Neuropsychiatric manifestations of Parkinson’s disease

Objective: This clinical update review focuses on the classification and description of common neuropsychiatric manifestations in Parkinson’s disease (PD). Method: We conducted a systematic search of the literature using Pubmed and selected the most recent and relevant papers for this review. Results: Neuropsychiatric manifestations in PD are are very frequent and may arise from an abnormal psychopathological response to the disease, neurobiological changes related to the disease itself, complications of treatments or a combination of all of these. Conclusions: Neuropsychiatric symptoms may precede the motor clinical presentation of PD. Early recognition is essential.

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A guide to management of neuropsychiatric manifestations of Parkinson’s disease

Australasian Psychiatry ◽

10.1177/1039856216654394 ◽

2016 ◽

Vol 24 (6) ◽

pp. 534-537 ◽

Cited By ~ 1

Author(s):

Rosa M Molina Ruiz ◽

Andrew H Evans ◽

Dennis Velakoulis ◽

Jeffrey CL Looi

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Impairment ◽

Psychotropic Drugs ◽

Neuropsychiatric Symptoms ◽

Neuropsychiatric Disorders ◽

Evidence Base ◽

Systematic Search ◽

Pharmacological Treatments ◽

Neuropsychiatric Manifestations

Objective: This clinical update review focuses on treatment approaches of neuropsychiatric manifestations in Parkinson’s disease. Methods: We conducted a systematic search of the literature using Pubmed and selected recent and relevant papers for this review. Results: Neuropsychiatric symptoms in Parkinson’s disease usually require optimization of levodopa therapy as a first step. Most psychotropic drugs can be used in Parkinson’s disease, however there is still lack of an evidence base due to limited studies and difficulties in diagnosis of neuropsychiatric disorders. Non-pharmacological treatments have also proved effective in Parkinson’s disease. Cognitive impairment requires special consideration. Conclusions: Management of neuropsychiatric manifestations in Parkinson’s disease is complicated by the lack of evidence. Treatment should be individualized and benefits and risks must be balanced.

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Neuropsychiatric symptoms in Parkinson's disease: aetiology, diagnosis and treatment

BJPsych Advances ◽

10.1192/bja.2019.79 ◽

2020 ◽

Vol 26 (6) ◽

pp. 333-342 ◽

Cited By ~ 1

Author(s):

Shoned Jones ◽

Kelli M. Torsney ◽

Lily Scourfield ◽

Katie Berryman ◽

Emily J. Henderson

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Neuropsychiatric Symptoms ◽

Treatment Strategies ◽

Current Treatment ◽

Motor Disorder ◽

Dopamine Dysregulation Syndrome ◽

Disease Aetiology ◽

Neuropsychiatric Manifestations ◽

Assessment Scales

SUMMARYHistorically, Parkinson's disease was viewed as a motor disorder and it is only in recent years that the spectrum of non-motor disorders associated with the condition has been fully recognised. There is a broad scope of neuropsychiatric manifestations, including depression, anxiety, apathy, psychosis and cognitive impairment. Patients are more predisposed to delirium, and Parkinson's disease treatments give rise to specific syndromes, including impulse control disorders, dopamine agonist withdrawal syndrome and dopamine dysregulation syndrome. This article gives a broad overview of the spectrum of these conditions, describes the association with severity of Parkinson's disease and the degree to which dopaminergic degeneration and/or treatment influence symptoms. We highlight useful assessment scales that inform diagnosis and current treatment strategies to ameliorate these troublesome symptoms, which frequently negatively affect quality of life.

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Emergencies and critical issues in Parkinson’s disease

Practical Neurology ◽

10.1136/practneurol-2018-002075 ◽

2019 ◽

pp. practneurol-2018-002075 ◽

Cited By ~ 1

Author(s):

Cristina Simonet ◽

Eduardo Tolosa ◽

Ana Camara ◽

Francesc Valldeoriola

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Clinical Presentation ◽

Early Recognition ◽

Medical Intervention ◽

Disease Course ◽

Precipitating Factors ◽

Critical Issues ◽

Prompt Attention ◽

Disease Specialist

Complications from Parkinson’s disease may develop over the disease course, sometimes unexpectedly, and require prompt or even urgent medical intervention. The most common are associated with aggravation of motor symptoms; serious non-motor complications, such as psychosis, orthostatic hypotension or sleep attacks, also occur. Here we review such complications, their clinical presentation, precipitating factors and management, including those related to using device-aided therapies. Early recognition and prompt attention to these critical situations is challenging, even for the Parkinson’s disease specialist, but is essential to prevent serious problems.

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Neuropsychiatric Symptoms Are Associated with Dementia in Parkinson's Disease but Not Predictive of it

Movement Disorders Clinical Practice ◽

10.1002/mdc3.13151 ◽

2021 ◽

Author(s):

Kyla‐Louise Horne ◽

Michael R. MacAskill ◽

Daniel J. Myall ◽

Leslie Livingston ◽

Sophie Grenfell ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Neuropsychiatric Symptoms

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

Journal of Geriatric Psychiatry and Neurology ◽

10.1177/08919887211018274 ◽

2021 ◽

Vol 34 (4) ◽

pp. 310-320 ◽

Cited By ~ 1

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.

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The perception of apathy by caregivers of patients with dementia in Parkinson's disease

Dementia & Neuropsychologia ◽

10.1590/s1980-5764-2016dn1004014 ◽

2016 ◽

Vol 10 (4) ◽

pp. 339-343 ◽

Cited By ~ 1

Author(s):

Carlos Henrique Ferreira Camargo ◽

Rafael Arthur Serpa ◽

Thiago Matnei ◽

Jivago Szpoganicz Sabatini ◽

Hélio Afonso Ghizoni Teive

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scale ◽

Neuropsychiatric Symptoms ◽

Parkinson’S Disease Dementia ◽

Disease Rating

ABSTRACT Background: Apathy is one of the main neuropsychiatric symptoms in patients with Parkinson's disease (PD) and is associated with Parkinson's disease dementia (PDD). Objective: To identify the characteristics of apathy in individuals with PDD according to caregiver perception. Methods: Thirty-nine patients with PD according to MDS criteria for PDD were included. The following scales were used: the Hoehn and Yahr, the Unified Parkinson's Disease Rating Scale III, Scales for Outcomes in Parkinson's Disease-Cognition (SCOPA Cog), the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Apathy Evaluation Scale (AES). Results: A total of 97.4% of the patients showed results consistent with apathy. Analysis of question 14 of the AES revealed no correlation with the total result of all the questions [r=-1293, r²=0.0167, 95%CI (-0.4274 to 0.1940), P=0.2162], however, there was a correlation of responses to the same question with depression data on the MADRS scale [r=-0.5213, r²=0.2718, 95%CI (-0.7186 to -0.2464), P=0.00033]. Conclusion: Apathy is a disorder associated with PDD. However, the scoring scheme of the AES questions can lead to different interpretations of caregiver responses, highlighting limitations of the tool for use in studies of PDD.

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10 Screening of neuropsychiatric symptoms in patients with parkinson’s disease in a uk general practice

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2017-bnpa.70 ◽

2017 ◽

Vol 88 (8) ◽

pp. A31.2-A31

Author(s):

Thomas Cronin ◽

Sean Gallagher

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

General Practice ◽

Neuropsychiatric Symptoms

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Implication of nigral dopaminergic lesion and repeated L-dopa exposure in neuropsychiatric symptoms of Parkinson’s disease

Behavioural Brain Research ◽

10.1016/j.bbr.2018.12.007 ◽

2019 ◽

Vol 360 ◽

pp. 120-127 ◽

Cited By ~ 5

Author(s):

Simon Loiodice ◽

Harry Wing Young ◽

Bertrand Rion ◽

Benoît Méot ◽

Pierre Montagne ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Neuropsychiatric Symptoms

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The Impact of Amyloid-Beta Positivity with 18F-Florbetaben PET on Neuropsychological Aspects in Parkinson’s Disease Dementia

Metabolites ◽

10.3390/metabo10100380 ◽

2020 ◽

Vol 10 (10) ◽

pp. 380

Author(s):

Seunghee Na ◽

Hyeonseok Jeong ◽

Jong-Sik Park ◽

Yong-An Chung ◽

In-Uk Song

Keyword(s):

Alzheimer’S Disease ◽

Parkinson’S Disease ◽

Alzheimer's Disease ◽

Parkinson's Disease ◽

Amyloid Beta ◽

Neuropsychiatric Symptoms ◽

Amyloid Pet ◽

Motor Symptoms ◽

Parkinson’S Disease Dementia ◽

The Impact

The neuropathology of Parkinson’s disease dementia (PDD) is heterogenous, and the impacts of each pathophysiology and their synergistic effects are not fully understood. The aim of this study was to evaluate the frequency and impacts of co-existence with Alzheimer’s disease in patients with PDD by using 18F-florbetaben PET imaging. A total of 23 patients with PDD participated in the study. All participants underwent 18F-florbetaben PET and completed a standardized neuropsychological battery and assessment of motor symptoms. The results of cognitive tests, neuropsychiatric symptoms, and motor symptoms were analyzed between the positive and negative 18F-florbetaben PET groups. Four patients (17.4%) showed significant amyloid burden. Patients with amyloid-beta showed poorer performance in executive function and more severe neuropsychiatric symptoms than those without amyloid-beta. Motor symptoms assessed by UPDRS part III and the modified H&Y Scale were not different between the two groups. The amyloid PET scan of a patient with PDD can effectively reflect a co-existing Alzheimer’s disease pathology. Amyloid PET scans might be able to help physicians of PDD patients showing rapid progression or severe cognitive/behavioral features.

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