The Growing Role of Cognitive Behavior Therapy in the Treatment of Parkinson’s Disease

2021 ◽  
Vol 34 (4) ◽  
pp. 310-320 ◽  
Author(s):  
Sneha R. Lopes ◽  
Sunna Khan ◽  
Suma Chand
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Pharmacological Treatment ◽  
Impulse Control ◽  
Psychiatric Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Cognitive Behavior ◽  
Sufficient Power

Neuropsychiatric symptoms occur frequently in Parkinson’s disease (PD) patients. Pharmacological treatment of the psychiatric symptoms has been found to be inadequate. Cognitive behavior therapy (CBT) is an evidence based form of psychotherapy that is effective in treating a number of psychiatric disorders. In this article we examine the evidence of CBT in treating common psychiatric symptoms seen in PD patients, namely depression, anxiety, insomnia and impulse control behaviors. Most of the studies adapted CBT to address PD related concerns. Caregivers were frequently part of the CBT programs. Among the studies reviewed, randomized controlled trials showed significant effects in treating depression with CBT in PD patients. Studies have also provided preliminary data for effects of CBT on anxiety, impulse-control behaviors and insomnia. There is a need for more well designed studies with sufficient power for CBT to be established as a useful non-pharmacological treatment for psychiatric symptoms in PD.

Cognitive Behavior Therapy for Anxiety in Parkinson’s Disease: Outcomes for Patients and Caregivers

2016 ◽  
Vol 40 (3) ◽  
pp. 159-171 ◽  
Author(s):  
Nadeeka N. W. Dissanayaka ◽  
Deidre Pye ◽  
Leander K. Mitchell ◽  
Gerard J. Byrne ◽  
John D. O’Sullivan ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Cognitive Behavior ◽  
Disease Outcomes

scholarly journals Probiotics Treatment Improves Hippocampal Dependent Cognition in a Rodent Model of Parkinson’s Disease

2020 ◽  
Vol 8 (11) ◽  
pp. 1661
Author(s):  
Caroline Xie ◽  
Asheeta A. Prasad
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Psychiatric Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Motor Dysfunction ◽  
Adjunctive Treatment ◽  
Motor Symptoms ◽  
Post Surgery ◽  
Probiotic Treatment ◽  
The Impact

Parkinson’s disease (PD) is a neurological disorder with motor dysfunction and a number of psychiatric symptoms. Symptoms such as anxiety and cognitive deficits emerge prior to motor symptoms and persist over time. There are limited treatments targeting PD psychiatric symptoms. Emerging studies reveal that the gut microbe is altered in PD patients. Here we assessed the effect of a probiotic treatment in a rat model of PD. We used the neurotoxin (6-hydroxydopamine, 6-OHDA) in a preclinical PD model to examine the impact of a probiotic treatment (Lacticaseibacillus rhamnosus HA-114) on anxiety and memory. Rats underwent either sham surgery or received 6-OHDA bilaterally into the striatum. Three weeks post-surgery, rats were divided into three experimental groups: a sham group that received probiotics, a 6-OHDA group that received probiotics, and the third group of 6-OHDA received the placebo formula. All rats had access to either placebo or probiotics formula for 6 weeks. All groups were assessed for anxiety-like behaviour using the elevated plus maze. Cognition was assessed for both non-hippocampal and hippocampal dependent tasks using the novel object recognition and novel place recognition. We report that the 6-OHDA lesion induced anxiety-like behaviour and deficits in hippocampal dependent cognition. Interestingly, the probiotics treatment had no impact on anxiety-like behaviour but selectively improved hippocampal dependent cognition deficits. Together, the results presented here highlight the utility of animal models in examining the neuropsychiatric symptoms of PD and the potential of probiotics as adjunctive treatment for non-motor symptoms of PD.

scholarly journals Parkinson’s Disease Impulsive-Compulsive Disorders Questionnaire – Current Short (QUIP-CS) – Translation and validation of content of Portuguese Version

2017 ◽  
Vol 66 (2) ◽  
pp. 111-115 ◽  
Author(s):  
Débora Mascella Krieger ◽  
Sabrina Vilanova Cardoso ◽  
Wolnei Caumo ◽  
Guilherme Valença ◽  
Daniel Weintraub ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Gold Standard ◽  
Impulse Control ◽  
Neuropsychiatric Symptoms ◽  
Compulsive Buying ◽  
Portuguese Version ◽  
Back Translation ◽  
Compulsive Disorders ◽  
Translation And Validation

ABSTRACT Objective Parkinson’s disease (PD) management is usually successfully reached with proper pharmacological treatment. However, PD patients can manifest neuropsychiatric symptoms secondary to medical therapy, including impulse control disorders (ICD), presenting as pathological gambling, hypersexuality, compulsive buying, drinking or eating disorders. We translated and validated the Portuguese version of the gold-standard questionnaire Parkinson’s Disease Impulsive-Compulsive Disorders Questionnaire, or (QUIP) for identifying ICDs in PD patients. Methods Translation, back translation and submission to instrument developer was performed, that approved its new version comparing it to his original, validated version, with no loss of it’s original properties. Then, the Portuguese version was administered to 30 PD patients. They also were asked to rate from 1 to 5 the level of comprehensibility of the questions. Results The average level of comprehension was 4.06 ± 0.69 DP, considering 3 or more as acceptable. No patient has answered 1 or 2. Conclusion Our results on Portuguese version of QUIP-CS show that QUIP-CS translated and corrected version was easily understood and easily self-applied.

scholarly journals Impact of Combined Subthalamic Nucleus and Substantia Nigra Stimulation on Neuropsychiatric Symptoms in Parkinson’s Disease Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-14 ◽  
Author(s):  
U. Hidding ◽  
A. Gulberti ◽  
A. Horn ◽  
C. Buhmann ◽  
W. Hamel ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Substantia Nigra ◽  
Subthalamic Nucleus ◽  
Impulse Control ◽  
Rating Scales ◽  
Rating Scale ◽  
Neuropsychiatric Symptoms ◽  
Impulse Control Disorder ◽  
High Frequency Stimulation

The goal of the study was to compare the tolerability and the effects of conventional subthalamic nucleus (STN) and combined subthalamic nucleus and substantia nigra (STN+SNr) high-frequency stimulation in regard to neuropsychiatric symptoms in Parkinson’s disease patients. In this single center, randomized, double-blind, cross-over clinical trial, twelve patients with advanced Parkinson’s disease (1 female; age:61.3±7.3years; disease duration:12.3±5.4years; Hoehn and Yahr stage:2.2±0.39) were included. Apathy, fatigue, depression, and impulse control disorder were assessed using a comprehensive set of standardized rating scales and questionnaires such as the Lille Apathy Rating Scale (LARS), Modified Fatigue Impact Scale (MFIS), Becks Depression Inventory (BDI-I), Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease Rating Scale (QUIP-RS), and Parkinson’s Disease Questionnaire (PDQ-39). Three patients that were initially assigned to the STN+SNr stimulation mode withdrew from the study within the first week due to discomfort. Statistical comparison of data retrieved from patients who completed the study revealed no significant differences between both stimulation conditions in terms of mean scores of scales measuring apathy, fatigue, depression, impulse control disorder, and quality of life. Individual cases showed an improvement of apathy under combined STN+SNr stimulation. In general, combined STN+SNr stimulation seems to be safe in terms of neuropsychiatric side effects, although careful patient selection and monitoring in the short-term period after changing stimulation settings are recommended.

Subthalamic stimulation and neuropsychiatric symptoms in Parkinson’s disease: results from a long-term follow-up cohort study

2018 ◽  
Vol 89 (8) ◽  
pp. 836-843 ◽  
Author(s):  
Marie Abbes ◽  
Eugénie Lhommée ◽  
Stéphane Thobois ◽  
Hélène Klinger ◽  
Emmanuelle Schmitt ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Impulse Control ◽  
Neuropsychiatric Symptoms ◽  
Impulse Control Disorders ◽  
Subthalamic Stimulation ◽  
Deep Brain

BackgroundReports on behavioural outcomes after subthalamic nucleus deep brain stimulation in Parkinson’s disease are controversial and limited to short-term data. Long-term observation in a large cohort allows a better counselling and management.MethodsTo determine whether a long-term treatment with subthalamic stimulation induces or reduces impulse control behaviours, neuropsychiatric fluctuations and apathy, 69 patients treated with subthalamic stimulation are prospectively and retrospectively assessed using Ardouin Scale of Behavior in Parkinson’s Disease before and after 3–10 years of stimulation.ResultsAt a mean follow-up of 6 years, all impulse control disorders and dopaminergic addiction were significantly decreased, apart from eating behaviour and hypersexuality. Neuropsychiatric fluctuations also significantly improved (ON euphoria: 38% of the patients before surgery and 1% after surgery, P<0.01; OFF dysphoria: 39% of the patients before surgery and 10% after surgery, P<0.01). However, apathy increased (25% of the patients after surgery and 3% before, P<0.01). With the retrospective analysis, several transient episodes of depression, apathy, anxiety and impulse control disorders occurred.ConclusionsBilateral subthalamic nucleus stimulation was overall very effective in improving impulse control disorders and neuropsychiatric fluctuations in parkinsonian patients in the long term despite a counteracting frequent apathy. Transient episodes of impulse control disorders still occurred within the follow-up. These findings recommend a close follow-up in parkinsonian patients presenting with neuropsychiatric symptoms before deep brain stimulation surgery.Clinical trial registrationNCT01705418;Post-results.

scholarly journals Psychosis and concurrent impulse control disorder in Parkinson's disease: A review based on a case report

2016 ◽  
Vol 10 (2) ◽  
pp. 148-151
Author(s):  
Bruno Fukelmann Guedes ◽  
Marcia Rubia Gonçalves ◽  
Rubens Gisbert Cury
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Case Report ◽  
Pathological Gambling ◽  
Replacement Therapy ◽  
Impulse Control ◽  
Psychiatric Symptoms ◽  
Repetitive Behaviors ◽  
Dopamine Replacement Therapy ◽  
Psychiatric Complications

ABSTRACT Psychosis, impulse control disorders (e.g., pathological gambling and hypersexuality) and repetitive behaviors such as punding are known psychiatric complications of Parkinson's disease (PD). Impulsive, compulsive and repetitive behaviors are strongly associated with dopamine-replacement therapy. We present the case of a 58-year-old man with PD and a myriad of psychiatric symptoms. Concurrent psychosis, punding and pathological gambling developed more than six years after the introduction of pramipexole and ceased shortly after the addition of quetiapine and discontinuation of pramipexole. This report emphasizes the importance of monitoring for a wide array of psychiatric symptoms in patients on dopamine replacement therapy.

Cognitive behavior therapy in patients with binge eating disorder

2011 ◽  
Vol 26 (S2) ◽  
pp. 739-739
Author(s):  
V. Vaidya
Keyword(s):  
Eating Disorder ◽  
Binge Eating ◽  
Disordered Eating ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Eating Behaviors ◽  
Psychiatric Symptoms ◽  
Eating Habits ◽  
Cognitive Behavior ◽  
Before And After

IntroductionWith the growing epidemic of obesity many treatments are aimed at reducing weight like diets, exercise, pharmacotherapy and bariatric surgery. All of these can reduce weight at least for a period; however none of them adequately address the behavior of binge eating/eating disorder.Aimassessed the role of Cognitive Behavior therapy in reducing disordered eating behavior.MethodThe subjects were enrolled in 12 weeks CBT. They were all obese and had a score of > 20 on the BES. They completed a BDI, MBSRQ, and BES before and after the groups. Their weight was recorded before and after the 12 weeks. 79 patients were enrolled in groups over a period of 3 years. Of those 56 patients completed the groups and questionnaires. Most groups consisted of 6–8 patients.Discussion70% of patients had psychiatric symptoms psychotropic medications like antidepressants. More than 70% felt their eating habits were more in control and felt more informed about themselves since attending CBT groups. All of the patients who stayed and attended groups felt that the connection helped them sustain better eating habits. 67% of patients had lost 4–30 lbs during the 12 weeks of CBT, none had gained weight.ConclusionCBT helps the patient reduce disordered eating behaviors by understanding the cause of their self sabotage. CBT addresses the core of the problem i.e. disordered behavior as opposed to its consequences (viz. obesity and its multiple medical comorbidities); while affecting weight indirectly.

scholarly journals Disrupted reward processing in Parkinson’s disease and its relationship with dopamine state and neuropsychiatric syndromes: a systematic review and meta-analysis

2021 ◽  
pp. jnnp-2021-327762
Author(s):  
Harry Costello ◽  
Alex J Berry ◽  
Suzanne Reeves ◽  
Rimona S Weil ◽  
Eileen M Joyce ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Reinforcement Learning ◽  
Psychiatric Symptoms ◽  
Meta Analysis ◽  
Neuropsychiatric Symptoms ◽  
Reward Processing ◽  
Option Valuation ◽  
Healthy Controls ◽  
Within Subjects

BackgroundNeuropsychiatric symptoms are common in Parkinson’s disease (PD) and predict poorer outcomes. Reward processing dysfunction is a candidate mechanism for the development of psychiatric symptoms including depression and impulse control disorders (ICDs). We aimed to determine whether reward processing is impaired in PD and its relationship with neuropsychiatric syndromes and dopamine replacement therapy.MethodsThe Ovid MEDLINE/PubMed, Embase and PsycInfo databases were searched for articles published up to 5 November 2020. Studies reporting reward processing task performance by patients with PD and healthy controls were included. Summary statistics comparing reward processing between groups were converted to standardised mean difference (SMD) scores and meta-analysed using a random effects model.ResultsWe identified 55 studies containing 2578 participants (1638 PD and 940 healthy controls). Studies assessing three subcomponent categories of reward processing tasks were included: option valuation (n=12), reinforcement learning (n=37) and reward response vigour (n=6). Across all studies, patients with PD on medication exhibited a small-to-medium impairment versus healthy controls (SMD=0.34; 95% CI 0.14 to 0.53), with greater impairments observed off dopaminergic medication in within-subjects designs (SMD=0.43, 95% CI 0.29 to 0.57). Within-subjects subcomponent analysis revealed impaired processing off medication on option valuation (SMD=0.57, 95% CI 0.39 to 0.75) and reward response vigour (SMD=0.36, 95% CI 0.13 to 0.59) tasks. However, the opposite applied for reinforcement learning, which relative to healthy controls was impaired on-medication (SMD=0.45, 95% CI 0.25 to 0.65) but not off-medication (SMD=0.28, 95% CI −0.03 to 0.59). ICD was the only neuropsychiatric syndrome with sufficient studies (n=13) for meta-analysis, but no significant impairment was identified compared tonon-ICD patients (SMD=−0.02, 95% CI −0.43 to 0.39).ConclusionReward processing disruption in PD differs according to subcomponent and dopamine medication state, and warrants further study as a potential treatment target and mechanism underlying associated neuropsychiatric syndromes.

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