Depression and Related Factors in Patients with Parkinson’s Disease at High Altitude

Cao, Yu; Li, Gongfeng; Xue, Jinsheng; Zhang, Guijuan; Gao, Sensen; Huang, Yung-Cheng; Zhu, Aiqin

doi:10.2147/ndt.s300596

Cited by 10 publications

(7 citation statements)

References 38 publications

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“…An Asian study has shown that the UPDRS II and UPDRS III scores of a depressed group were significantly higher than those of a non-depressed group. 25 That finding is consistent with the results of the present study, fully confirming that disease severity is related to depression severity in PD patients. From the perspective of disease and treatment, motor symptoms and depression in PD patients have the same pathophysiological basis and are closely related to the dysfunction of the 5-hydroxytryptamine (serotonin) system.…”

Section: Discussionsupporting

confidence: 93%

Prevalence and Influencing Factors of Depression in Patients with Parkinson’s Disease

Li,

Wang,

You

et al. 2024

ALPHA PSYCHIATRY

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Objective: The aim was to explore the prevalence and influencing factors of depression in patients with Parkinson’s disease (PD). Methods: This was a cross-sectional study of the clinical data of 179 PD patients for retrospective analysis. Using the self-rating depression scale (SDS) and the Hamilton depression scale-21 (HAMD-21), we evaluated the prevalence of depression and analyzed the factors influencing depression in PD. Results: The prevalence of depression in PD patients was 45.25%, and the degree of depression was mainly mild to moderate. Sleep status, daily use of levodopa, a high Hoehn and Yahr stage, a high unified Parkinson’s disease rating scale (UPDRS) II score, and a high UPDRS III score were all risk factors for depression in PD patients. Conclusion: The prevalence of depression in PD patients is high, and the degree of depression is closely related to many factors, which should receive close attention in clinical work.

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Section: Discussionsupporting

confidence: 93%

Prevalence and Influencing Factors of Depression in Patients with Parkinson’s Disease

Li,

Wang,

You

et al. 2024

ALPHA PSYCHIATRY

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“…Marital status has been addressed in various studies of PD-related MDD, without finding any association between this variable and the disease [3,21,22]. In our study, we encountered no association between the severity of the MDD and marital status.…”

Section: Discussioncontrasting

confidence: 67%

Naturalistic Study of Depression Associated with Parkinson’s Disease in a National Public Neurological Referral Center in Mexico

et al. 2022

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Major depressive disorder (MDD) is a major health problem in Parkinson’s disease (PD) patients. We described the clinical and sociodemographic factors of MDD among patients with PD at a national neurological referral center in Mexico. One hundred patients with PD + MDD were included in the study. All the patients were evaluated during the “ON” treatment phase of PD. Clinical scales for cognition (MMSE and MoCA) and MDD (MADRS) were applied. The mean age was 58.49 ± 11.02 years, and 57% of the sample was male. The most frequent symptom of PD was tremor (67%), and onset was more frequent on the right side (57%). Additionally, 49% of the patients with PD had moderate to severe (M/S) MDD. Selective serotonin reuptake inhibitors were the most frequent antidepressant treatment (69%). The scores of the scales were MADRS 21.33 ± 5.49, MoCA 21.06 ± 4.65, and MMSE 26.67 ± 1.20. The females had lower MMSE scores compared to the males (p = 0.043). The patients with M/S MDD had more rigidity at the beginning of PD (p = 0.005), fewer march alterations (p = 0.023), and a greater prevalence of left-side initial disease (p = 0.037). Rigidity was associated with M/S MDD (OR 3.75 p = 0.013). MDD was slightly more frequent in the males than in the females. The MDD symptoms and cognitive impairment were worse in the female population.

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“…The hippocampus, entorhinal cortex, and cingulate gyrus are all important components of the limbic system and have extensive connections with other brain functional areas such as the thalamus, brain stem and neocortex ( Bubb et al, 2017 ), playing an important role in emotional experience, emotional expression, and episodic memory formation. Numerous studies ( Kious et al, 2018 ; Cao et al, 2021 ; Wang et al, 2021 ) have reported a higher prevalence of depression in people exposed to low-oxygen environment at high altitudes compared to people in plains areas, as well as significant decreases in cognitive function ( Davis et al, 2015 ; Das et al, 2018 ). The finding of weakened FC among multiple brain regions in this study indicates that connections between the caudate nucleus, hippocampus, thalamus, and other regions are affected by chronic hypoxia.…”

Section: Discussionmentioning

confidence: 99%

Brain-aging related protein expression and imaging characteristics of mice exposed to chronic hypoxia at high altitude

Cao,

et al. 2023

Front. Aging Neurosci.

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ObjectiveTo determine changes in protein expression related to brain aging and imaging features in mice after chronic hypoxia exposure at high altitude.MethodA total of 24 healthy 4-week-old mice were randomly divided into high altitude hypoxia (HH) and plain control (PC) groups (n = 8 per group). HH mice were transported from Xi’an (450 m above sea level) to Maduo (4,300 m above sea level) while PC mice were raised in Xi’an. After 6 months, 7.0T magnetic resonance imaging (MRI) was performed. All mice completed T2-weighted imaging (T2WI), diffusion tensor imaging (DTI), resting-state functional MRI (rs-fMRI), arterial spin labeling (ASL), and magnetic resonance angiography (MRA) examinations. Next, brain slices were prepared and Nissl staining was used to observe morphological changes in neurons. Ultrastructural changes in neurons were observed by transmission electron microscopy. Expression changes of Caspase-3, klotho, P16, P21, and P53 at the gene and protein levels were detected by real-time PCR (RT-PCR) and Western blot.ResultsThe number of neuronal Nissl bodies in the hippocampus and frontal cortex was significantly decreased in the HH group compared to the PC group. Some hippocampal and frontal cortical neurons were apoptotic, the nuclei were wrinkled, chromatin was aggregated, and most mitochondria were mildly swollen (crista lysis, fracture). Compared with the PC group, the HH group showed elevated expression of caspase-3 mRNA, P16 mRNA, P21 mRNA, and P53 mRNA in the hippocampus and frontal cortex. Expression of Klotho mRNA in the frontal cortex was also significantly decreased. Western blot results showed that caspase-3 protein expression in the hippocampus and frontal cortex of the HH group was increased compared with the PC group. Moreover, there was decreased Klotho protein expression and significantly increased P-P53 protein expression. Compared with the PC group, expression of P16 protein in the frontal cortex of the HH group was increased and the gray matter (GM) volume in the left visceral area, left caudate nucleus, and left piriform cortex was decreased. Furthermore, the amplitude of low frequency fluctuation was decreased in the left posterior nongranular insular lobe, right small cell reticular nucleus, left flocculus, left accessory flocculus, and left primary auditory area, but increased in the GM layer of the left superior colliculus. Regional homogeneity was decreased in the left and right olfactory regions, but increased in the left bed nucleus. After exposure to high altitude, functional connectivity (FC) between the bilateral caudate nucleus and thalamus, corpus callosum, cingulate gyrus, anterior limbic cortex, globus pallidus, and hippocampus was weakened. FC between the right caudate nucleus and hypothalamus and entorhinal cortex was also weakened. The fractional anisotropy value of the left hippocampus was decreased in the HH group. Compared with the PC group, the HH group showed significantly increased inner diameters of the bilateral common carotid artery and left internal carotid artery. The cerebral blood flow values of the bilateral cortex and bilateral hippocampus in the HH group did not change significantly.ConclusionTaken together, our findings show that chronic hypoxia exposure at high altitude may promote neuronal apoptosis and abnormal expression of related proteins, changing the structure and function of brain. These changes may contribute to brain aging.

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Depression and Related Factors in Patients with Parkinson’s Disease at High Altitude

Cited by 10 publications

References 38 publications

Prevalence and Influencing Factors of Depression in Patients with Parkinson’s Disease

Prevalence and Influencing Factors of Depression in Patients with Parkinson’s Disease

Naturalistic Study of Depression Associated with Parkinson’s Disease in a National Public Neurological Referral Center in Mexico

Brain-aging related protein expression and imaging characteristics of mice exposed to chronic hypoxia at high altitude

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