scholarly journals Case Report: Levodopa - induced creative awakening in a patient with Parkinson’s disease

2021 ◽  
Vol 14 (1) ◽  
pp. 18-21
Author(s):  
Sanju George ◽  
Jacob Chacko ◽  
Sheetal Cyriac
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Case Report ◽  
Dopamine Agonists ◽  
Neurodegenerative Disorder ◽  
Psychiatric Symptoms ◽  
Neurological Symptoms ◽  
Levodopa Treatment ◽  
Clinical Benefits

Parkinson’s disease is primarily a neurodegenerative disorder and presents with neurological symptoms but it can also have  accompanying psychiatric symptoms. In addition, in some patients with Parkinson’s disease there can be an awakening of their creativity, which can take several forms. Such creativity can be seen in art-naïve patients or in whom the creativity lay dormant. Although the precise mechanism for this phenomenon is not understood, treatment with levodopa and dopamine agonists have been considered responsible in some cases. Here, we describe a patient with Parkinson’s disease in whom levodopa treatment triggered a latent creative skill that was dormant since childhood. Through the patient’s own and his wife’s eyes, we discuss the clinical benefits of this phenomenon.

scholarly journals Correlates of psychiatric and psychological distress in patients with Parkinson’s disease

2019 ◽  
pp. 50-60
Author(s):  
Helena M van Oers
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Psychological Distress ◽  
Neurodegenerative Disorder ◽  
Psychiatric Symptoms ◽  
Behavioural Therapy ◽  
Dopaminergic Drugs ◽  
Cognitive Behavioural ◽  
Psychological Difficulties

Parkinson’s disease is the second most commonly diagnosed neurodegenerative disorder worldwide and the physical manifestations of the disease are well documented in the literature. However, in excess of 60% of patients with the disease report having one or more psychiatric symptoms which worsen as the disease progresses. These symptoms arise differentially from the same pathology which underlies the disease or from the treatment with dopaminergic drugs. Psychiatric and psychological difficulties tend to be under-recognised and undertreated yet cause great disability, significantly impact the quality of life of patients and add to greater burden on their caregivers. These symptoms can be relieved through adjusting the doses of anti-Parkinson’s drug therapy and success in improving psychological distress has been found using adjuvant psychotherapeutic intervention, most notably with Cognitive Behavioural Therapy.

Non-Motor Symptoms of Parkinson’s Disease: The Neurobiology of Early Psychiatric and Cognitive Dysfunction

2021 ◽  
pp. 107385842110119
Author(s):  
Ayan Hussein ◽  
Christopher A. Guevara ◽  
Pamela Del Valle ◽  
Swati Gupta ◽  
Deanna L. Benson ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Neurodegenerative Disorder ◽  
Psychiatric Symptoms ◽  
Brain Cell ◽  
Synaptic Function ◽  
Motor Symptoms ◽  
Cognitive Symptoms ◽  
Signaling Crosstalk ◽  
Non Motor Symptoms

Parkinson’s disease (PD) is a progressive neurodegenerative disorder that has been recognized for over 200 years by its clinically dominant motor system impairment. There are prominent non-motor symptoms as well, and among these, psychiatric symptoms of depression and anxiety and cognitive impairment are common and can appear earlier than motor symptoms. Although the neurobiology underlying these particular PD-associated non-motor symptoms is not completely understood, the identification of PARK genes that contribute to hereditary and sporadic PD has enabled genetic models in animals that, in turn, have fostered ever deepening analyses of cells, synapses, circuits, and behaviors relevant to non-motor psychiatric and cognitive symptoms of human PD. Moreover, while it has long been recognized that inflammation is a prominent component of PD, recent studies demonstrate that brain-immune signaling crosstalk has significant modulatory effects on brain cell and synaptic function in the context of psychiatric symptoms. This review provides a focused update on such progress in understanding the neurobiology of PD-related non-motor psychiatric and cognitive symptoms.

scholarly journals Remission of Cognitive Deficits in Parkinson’s Disease: Recovery from a Nonamnestic Mild Cognitive Impairment or Psychiatric Symptoms Remission?

2012 ◽  
Vol 2012 ◽  
pp. 1-7
Author(s):  
Jonas Jardim de Paula ◽  
Marco Túlio Gualberto Cintra ◽  
Débora Marques Miranda ◽  
Maria Aparecida Camargos Bicalho ◽  
Edgar Nunes Moares ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Case Report ◽  
Mild Cognitive Impairment ◽  
Psychiatric Symptoms ◽  
Disease Patient ◽  
Vitamin B12 Deficiency ◽  
Executive Dysfunction ◽  
One Year

Mild cognitive impairment is a clinical condition more frequent in patients with Parkinson's disease than in general population. The nonamnestic presentations, usually characterized by executive dysfunction, are most prevalent. We present a case report of a Parkinson’s disease patient diagnosed with nonamnestic mild cognitive impairment that showed complete remission of cognitive symptoms after one year. We discuss the possible causes for the remission, focusing on the treatment of medical conditions such as a major depressive episode and vitamin B12 deficiency, in addition to the change of pharmacological treatment. In a third assessment, cognitive performance remained normal. The case report highlights the importance of controlling clinical comorbidities on the assessment and followup of mild cognitive impairment, especially on Parkinson’s disease.

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.

scholarly journals 29 Shedding light on the relationship between dyskinesia and impulsive compulsive behaviour disorders in Parkinson’s disease

2020 ◽  
Vol 91 (8) ◽  
pp. e20.1-e20
Author(s):  
Lucia Ricciardi ◽  
Andrea De Angelis ◽  
Chiara Siri ◽  
Malcon Horne ◽  
Alison Leake ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dopamine Agonists ◽  
Rating Scale ◽  
Psychiatric Symptoms ◽  
Structured Interview ◽  
Percent Time ◽  
Binary Regression Analysis ◽  
Compulsive Behaviour ◽  
The Relationship

ObjectivesImpulsive compulsive behaviour disorders (ICB) and dyskinesia are common and disabling complications occurring during the course of Parkinson’s disease (PD). Their pathophysiology is not clear yet, however an association has been suggested. In the present study we aimed to evaluate the relationship between the presence of dyskinesia objectively detected using a wearable device and the presence of active and past ICB in PD patients.MethodsPatients’ demographic and clinical characteristics were gathered, PD medications were converted in total levodopa equivalent daily dose (LEDD) and LEDD dopamine-agonists. Patients were assessed with: Unified PD Rating Scale (UPDRS) parts I-IV and Rusk Dyskinesia Rating Scale (RDRS). To objectively measure dyskinesia we used a wearable devise, the Parkinson’s KinetiGraph™ system (PKG®), an accelerometry-based system for automated assessment of dyskinesia and bradykinesia. Past and active ICB were diagnosed with a semi-structured interview.Questionnaire for Impulsive-Compulsive Disorders in PD-Rating Scale (QUIP-RS) was employed to rate ICB severity. Psychiatric symptoms were evaluated including depression, anxiety, apathy and impulsivity.ResultsFifty-five PD patients were evaluated (36 males, mean age 60.7±6.7; mean disease duration 10.5±4.9). Twenty-five patients (45%) had dyskinesia as per PKG ‘Percent Time in Dyskinesia’ score. Nineteen patients had ICB (34%). There was no difference in active/past ICB between patients with and without dyskinesia (p=0.8 and 0.6). Patients with dyskinesia had higher LEDD dopamine-agonists (p=0.005), UPDRS-IV (p=0.02), RDRS (p=0.002). There was no difference between groups in psychiatric symptoms. We categorized patients in 3 groups (none, mild/moderate and severe dyskinesia) and we found no difference among groups in any demographic, clinical, psychiatric and behavioural variable except for LEDD dopamine-agonists (p=0.004), UPDRS-IV (p=0.06), RDRS (p=0.004).Binary regression analysis did not show any association between the presence of dyskinesia and ICB, depression, anxiety, apathy and impulsivity.ConclusionOur data suggest that ICB and dyskinesia are common but unrelated disorders in PD.

scholarly journals Review of medicine utilization for Parkinson’s disease management: the Bulgarian perspective

2021 ◽  
Author(s):  
Zornitsa Mitkova ◽  
Maria Kamusheva ◽  
Dobrinka Kalpachka ◽  
Desislava Ignatova ◽  
Konstantin Tachkov ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dopamine Agonists ◽  
Neurodegenerative Disorder ◽  
Disease Prevalence ◽  
Published Data ◽  
Decarboxylase Inhibitor ◽  
Inclusion Criteria ◽  
Treatment Approaches ◽  
Common Neurodegenerative Disorder

Background: Parkinson’s disease (PD), which occurs in 1% of the population, is the second most common neurodegenerative disorder. Despite the broad spectrum of PD manifestations and high disease prevalence, there are insufficient data on medicine utilization and prescription strategies. The purpose of the current study was to analyze published data concerning treatment approaches and to compare them with Bulgarian therapeutic practice.Design and methods: We conducted a systematic review of the PubMed and Google Scholar databases, and we calculated medicine utilization in Bulgaria during 2018 and 2019 using the WHO methodology.Results: The literature search identified a total of 311 publications, but only 12 met the inclusion criteria. Eleven studies pointed out that levodopa-containing medicine are the most frequently used, followed by dopamine agonists. The highest rate was found for levodopa-containing products and decarboxylase inhibitor (1.06 and 1.33 DDD/1000 inh/day), followed by anticholinergic Biperiden (0.494 and 0.455 DDD/1000 inh/day) during 2018 and 2019 in Bulgaria.Conclusion: Overall, the treatment approaches used in the last decade comply with guideline recommendations, despite variations in levodopa and dopamine agonist utilization. Even though new medicines have been approved for PD management, levodopa-containing products are still most often prescribed and used worldwide.

scholarly journals Cardiac Surgery in a Patient with Implanted Brain Pacemaker: A Case Report

2018 ◽  
Vol 02 (01) ◽  
pp. 041-043
Author(s):  
Ajmer Singh ◽  
Yatin Mehta ◽  
Naresh Trehan
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cardiac Surgery ◽  
Case Report ◽  
Aortic Valve ◽  
Electromagnetic Interference ◽  
Perioperative Management ◽  
Neurodegenerative Disorder ◽  
Deep Brain Stimulator ◽  
Deep Brain

AbstractParkinson’s disease, a neurodegenerative disorder, affects approximately 1% of population older than 60 years. Patients with Parkinson’s disease with intractable symptoms often require placement of deep brain stimulator, conventionally known as brain pacemaker. Patients implanted with this device pose specific challenges to the anesthesiologist in view of the primary illness, possible drug interactions, risk of cerebral hemorrhage from anticoagulant therapy, and potential for device malfunction by electromagnetic interference during cardiac surgery. The authors describe perioperative management of a patient with implanted brain pacemaker who underwent aortic valve replacement at their institution.

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