DOI: 10.1586/14737175.2014.936388] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Sagna A, Gallo JJ, Pontone GM. Systematic review of factors associated with depression and anxiety disorders among older adults with Parkinson's disease. Parkinsonism Relat Disord 2014; 20:708-15. [PMID: 24780824 PMCID: PMC4648277 DOI: 10.1016/j.parkreldis.2014.03.020] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 03/18/2014] [Accepted: 03/21/2014] [Indexed: 12/19/2022]
Abstract
Depression and anxiety disorders have a substantial impact on the quality of life, the functioning and mortality of older adults with Parkinson's disease (PD). The purpose of this systematic review was to examine the factors associated with the prevalence of depression and anxiety disorders among individuals with PD aged 60 years and older. Following a literature search in PubMed, PsycINFO, CINAHL, and EMBASE, 5 articles met the inclusion criteria (adults aged 60 years and older, individuals with PD, and with depression and anxiety disorders, and English-language peer reviewed articles) and were included in this review. These studies were conducted in the U.S (n = 3), in Italy (n = 1) and the U.K (n = 1). Findings indicated that autonomic symptoms, motor fluctuations, severity and frequency of symptoms, staging of the disease, and PD onset and duration were associated with the prevalence of depression and anxiety disorders among older adults suffering from PD. Despite the limited number of studies included in the review, depression and anxiety disorders are often unrecognized and untreated and the comorbidity greatly exacerbates PD symptoms. The identification of factors associated with the development of depression and anxiety disorders could help in designing preventive interventions that would decrease the risk and burden of depression and anxiety disorders among older adults with PD.
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Affiliation(s)
- Atami Sagna
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joseph J Gallo
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Gregory M Pontone
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Abstract
Anxiety disturbances are recognized as common psychiatric comorbidities in Parkinson's disease (PD) and contribute to significant impairments in areas of cognitive, functional, motor and social performance. Anxiety in PD results in reduced quality of life, higher levels of care dependency and increased caregiver burden. Surprisingly, there is a paucity of treatment data. In one randomized, controlled study, bromazepam was found to be effective for anxiety in PD. However, usage of benzodiazepines in the PD population is limited by potential risk of confusion and falls. There are no controlled studies of selective serotonin reuptake inhibitors (SSRIs) for anxiety in PD. However, results from uncontrolled studies suggest that SSRIs are effective for anxiety in PD, although in these studies anxiety outcomes were secondary. This review underscores that, given the high prevalence of anxiety disturbances in PD, there is a significant paucity of treatment data for this population. Additional studies are warranted. In the meantime, clinicians should rely on empiric assessments of known risks and putative benefits to guide treatment decisions. Cognitive and behavioral therapies (with or without pharmacotherapy) have demonstrated efficacy and warrant consideration. When feasible, a targeted and individualized multimodal approach utilizing psychotherapeutic interventions along with pharmacologic therapies should be considered.
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Affiliation(s)
- Jack J Chen
- Associate Professor (Neurology), Schools of Medicine and Pharmacy, Loma Linda University, Shyrock Hall #225, Loma Linda, CA 92350, USA
| | - Laura Marsh
- Michael E. DeBakey Veterans Affairs Medical Center and Departments of Psychiatry and Neurology, Baylor College of Medicine, Houston, TX, USA
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Kapfhammer HP. [Coexistent depressive and anxiety disorders in neurological diseases: from a perspective of multimorbidity]. DER NERVENARZT 2014; 85:437-44. [PMID: 24619147 DOI: 10.1007/s00115-013-3936-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The high rate of coexistent emotional disorders in neurological diseases is challenging. As a rule this coexistence comprises a more dramatic subjective suffering, reduced psychological coping, possible negative interferences with somatic treatments and rehabilitation, an impaired quality of life and higher grades of psychosocial disability. It may also lead to an overall increased risk of somatic morbidity and even mortality in the further course of illness. The complex interrelations may be favorably integrated within a biopsychosocial model. Psychological and psychosocial stressors can be appreciated on their own discrete levels but have to be reflected in their neurobiological correlates. Both neurological and emotional disorders frequently share decisive pathogenetic mechanisms, i.e. the underlying process of neurological disease may contribute to major affective problems also in a somatopsychic direction. From a perspective of multimorbidity the prevalence and clinical relevance of coexistent depressive and anxiety disorders, common pathogenetic mechanisms and implications for treatment will be described for stroke and Parkinson's disease, as selected neurological disorders.
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Affiliation(s)
- H P Kapfhammer
- Klinik für Psychiatrie, Medizinische Universität Graz, Auenbruggerplatz 31, 8036, Graz, Österreich,
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Kosari-Nasab M, Babri S, Fatehi-Gharehlar L, Doosti MH, Pakzad S. Involvement of GABAergic system in regulation of the anxiolytic- and antidepressant-like effects of Scrophularia striata extract in rats. PHARMACEUTICAL BIOLOGY 2013; 51:581-588. [PMID: 23373710 DOI: 10.3109/13880209.2012.749924] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
CONTEXT Neuropsychiatric disorders, like anxiety and depression, are global problems for clinical researchers in neurology. Recently, some authors have shown neuroprotective and anti-inflammatory effects of Scrophularia striata Boiss (Scrophulariaceae) extract in rodents. OBJECTIVE The purpose of the current study was to investigate the effects of S. striata extract on anxiety and depressant-like behaviors and find a possible mechanism for these impacts. MATERIALS AND METHODS In this study, the elevated plus-maze (EPM) and forced swimming test (FST), which are useful models for selective identification of anxiolytic and antidepressant drug effects in rodents, were used. We investigated the effects of S. striata ethanol extract at different doses (20, 50, 100, 160 and 220 mg/kg) on anxiety and depression behaviors in the EPM and FST, and then we assessed the role of γ-aminobutyric acid (GABA)A receptor in modulation of the effects of S. striata extract in the brain. RESULTS Our results showed that effective doses of S. striata (100 and 160 mg/kg) increased the percentages of open arm time and entries in the EPM and decreased immobility time in the FST in comparison with control group, indicating anxiolytic and antidepressant effects, respectively. Moreover, intracerebroventricular administration of GABAA receptor agonist (muscimol; 1 µg/rat) enhanced the impact of S. striata, and GABAA receptor antagonist (bicuculline; 1 µg/rat) blocked these effects in rats, indicating that significant interactions existed between S. striata and the GABAergic system in the brain. DISCUSSION AND CONCLUSION Findings of this study suggest that anxiolytic and antidepressant effects of S. striata may be modulated via the GABAergic system.
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Affiliation(s)
- Morteza Kosari-Nasab
- Laboratory of Plant Biotechnology, Hayyan Research Institute, University of Tabriz, Tabriz, Iran
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Yamanishi T, Tachibana H, Oguru M, Matsui K, Toda K, Okuda B, Oka N. Anxiety and depression in patients with Parkinson's disease. Intern Med 2013; 52:539-45. [PMID: 23448761 DOI: 10.2169/internalmedicine.52.8617] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To investigate the prevalence and clinical correlates of anxiety and depression in patients with Parkinson's disease (PD) and to examine the relationship between anxiety and depression and the quality of life (QOL). METHODS One hundred and seventeen patients with PD completed the state-trait anxiety inventory (STAI), the beck depression inventory second edition (BDI-II), Starkstein's apathy scale (AS) and 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 Anxiety (STAI score ≥41 for men or ≥42 for women) was diagnosed in 55% of the patients and depression (BDI-II score ≥14) was diagnosed in 56% of the patients. Anxiety coexisted with depression in 41% of the patients, while depression without anxiety was observed in 15% of the patients and anxiety without depression was observed in 14% of the patients. The STAI score was found to be significantly correlated with the UPDRS (I, IV) and AS scores, whereas the BDI-II score was found to correlate with the HY stage and the UPDRS (I, III, IV) and AS scores. Both the STAI and BDI-II scores were found to negatively correlate with QOL. A multivariate analysis revealed that depression and anxiety are similarly associated with the PD specific QOL (PDQ-39), while motor severity, as judged by the HY stage and UPDRS III score, is not. CONCLUSION These findings indicate that recognizing anxiety and depression in patients with PD is important, since both conditions are commonly observed in patients with PD and are similarly associated with the QOL, independent of motor severity.
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RETRACTED ARTICLE: Involvement of the GABA-Ergic System in Anxiolytic and Antidepressive Effects of the Scrophularia striata Extract in Rats. NEUROPHYSIOLOGY+ 2013. [DOI: 10.1007/s11062-013-9333-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Erro R, Pappatà S, Amboni M, Vicidomini C, Longo K, Santangelo G, Picillo M, Vitale C, Moccia M, Giordano F, Brunetti A, Pellecchia MT, Salvatore M, Barone P. Anxiety is associated with striatal dopamine transporter availability in newly diagnosed untreated Parkinson's disease patients. Parkinsonism Relat Disord 2012; 18:1034-8. [DOI: 10.1016/j.parkreldis.2012.05.022] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Revised: 05/21/2012] [Accepted: 05/24/2012] [Indexed: 11/27/2022]
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McDowell K, Chesselet MF. Animal models of the non-motor features of Parkinson's disease. Neurobiol Dis 2012; 46:597-606. [PMID: 22236386 PMCID: PMC3442929 DOI: 10.1016/j.nbd.2011.12.040] [Citation(s) in RCA: 111] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2011] [Revised: 12/17/2011] [Accepted: 12/22/2011] [Indexed: 12/21/2022] Open
Abstract
The non-motor symptoms (NMS) of Parkinson's disease (PD) occur in roughly 90% of patients, have a profound negative impact on their quality of life, and often go undiagnosed. NMS typically involve many functional systems, and include sleep disturbances, neuropsychiatric and cognitive deficits, and autonomic and sensory dysfunction. The development and use of animal models have provided valuable insight into the classical motor symptoms of PD over the past few decades. Toxin-induced models provide a suitable approach to study aspects of the disease that derive from the loss of nigrostriatal dopaminergic neurons, a cardinal feature of PD. This also includes some NMS, primarily cognitive dysfunction. However, several NMS poorly respond to dopaminergic treatments, suggesting that they may be due to other pathologies. Recently developed genetic models of PD are providing new ways to model these NMS and identify their mechanisms. This review summarizes the current available literature on the ability of both toxin-induced and genetically-based animal models to reproduce the NMS of PD.
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Affiliation(s)
- Kimberly McDowell
- Department of Neurology, The David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-1769, USA
| | - Marie-Françoise Chesselet
- Department of Neurology, The David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-1769, USA
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Latchney SE, Eisch AJ. Therapeutic application of neural stem cells and adult neurogenesis for neurodegenerative disorders: regeneration and beyond. EUROPEAN JOURNAL OF NEURODEGENERATIVE DISEASE 2012; 1:335-351. [PMID: 25729743 PMCID: PMC4340249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
With the growth of the aging population and increasing life expectancy, the diagnosis of age-related neurodegenerative diseases is predicted to increase 12% by 2030. There is urgent need to develop better and novel treatments for disorders like Alzheimer's, Huntington's, and Parkinson's diseases. As these neurodegenerative diseases are customarily defined by the progressive loss of neurons, treatment strategies have traditionally focused on replacing neurons lost during disease progression. To this end, the self-renewing and multipotent properties of neural stem/precursor cells (NSPCs) that exist in the adult brain suggest that NSPCs could contribute to a therapy for replacement of damaged or lost neurons. Although a wealth of research demonstrates the proof-of-concept that NSPC transplantation has therapeutic potential, there are considerable barriers between the theory of cell transplantation and clinical implementation. However, a new view on harnessing the power of NSPC for treatment of neurodegenerative disorders has emerged, and focuses on treating neuropathological aspects of the disease prior to the appearance of overt neuronal loss. For example, rather than merely replacing lost neurons, NSPCs are now being considered for their ability to provide trophic support. Here we review the evolution of how the field has considered application of NSPCs for treatment of neurodegeneration disorders. We discuss the challenges posed by the "traditional" view of neurodegeneration - overt cell loss - for utilization of NSPCs for treatment of these disorders. We also review the emergence of an alternative strategy that involves fine-tuning the neurogenic capacity of existing adult NSPCs so that they are engineered to address disease-specific pathologies at specific time points during the trajectory of disease. We conclude with our opinion that for this strategy to become a translational reality, it requires a thorough understanding of NSPCs, the dynamic process of adult neurogenesis, and a better understanding of the pathological trajectory of each neurodegenerative disease.
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Affiliation(s)
| | - Amelia J. Eisch
- Corresponding author: , Telephone: (214)-648-5549, Fax: (214) 645-9549
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Bogdanova Y, Cronin-Golomb A. Neurocognitive correlates of apathy and anxiety in Parkinson's disease. PARKINSON'S DISEASE 2011; 2012:793076. [PMID: 22203919 PMCID: PMC3238406 DOI: 10.1155/2012/793076] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/31/2011] [Accepted: 10/25/2011] [Indexed: 11/18/2022]
Abstract
Parkinson's disease (PD) is associated with various nonmotor symptoms including neuropsychiatric and cognitive dysfunction. We examined the relation between apathy, anxiety, side of onset of motor symptoms, and cognition in PD. We hypothesized that PD patients would show different neuropsychiatric and neurocognitive profiles depending on the side of onset. 22 nondemented PD patients (11 right-side onset (RPD) with predominant left-hemisphere pathology, and 11 LPD) and 22 matched healthy controls (NC) were administered rating scales assessing apathy and anxiety, and a series of neuropsychological tests. PD patients showed a higher anxiety level than NC. There was a significant association between apathy, anxiety, and disease duration. In LPD, apathy but not anxiety was associated with performance on nonverbally mediated executive function and visuospatial measures, whereas, in RPD, anxiety but not apathy correlated with performance on verbally mediated tasks. Our findings demonstrated a differential association of apathy and anxiety to cognition in PD.
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Affiliation(s)
- Yelena Bogdanova
- Department of Psychology, Boston University, Boston, MA 02215, USA
- Psychology Research (151-A), VA Boston Healthcare System, 150 South Huntington Street, Boston, MA 02130, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
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