Clinical aspects of depression in Parkinson's disease

2016 ◽  
Vol 33 (S1) ◽  
pp. S380-S380
Author(s):  
F. Leite ◽  
H. Salgado ◽  
O. Campos ◽  
P. Carvalho ◽  
M. Pinto da Costa ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Depressive Symptoms ◽  
Clinical Manifestations ◽  
The Elderly ◽  
Panic Attacks ◽  
Clinical Aspects ◽  
Motor Symptoms ◽  
Loss Of Self ◽  
Competing Interest

IntroductionParkinson's disease is the most common neurodegenerative movement disorder in the elderly population. The disease is clinically characterized by major motor symptoms that include bradykinesia, rigidity, tremor and postural instability. In addition to the motor symptoms, Parkinson‘s disease is characterized by emotional and cognitive deficits, which reduce quality of life independently from motor manifestations.Objectives/AimsTo discuss the clinical manifestations of depression in Parkinson's disease according to the most recent scientific literature.MethodsOnline search/review of the literature has been carried out, using Medline/Pubmed, concerning, “Parkinson's disease” and “depression”.ResultsDepression is the most frequent psychiatric disorder in Parkinson's disease. In up to 30% of the cases, the depressive symptoms precede the development of motor symptoms. Independently of the age of appearance, duration and severity of the motor symptoms, depression is generally an integral part of the disease. Depression in Parkinson's disease is generally mild or moderate, with premature loss of self-esteem and volition. Although the high rates of suicidal ideation, suicide is rare. There is also a high prevalence of panic attacks and anxiety.ConclusionsIt is difficult to correctly identify depression in Parkinson's disease as some symptoms assigned to Parkinson's disease itself can in fact be the clinical manifestation of a depressive disorder. On the other hand, depressive symptoms may not be recognized as such, but considered manifestations of Parkinson's disease.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Observation on the Curative Effect of Madopar Combined with Pramipexole in the Treatment of Parkinson’s Diseases

2017 ◽  
Vol 6 (1) ◽  
Author(s):  
Yongting Yu ◽  
Min Yang ◽  
Ruihui Chen ◽  
Hongbing Chen
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Muscle Tone ◽  
Clinical Manifestations ◽  
The Elderly ◽  
Disease Symptoms ◽  
Loss Of Self ◽  
Abnormal Posture ◽  
Parkinson’S Diseases ◽  
Normal Human

<p>Parkinson’s disease is a common neurological degenerative disease in the elderly. The clinical manifestations are static tremor, increased muscle tone, slow movement, abnormal posture gait, and severe symptoms of loss of self-care. Parkinson’s disease has become a burden to not only patient, but also to his family and to the society. Normal human brain neurotransmitter dopamine and acetylcholine are in a balanced state, the two antagonism can maintain normal body function. The pathological changes of patients with Parkinson’s disease is degeneration and apoptosis of dopaminergic neurons in striatum, resulting in a significant reduction in dopamine levels, and thus lead to an imbalance in the effects of dopamine and acetylcholine, and a decrease in dopamine resistance to acetylcholine Parkinson’s disease symptoms. As such, this article will focus on the analysis of the Madopar and pramipexole in the treatment of Parkinson’s disease symptoms.</p>

scholarly journals Cognitive and Behavior Deficits in Parkinson’s Disease with Alteration of FDG-PET Irrespective of Age

Geriatrics ◽  
2021 ◽  
Vol 6 (4) ◽  
pp. 110
Author(s):  
Fulvio Lauretani ◽  
Livia Ruffini ◽  
Crescenzo Testa ◽  
Marco Salvi ◽  
Mara Scarlattei ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Progression ◽  
Metabolic Activity ◽  
Fdg Pet ◽  
Surrogate Marker ◽  
Metabolic Imaging ◽  
Clinical Aspects ◽  
Histopathological Diagnosis ◽  
Motor Symptoms

Significant progress has been made in our understanding of the neurobiology of Parkinson’s disease (PD). Post-mortem studies are an important step and could help to comprehend not only the progression of motor symptoms, but also the involvement of other clinical domains, including cognition, behavior and impulse control disorders (ICDs). The correlation of neuropathological extension of the disease with the clinical stages remains challenging. Molecular imaging, including positron emission tomography (PET) and single photon computed tomography (SPECT), could allow for bridging the gap by providing in vivo evidence of disease extension. In the last decade, we have observed a plethora of reports describing improvements in the sensitivity of neuroimaging techniques. These data contribute to increasing the accuracy of PD diagnosis, differentiating PD from other causes of parkinsonism and also obtaining a surrogate marker of disease progression. FDG-PET has been used to measure cerebral metabolic rates of glucose, a proxy for neuronal activity, in PD. Many studies have shown that this technique could be used in early PD, where reduced metabolic activity correlates with disease progression and could predict histopathological diagnosis. The aim of this work is to report two particular cases of PD in which the assessment of brain metabolic activity (from FDG-PET) has been combined with clinical aspects of non-motor symptoms. Integration of information on neuropsychological and metabolic imaging allows us to improve the treatment of PD patients irrespective of age.

Brain Grafting as a Treatment for Parkinson's Disease

Neurosurgery ◽  
1987 ◽  
Vol 20 (2) ◽  
pp. 335-342 ◽  
Author(s):  
Mark J. Perlow
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Manifestations ◽  
Dopamine Neurons ◽  
Clinical Aspects ◽  
Pathological Changes ◽  
Pharmacological Treatments ◽  
The Central Nervous System ◽  
The Brain

Abstract Parkinson's disease is an illness with neuropathological and neuroanatomical abnormalities in many areas of the central nervous system. Some clinical manifestations of this illness are correlated with pathological changes in the substantia nigra and with a loss of dopamine in the nigra and striatum. The most effective pharmacological treatments have used agents that either replace the lost dopamine or act as agonists on dopamine receptors. Recent studies in animal models of Parkinson's disease demonstrate that the loss of dopamine and many clinical manifestations of dopamine reduction can be reversed by transplantation of fetal dopamine-containing cells to specific dopamine-depleted areas of the brain. Long term viability of these transplants has also been demonstrated. The author suggests that the transplantation of dopamine neurons, even across species barriers, is a reasonable consideration for the treatment of human Parkinson's disease. This article reviews in detail the results of recent experiments and how the experience in these models might be utilized in determining a transplantation strategy for the treatment of specific clinical aspects of this illness.

scholarly journals A clinical-anatomical signature of Parkinson’s Disease identified with partial least squares and magnetic resonance imaging

2017 ◽  
Author(s):  
Yashar Zeighami ◽  
Seyed-Mohammad Fereshtehnejad ◽  
Mahsa Dadar ◽  
D. Louis Collins ◽  
Ronald B. Postuma ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Least Squares ◽  
Partial Least Squares ◽  
Large Scale ◽  
De Novo ◽  
Neurodegenerative Disorder ◽  
Clinical Manifestations ◽  
Motor Symptoms ◽  
Non Motor Symptoms

AbstractParkinson’s disease (PD) is a neurodegenerative disorder characterized by a wide array of motor and non-motor symptoms. It remains unclear whether neurodegeneration in discrete loci gives rise to discrete symptoms, or whether network-wide atrophy gives rise to the unique behavioural and clinical profile associated with PD. Here we apply a data-driven strategy to isolate large-scale, multivariate associations between distributed atrophy patterns and clinical phenotypes in PD. In a sample of N = 229 de novo PD patients, we estimate disease-related atrophy using deformation based morphometry (DBM) of T1 weighted MR images. Using partial least squares (PLS), we identify a network of subcortical and cortical regions whose collective atrophy is associated with a clinical phenotype encompassing motor and non-motor features. Despite the relatively early stage of the disease in the sample, the atrophy pattern encompassed lower brainstem, substantia nigra, basal ganglia and cortical areas, consistent with the Braak hypothesis. In addition, individual variation in this putative atrophy network predicted longitudinal clinical progression in both motor and non-motor symptoms. Altogether, these results demonstrate a pleiotropic mapping between neurodegeneration and the clinical manifestations of PD, and that this mapping can be detected even in de novo patients.

scholarly journals Nocturnal Sleep Problems Mediate the Impact on Quality of Life of Early Morning Off in Parkinson's Disease

2021 ◽  
Vol 13 ◽  
Author(s):  
Yu Zhang ◽  
Zi en Zhang ◽  
De Shi ◽  
Yi Zhao ◽  
Lihong Huang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sleep Problems ◽  
Clinical Manifestations ◽  
Early Morning ◽  
Motor Symptoms ◽  
Nocturnal Sleep ◽  
The Impact

Background: Early morning off (EMO) refers to off-states in the morning in people diagnosed with Parkinson's disease (PwPD). This study determined the clinical manifestations of EMO and the association with nocturnal sleep problems and quality of life (QOL) in Chinese PwPD.Methods: In this multicenter, observational, cross-sectional study, data concerning the clinical manifestations of EMO were collected from PwPD in Shanghai by questionnaire. The stepwise logistic regression was performed to analyze the potential risk factors, as well as whether EMO was an independent risk factor for functional dependency in daily life. The mediation analyses were conducted to evaluate whether nocturnal sleep problems might mediate the association between EMO and the QOL.Results: Among the 454 subjects evaluated, EMO occurred in 39.43% of PwPD across all disease stages. The prevalence of EMO increased as the Hoehn and Yahr stage increased and was observed in 35.60% of patients in stages 1–2.5 and 48.85% of patients in stages 3–5. EMO was associated with non-motor symptoms (NMSs). The predominant NMSs associated with EMO were nocturnal sleep problems (98.90%), mood/cognition impairment (93.90%), decreased attention/memory (91.60%), gastrointestinal symptoms (91.60%), and urinary urgency (90.50%). The QOL of PwPD with EMO was significantly reduced (P &lt; 0.001). Moreover, nocturnal sleep problems might partially mediate this relationship (indirect effect: β = 13.458, 95% boot CI: 6.436, 22.042).Conclusion: PwPD have EMO throughout all stages of the disease. Patients with EMO have severe motor symptoms and NMSs. EMO decreases the QOL in PwPD and this relationship is partially mediated by nocturnal sleep problems. In light of these findings, it is suggested that recognition and appropriate treatment of EMO and nocturnal sleep problems could improve the management of PwPD.

scholarly journals Non-motor clinical manifestations of Parkinson’s disease and its relevance in early diagnosis

2021 ◽  
Author(s):  
Lucca Ferdinando Queiroz Fernandes ◽  
Raiana Carol de Medeiros Dantas ◽  
Maria Clara Medeiros Araújo ◽  
Lucas de Oliveira Araújo Andrade
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sleep Disorders ◽  
Complex Disease ◽  
Clinical Manifestations ◽  
Olfactory Dysfunction ◽  
Screening Tests ◽  
Motor Symptoms ◽  
Scientific Publications ◽  
Study Results

Introduction: Parkinson’s disease is a progressive neurodegenerative disease that affects millions of people worldwide. Although Parkinson’s disease has traditionally been described as a disorder of the motor system, it is now recognized as a complex disease with several clinical features that include neuropsychiatric and non-motor manifestations. Studies show that 97% of patients with Parkinson’s disease report non-motor symptoms, in addition to motor symptoms, and some non-motor characteristics may appear before classic motor signs. Objectives: To list the main non-motor clinical manifestations of Parkinson’s disease and analyze its importance in establishing an accurate and early clinical diagnosis. Methods: This is an integrative review, carried out based on the search of scientific publications indexed in the datebase MEDLINE via PubMed, Lilacs and SciELO. At the end of the searches, 66 publications met the eligibility criteria and were selected to compose the study. Results: Within the non-motor clinical manifestations, there may be present: cognitive dysfunction and dementia, psychosis and hallucinations, mood disorders, sleep disorders, fatigue, autonomic dysfunction, olfactory dysfunction, gastrointestinal dysfunction, pain, sensory disorders and dermatological manifestations. Of these, olfactory dysfunction, constipation, depression and sleep disorders stand out because they often precede the motor symptoms of Parkinson’s disease. Conclusion: In this perspective, it is up to the general practitioner and the neurologist or geriatrician to carry out, whenever possible, screening tests to identify early changes that may precede Parkinson’s disease, guaranteeing patients an early multiprofessional treatment and consequently a better prognosis in the course of the disease.

scholarly journals Systematic review of genetic variants associated with cognitive impairment and depressive symptoms in Parkinson’s disease

2019 ◽  
Vol 32 (1) ◽  
pp. 10-22 ◽  
Author(s):  
Tyrra D’Souza ◽  
Anto P. Rajkumar
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Genetic Variants ◽  
Molecular Mechanisms ◽  
Association Studies ◽  
Motor Symptoms ◽  
Non Motor Symptoms

AbstractObjective:Cognitive impairment and depression are among the most prevalent and most disabling non-motor symptoms in Parkinson’s disease (PD). The genetic factors that are associated with these symptoms remain uncertain. This systematic review aims to summarise the prevailing evidence from all genetic association studies investigating the genetic variants associated with cognitive impairment and depressive symptoms in people with PD.Method:A systematic review using five online databases: PubMed, PsycINFO, CINAHL, EMBASE and OpenGrey (PROSPERO protocol: CRD42017067431). We completed the quality assessment using the Q-Genie tool.Results:2353 articles were screened, and 43 articles were found to be eligible to be included. A meta-analysis of studies investigating LRRK2 rs34637584 confirmed that the minor allele carriers had significantly less cognitive impairment (p = 0.015). Further meta-analyses showed that GBA variants rs76763715 (p < 0.001) and rs421016 (p = 0.001) were significantly associated with more cognitive impairment in people with PD. Minor alleles of GBA variants rs76763715, rs421016, rs387906315 and rs80356773 were associated with more depressive symptoms in PD. Moreover, APOE ε4 allele has been associated with more cognitive impairment in PD. BDNF (rs6265) and CRY1 (rs2287161) variants have been associated with more depressive symptoms in people with PD.Conclusions:PD carriers of GBA variants are at high risk for cognitive decline and depression. Screening for these variants may facilitate early identification and effective management of these non-motor symptoms. The molecular mechanisms underlying favourable cognitive functioning in LRRK2 rs34637584 variant carriers warrant further investigation.

scholarly journals Nordic Walking and Free Walking Improve the Quality of Life, Cognitive Function, and Depressive Symptoms in Individuals with Parkinson’s Disease: A Randomized Clinical Trial

2020 ◽  
Vol 5 (4) ◽  
pp. 82
Author(s):  
Elren Passos-Monteiro ◽  
Felipe B. Schuch ◽  
Leandro T. Franzoni ◽  
Alberito R. Carvalho ◽  
Natalia A. Gomeñuka ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Depressive Symptoms ◽  
Cognitive Function ◽  
Controlled Trial ◽  
Motor Symptoms ◽  
Health Related ◽  
Clinical Potential

Nordic walking’s (NW) degree of effectiveness regarding health-related parameters in people with Parkinson’s Disease (PD) is a subject of debate. While NW seems to improve functionality, a clear non-motor benefit has not been demonstrated. The aim of this randomized controlled trial was to compare the effects of 9-week NW and free walking (FW) training programs on quality of life, cognitive function, and depressive symptoms in individuals with PD. Thirty-three people with PD, (Hoehn and Yahr 1–4) were randomized into two groups: NW (n = 16) and FW (n = 17). We analyzed quality of life, cognitive function, depressive symptoms, and motor symptoms. Significant improvements were found in the overall, physical, psychological, social participation, and intimacy domains of quality of life, as well as in cognitive function and depressive symptoms for both groups. Only the NW group showed improvement in the autonomy domain. Individuals with PD had a similar enhancement of non-motor symptoms after walking training, with or without poles. However, the NW group showed a more significant improvement in the autonomy domain, strengthening the applied and clinical potential of NW in people with PD. Future studies are needed to determine the efficacy of walking training without poles in subjects with PD.

scholarly journals Effectiveness of Telerehabilitation on Motor Impairments, Non-motor Symptoms and Compliance in Patients With Parkinson's Disease: A Systematic Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Chiara Vellata ◽  
Stefano Belli ◽  
Francesca Balsamo ◽  
Andrea Giordano ◽  
Roberto Colombo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Patient Satisfaction ◽  
Cochrane Library ◽  
Clinical Aspects ◽  
Motor Symptoms ◽  
Non Motor Symptoms

Introduction: Parkinson's disease (PD) is a chronic neurodegenerative disease involving a progressive alteration of the motor and non-motor function. PD influences the patient's daily living and reduces participation and quality of life in all phases of the disease. Early physical exercise can mitigate the effects of symptoms but access to specialist care is difficult. With current technological progress, telemedicine, and telerehabilitation is now a viable option for managing patients, although few studies have investigated the use of telerehabilitation in PD. In this systematic review, was investigated whether telerehabilitation leads to improvements in global or specific motor tasks (gait and balance, hand function) and non-motor dysfunction (motor speech disorder, dysphagia). The impact of TR on quality of life and patient satisfaction, were also assessed. The usage of telerehabilitation technologies in the management of cognitive impairment was not addressed.Method: An electronic database search was performed using the following databases: PubMed/MEDLINE, COCHRANE Library, PEDro, and SCOPUS for data published between January 2005 and December 2019 on the effects of telerehabilitation systems in managing motor and non-motor symptoms. This systematic review was conducted in accordance with the PRISMA guideline and was registered in the PROSPERO database (CRD42020141300).Results: A total of 15 articles involving 421 patients affected by PD were analyzed. The articles were divided into two categories based on their topic of interest or outcome. The first category consisted of the effects of telerehabilitation on gait and balance (3), dexterity of the upper limbs (3), and bradykinesia (0); the second category regarded non-motor symptoms such as speech disorders (8) and dysphagia (0). Quality of life (7) and patient satisfaction (8) following telerehabilitation programs were also analyzed, as well as feasibility and costs.Conclusion: Telerehabilitation is feasible in people affected by PD. Our analysis of the available data highlighted that telerehabilitation systems are effective in maintaining and/or improving some clinical and non-clinical aspects of PD (balance and gait, speech and voice, quality of life, patient satisfaction).Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier: CRD42020141300.

Sign in / Sign up

Export Citation Format

Share Document