Depression in Parkinson's disease: clinical-epidemiological correlates and comparison with a controlled group of non-parkinsonian geriatric patients

OBJECTIVE: To evaluate and compare the frequency and severity of major depression in patients with Parkinson's disease and in individuals older than 60 years without neurological, rheumatological and/or oncological comorbidities. METHOD: We studied 50 patients with Parkinson's disease older than 60 years and 50 geriatric patients. Subjects with scores of Mini Mental State Examination indicating cognitive impairment were excluded. We used Diagnostic Statistical Manual of Mental Diseases-IV criteria to diagnose major depression and the Hamilton Depression Scale and the Beck Depression Inventory to rate it. The Unified Parkinson's Disease Rating Scale part 3 and the Hoehn and Yahr Scale were used to evaluate the motor severity of Parkinson's disease. RESULTS: Major depression was found in 42% of Parkinson's disease patients and in 10% of the geriatric patients (p < 0.001). The scores of the Hamilton Depression Scale and the Beck Depression Inventory were higher in Parkinson's disease patients (p < 0.001). Depressed Parkinson's disease patients had longer duration of Parkinson's disease (p = 0.020) and higher scores on the Unified Parkinson's Disease Rating Scale part 3 (p = 0.029) and the Yahr Scale (p = 0.027). CONCLUSIONS: The frequency (42%) and severity of major depression were higher in Parkinson's disease patients. Longer duration of Parkinson's disease, higher scores on the Unified Parkinson's Disease Rating Scale part 3 and the Hoehn and Yahr Scale were significantly associated with major depression.

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A Comparison of Pain between Parkinson’s Disease and Multiple System Atrophy: A Clinical Cross-Sectional Survey

Pain Research and Management ◽

10.1155/2019/3150306 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

He-Yang You ◽

Lei Wu ◽

Hai-Ting Yang ◽

Chen Yang ◽

Xiao-Ling Ding

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Multiple System Atrophy ◽

Rating Scale ◽

Depression Scale ◽

Healthy Controls ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Disease Rating ◽

Vas Scores

Background. Pain is frequent in Parkinson’s disease (PD) and Parkinson-plus syndrome. This study aimed to assess the prevalence, characteristics, therapy (especially the effect of dopaminergic therapy), and associated symptoms of pain in Parkinson's disease and multiple system atrophy (MSA) patients. Methods. Seventy-one PD patients, sixty-five MSA patients, and forty age-matched healthy controls were enrolled and evaluated by using the German pain questionnaire and visual analogue scale (VAS). In addition, the influence of pain in PD patients on anxiety, depression, and the quality of life was assessed with the Hospital Anxiety and Depression Scale (HADS) and Parkinson’s Disease Questionnaire (PDQ-39). Results. Compared to that of the healthy controls, the PD and MSA patients had a significantly higher presence of pain (P<0.01, P<0.01). PD patients had a higher presence of pain than MSA patients (P=0.007). No difference in VAS scores was observed between the PD and MSA patients (P=0.148). A total of 21 PD patients (42.85%) with pain and 13 MSA patients (43.33%) with pain received treatment. A total of 13 PD patients with pain and 6 MSA patients with pain had an improved pain intensity after using dopaminergic medication. The differences in the disease duration, Hoehn and Yahr stages, and scores on the Unified Parkinson’s Disease Rating Scale motor score, HAD-D, HAD-A, and PDQ-39 were significant between the PD patients with and without pain. Conclusion. PD and MSA patients are prone to pain with insufficient treatment. Pain interventions should be provided as soon as possible to improve the patient’s life.

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Urinary dysfunction with detrusor hyperactivity in women with Parkinson's disease cannot be blamed as a factor of worsening motor performance

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20130101 ◽

2013 ◽

Vol 71 (9A) ◽

pp. 591-595 ◽

Cited By ~ 6

Author(s):

Raimundo Nonato Campos-Sousa ◽

Elizabeth Maria Aparecida Barasnevicius Quagliato ◽

Kelson James Almeida ◽

Inacio Augusto Dias de Castro ◽

Viriato Campelo

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Performance ◽

Rating Scale ◽

Clinical Symptoms ◽

Urinary Dysfunction ◽

Clinical Aspects ◽

Yahr Scale ◽

Disease Rating ◽

Detrusor Hyperactivity

Introduction Detrusor hyperactivity is the leading cause of urinary dysfunction in Parkinson's disease (PD). There are few studies correlating PD clinical aspects with this autonomic feature. Methods A cohort of 63 women with PD were prospectively examined for assessment of clinical aspects and disease severity using unified Parkinson's disease rating scale and Hoehn-Yahr scale, respectively. The urologic function was evaluated by the urodynamic study. Two groups were categorized at this time - groups with and without detrusor hyperactivity. After seven years, the same parameters were re-evaluated. Results Progression of the disease on mental scores was found in the group with detrusor hyperactivity. On follow-up, clinical symptoms and severity did not show significant worsening between the groups. Conclusion Detrusor hyperactivity is a frequent urodynamic finding in PD, and even though it is associated with dopaminergic dysfunction, it cannot be blamed as a factor of worsening motor performance, but is probably associated with poor cognitive and mental prognosis.

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Pergolide Mesilate May Improve Fatigue in Patients with Parkinson’s Disease

Behavioural Neurology ◽

10.1155/2002/473140 ◽

2002 ◽

Vol 13 (3-4) ◽

pp. 117-121 ◽

Cited By ~ 19

Author(s):

Kazuo Abe ◽

Mayako Takanashi ◽

Takehiko Yanagihara ◽

Sabro Sakoda

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Dopamine Receptor ◽

Rating Scale ◽

D1 Receptor ◽

Dopamine Receptor Agonist ◽

Functional Correlation ◽

Yahr Scale ◽

Disease Rating ◽

Selective Dopamine

Objectives:Fatigue is a complaint frequently encountered among patients with Parkinson’s disease (PD). Considering the possible relationship between fatigue and dopaminergic dysfuncion, we investigated the effect of pergolide mesilate (a D2 and D1 dopamine receptor agonist) and bromocriptine (a D2 selective dopamine receptor) in patients with PD.Methods:We evaluated 41 patients with PD and controls. We assessed the degree of fatigue by using a fatigue scale. The severity of PD was evaluated by the Hoehn and Yahr Scale and the unified Parkinson’s disease rating scale (UPDRS).Results:After five weeks from prescription, patients taking pergolide mesilate showed significant improvement in the fatigue scale (from 5.1 ± 0.7 to 4.4 ± 0.55,p< 0.05, ) but patients taking bromocriptine did not (from 4.8 ± 0.9 to 4.7 ± 0.8).Conclusions:Our study suggested the possibility of functional correlation between fatigue and D1 receptor in patients with PD.

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Microelectrode-guided posteroventral medial radiofrequency pallidotomy for Parkinson's disease

Journal of Neurosurgery ◽

10.3171/jns.1997.87.1.0052 ◽

1997 ◽

Vol 87 (1) ◽

pp. 52-59 ◽

Cited By ~ 39

Author(s):

Oleg Kopyov ◽

Deane Jacques ◽

Christopher Duma ◽

Galen Buckwalter ◽

Alex Kopyov ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Side Effects ◽

Daily Living ◽

Rating Scale ◽

Target Region ◽

Content Type ◽

Significant Control ◽

Yahr Scale ◽

Disease Rating

✓ The outcome of radiofrequency-guided posteroventral medial pallidotomy was investigated in 29 patients with recalcitrant Parkinson's disease. Extracellular recordings were obtained in the target region to differentiate the internal from the external globus pallidus, and distinct waveforms were recorded in each region. Stimulation of the target site further verified the lesion location. Of the 29 patients treated during the course of 1 year, none showed any adverse side effects (such as hemianopsia or hemiparesis) from the procedure. Significant and immediate improvement in motor involvement (dyskinesia, rigidity, dystonia, freezing, and tremor) was observed as measured by the Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr scale. Patients experienced improvements in their condition as measured on a self-rating scale, and their ability to perform the activities of daily living was also significantly improved. Although the onset and duration of the effect of a single dose of levodopa did not change, the number of hours in an “off” state of dyskinesia per day was significantly decreased. These results provide further evidence, in a large group of patients, that posteroventral medial pallidotomy results in significant control of the motor symptoms of Parkinson's disease with a minimum of undesirable side effects.

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The accuracy of diagnosis of major depression in patients with Parkinson's disease: a comparative study among the UPDRS, the geriatric depression scale and the Beck depression inventory

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2008000200002 ◽

2008 ◽

Vol 66 (2a) ◽

pp. 152-156 ◽

Cited By ~ 38

Author(s):

Vitor Tumas ◽

Guilherme Gustavo Ricioppo Rodrigues ◽

Tarsis Leonardo Almeida Farias ◽

José Alexandre S. Crippa

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Major Depression ◽

Beck Depression Inventory ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Diagnostic Value ◽

Geriatric Depression ◽

Operating Characteristics ◽

Highly Correlated

OBJECTIVE: Evaluate the accuracy of diagnosis of major depression in patients with Parkinson's disease (PD) using the UPDRS, the 15-item Geriatric Depression Scale (GDS15) and the Beck Depression Inventory (BDI). METHOD: 50 consecutive patients with PD were evaluated. The diagnosis of major depression was made according to the DSM-IV criteria. RESULTS: We found a 24% prevalence of major depression. All depression scales were highly correlated but UPDRS depression item had the lowest diagnostic value. The GDS15 had the more appropriate "receiver operating characteristics" curve. The best cut-off scores for screening depression were 17/18 for BDI and 8/9 for GDS15. We did not find any correlation between the level of depression and intensity of motor symptoms, functional capacity and duration of the disease. CONCLUSION: GDS15 is better than the BDI and the UPDRS for screening depression in PD and depression is not related to the degree of parkinsonian symptoms.

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An Open-Label, 8-Week Study of Safety and Efficacy of Pimavanserin Treatment in Adults with Parkinson’s Disease and Depression

Journal of Parkinson s Disease ◽

10.3233/jpd-202058 ◽

2020 ◽

Vol 10 (4) ◽

pp. 1751-1761

Author(s):

Daryl DeKarske ◽

Gustavo Alva ◽

Jason L. Aldred ◽

Bruce Coate ◽

Marc Cantillon ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Adverse Events ◽

Reuptake Inhibitor ◽

Adjunctive Therapy ◽

Rating Scale ◽

Depression Scale ◽

System Organ Class ◽

Hamilton Depression Scale ◽

Open Label

Background: Many patients with Parkinson’s disease (PD) experience depression. Objective: Evaluate pimavanserin treatment for depression in patients with PD. Methods: Pimavanserin was administered as monotherapy or adjunctive therapy to a selective serotonin reuptake inhibitor or serotonin/noradrenaline reuptake inhibitor in this 8-week, single-arm, open-label phase 2 study (NCT03482882). The primary endpoint was change from baseline to week 8 in Hamilton Depression Scale–17-item version (HAMD-17) score. Safety, including collection of adverse events and the Mini-Mental State Examination (MMSE) and Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale Part III (MDS-UPDRS III) scores, was assessed in patients who received ≥1 pimavanserin dose. Results: Efficacy was evaluated in 45 patients (21 monotherapy, 24 adjunctive therapy). Mean (SE) baseline HAMD-17 was 19.2 (3.1). Change from baseline to week 8 (least squares [LS] mean [SE]) in the HAMD-17 was –10.8 (0.63) (95% CI, –12.0 to –9.5; p < 0.0001) with significant improvement seen at week 2 (p < 0.0001) and for both monotherapy (week 8, –11.2 [0.99]) and adjunctive therapy (week 8,–10.2 [0.78]). Most patients (60.0%) had ≥50% improvement at week 8, and 44.4% of patients reached remission (HAMD-17 score ≤7). Twenty-one of 47 patients experienced 42 treatment-emergent adverse events; the most common by system organ class were gastrointestinal (n = 7; 14.9%) and psychiatric (n = 7; 14.9%). No negative effects were observed on MMSE or MDS-UPDRS Part III. Conclusion: In this 8-week, single-arm, open-label study, pimavanserin as monotherapy or adjunctive therapy was well tolerated and associated with early and sustained improvement of depressive symptoms in patients with PD.

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Evaluation of body image and self-concept and their correlation with depressive symptoms in Parkinson's disease

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2009000400002 ◽

2009 ◽

Vol 67 (3a) ◽

pp. 585-590 ◽

Cited By ~ 8

Author(s):

Ariane Haydée Estrada Gamarra ◽

Cibele Silva Molski ◽

Arlete Hilbig ◽

Cristina Kern Valentini ◽

Vera Lúcia Widniczck Striebel ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Body Image ◽

Depressive Symptoms ◽

Rating Scale ◽

Self Concept ◽

Yahr Scale ◽

Image Test ◽

Disease Rating ◽

Depression Symptomatology

OBJECTIVE: To identify characteristics of body image and self-concept in individuals over fifty years of age with Parkinson's disease (PD). The secondary objectives are to analyze whether body image and self-concept are influenced by the severity of PD and to verify if there is correlation between depression, self-concept and body image in cases of PD. METHOD: Participating in the study were 48 individuals, being 26 with PD and 22 Controls. The instruments used were: The Mini Exam of Mental State, The My Body Image Test, The Factorial Self-concept Test, The Beck Depression Inventory, the motor section of The Unified Parkinson's Disease Rating Scale and The Modified Hoehn and Yahr Scale. RESULTS: In PD the perception of body image and self-concept demonstrated significantly reduced values p<0.001 and p=0.012 respectively, and the presence of depression symptomatology was significantly more (p=0.002). CONCLUSION: Individuals with PD present alteration of body image and self-concept and also present lower personal confidence and lower social receptivity, correlated with depressive symptoms.

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Pain in Parkinson's disease

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2009000400003 ◽

2009 ◽

Vol 67 (3a) ◽

pp. 591-594 ◽

Cited By ~ 12

Author(s):

Grace Helena Letro ◽

Elizabeth M.A.B. Quagliato ◽

Maura Aparecida Viana

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Beck Depression Inventory ◽

Rating Scale ◽

Yahr Stage ◽

Disease Rating

Pain may precede the diagnosis in Parkinson's disease (PD). The goal of this study was to assess the pain in a group of 20 females and 30 males with PD, after excluding co-morbidities as causes. It was used the following tools: Unified Parkinson's Disease Rating Scale, McGill questionnaire and Beck Depression Inventory. In 27 patients (54%), the pain was associated with PD, occurring in 22 (44%) in the off period and 5 (10%) in both on and off periods. The off period resulted in an increased frequency of pain, which was related to stiffness. There was no association between pain and tremor in off period, neither between pain and Modified Hoehn and Yahr stage, nor the Schwab and England scale. It was not observed an association between pain and depression, neither between pain and dyskinesia. It was noticed the improvement in pain in 16 patients with levodopa (59.26%).

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Brazilian version of the Multidimensional Fatigue Inventory for Parkinson’s disease

Fisioterapia em Movimento ◽

10.1590/1980-5918.033.ao61 ◽

2020 ◽

Vol 33 ◽

Author(s):

Josiane Lopes ◽

Hayslenne Andressa Gonçalves de Oliveira Araújo ◽

Suhaila Mahmoud Smaili

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Psychometric Properties ◽

Rating Scale ◽

Intraclass Correlation ◽

Depression Scale ◽

Multidimensional Fatigue Inventory ◽

Brazilian Version ◽

Disease Rating ◽

Fatigue Severity

Abstract Introduction: The multidimensional fatigue inventory (MFI) has not been applied in Brazilian Parkinson`s disease (PD) population due to the lack of validation. Objective: The aim of this study was to cross-culturally adapt, to validate, and investigate the psychometric properties of Brazilian version of the MFI in PD. Method: Idiopathic PD individuals (N = 90) were recruited. The MFI was translated into Brazilian Portuguese using established forward-backward translation procedures, and the psychometric properties were evaluated. All individuals were assessed by socio-clinical questionnaire, Mini-Mental State Examination (MMSE), Unified Parkinson’s Disease Rating Scale (MDS-UPDRS Part I-IV), Hoehn-Yahr disability scale (HY), hospital anxiety and depression scale (HADS), fatigue severity scale (FSS), Parkinson Fatigue Scale (PFS-16) and MFI-PD/ BR with retest of the MFI-PD/BR after seven days. Results: The adaptation phase kept the same items of original MFI-PD. No data missing, floor nor ceiling effects were found. The overall Cronbach's alpha coefficient for the 20 items was 0.81, ranging from 0.73 to 0.81 for each of the five subscales. Bland and Altman analysis showed no systematic differences between assessments. The intraclass correlation coefficient test-retest was higher or equal 0.70 (p < 0.01) for the MFI-PD/BR score, which was moderately correlated with the HADS, MDS-UPDRS score (motor examination, motor and non-motor experiences of daily living and motor complications), FSS and PFS-16. It was revealed the MFI-PD/ BR > 55 points as cut-off point to indicate fatigued subjects with accuracy of 0.84 (p < 0.001). Conclusion: The MFI-PD/BR can be considered a valid and reproducible instrument for assessing PD-related fatigue.

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BILATERAL ELECTRICAL STIMULATION OF PRELEMNISCAL RADIATIONS IN THE TREATMENT OF ADVANCED PARKINSON'S DISEASE

Neurosurgery ◽

10.1227/01.neu.0000316001.03765.e8 ◽

2008 ◽

Vol 62 (2) ◽

pp. 347-359 ◽

Cited By ~ 37

Author(s):

Josè D. Carrillo-Ruiz ◽

Francisco Velasco ◽

Fiacro Jimènez ◽

Guillermo Castro ◽

Ana L. Velasco ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Electrical Stimulation ◽

Rating Scales ◽

Rating Scale ◽

Zona Incerta ◽

Yahr Scale ◽

Disease Rating ◽

Chronic Electrical Stimulation ◽

Stimulation Of

Abstract OBJECTIVE Tremor and rigidity have been efficiently controlled by electrical stimulation of contralateral prelemniscal radiations (Raprl) in patients with unilateral Parkinson's disease. The present study determines the effect of bilateral Raprl electrical stimulation in a group of patients with severe bilateral tremor, rigidity, and bradykinesia. METHODS Five patients with Parkinson's disease (Hoehn and Yahr scale, Stage V) underwent bilateral stereotactic electrode implantation. Postoperative magnetic resonance imaging studies confirmed their position. Bipolar chronic electrical stimulation was performed through contiguous contacts of each electrode, which were selected by means of a screening test that explored multiple combinations. Preoperative and 3-, 6-, 9-, and 12-month postoperative evaluations were performed using international rating scales. Postoperative evaluations were performed with 24 hours off medication-on stimulation. RESULTS Contralateral tremor and rigidity were significantly decreased by simple insertion of electrodes in Raprl and returned hours to days later. Contacts for chronic stimulation were located in the area between the red and subthalamic nuclei, including Raprl, zona incerta, and substantia Q. Efficient stimulation had at least one contact in Raprl and in four cases, both contacts were only in Raprl. Stimulation parameters were 90 to 130 Hz, 90 to 330 μs, and 1.5 to 3.5 V. Unified Parkinson's Disease Rating Scale (motor, Part III) scores decreased 65% (P < 0.001), with improvements of 90% in tremor (P < 0.001), 94% in rigidity (P < 0.001), 75% in bradykinesia (P < 0.001), 40% in gait, and 35% in postural stability (P < 0.05) at 1 year. CONCLUSION Raprl electrical stimulation is safe and efficient to treat patients with the Parkinson's disease symptomatic triad. By use of Raprl stereotactic coordinates, electrodes were placed behind the subthalamic nucleus.

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