Depression Impairs Executive Functioning in Parkinson Disease Patients With Low Educational Level

Kümmer, Arthur; Harsányi, Estefânia; Dias, Fernando Machado Vilhena; Cardoso, Francisco; Caramelli, Paulo; Teixeira, Antônio Lúcio

doi:10.1097/wnn.0b013e3181b278f9

Cited by 35 publications

(33 citation statements)

References 37 publications

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“…The increased tendency of older patients and those with less education, longer disease duration and more severe motor disabilities to exhibit poor frontal lobe function is consistent with the result of another study of 82 PD patients, which found that younger patients and those with higher education performed better on the FAB test and that the severity of the disease was correlated with FAB performance [24] . Our study also found that patients with longer disease duration and more severe motor disabilities exhibited more severe frontal behavioral changes.…”

Section: Discussionsupporting

confidence: 87%

Impact of Frontal Lobe Function and Behavioral Changes on Health-Related Quality of Life in Patients with Parkinson's Disease: A Cross-Sectional Study from Southwest China

Guo

Song²,

Chen³

et al. 2015

Eur Neurol

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Background: Cognitive impairment may negatively impact the health-related quality of life (HRQoL) in patients with Parkinson's disease (PD). However, information on the effects of frontal lobe function and behavior changes on the HRQoL of the Chinese PD population is limited. Studies on the associations among frontal lobe function, behavioral changes and the HRQoL may help optimize the treatment and improve the HRQoL of PD patients. Methods: A total of 309 PD patients were evaluated using the Frontal Assessment Battery, the Frontal Behavioral Inventory (FBI) and the PD Questionnaire 39-item version (PDQ-39). Results: Patients with worse frontal lobe function were older (p < 0.001), had longer disease durations (p = 0.002), higher Unified Parkinson's Disease Rating Scale part III (UPDRS-III) scores (p < 0.001) and higher Hoehn and Yahr (H-Y) stages (p = 0.001), and exhibited significantly higher PDQ-39 summary index (SI; p = 0.001) compared with those who had better frontal lobe function. In addition, the disease duration (p = 0.008), UPDRS-III scores (p < 0.001), H-Y stage (p < 0.001), PDQ-39 SI and scores for each domain of the PDQ-39 (p < 0.001) were higher as the severity of frontal behavioral changes increased. The total FBI score (p < 0.001) was positively correlated with the PDQ-39 SI. Conclusions: Frontal behavioral changes were closely associated with poor HRQoL in Chinese PD patients.

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Section: Discussionsupporting

confidence: 87%

Impact of Frontal Lobe Function and Behavioral Changes on Health-Related Quality of Life in Patients with Parkinson's Disease: A Cross-Sectional Study from Southwest China

Guo

Song²,

Chen³

et al. 2015

Eur Neurol

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“…Risk factors responsible for cognitive impairment include advanced age, low educational level, long disease duration, severity of motor signs, rigid-akinetic PD variant, depression and psychosis [38]. Patients with low educational level are particularly susceptible to the deleterious effect of depression on cognition [42]. The prevalence of dementia in PD is about 31% [38].…”

Section: Depression and Cognitive Impairment In Pdmentioning

confidence: 99%

Depression and Cognitive Impairment in Parkinson's Disease: A Role for Inflammation and Immunomodulation?

Rocha

Reis

Berghe

et al. 2014

Neuroimmunomodulation

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The etiology of Parkinson's disease (PD) is complex and not fully understood, most probably because of the multiplicity of factors involved. Inflammatory and abnormal immune responses have been hypothesized to play a crucial role in PD. Not only in the brain, but also peripherally, inflammation is believed to contribute to the onset and progression of the neurodegenerative process seen in PD. Furthermore, increased inflammatory responses have been described both in the brain and peripheral blood of PD subjects. Although PD is considered a motor disorder, nonmotor symptoms are extremely frequent and disabling. Cognitive impairment and mood alterations are such symptoms that deserve increased attention since on the one hand they can appear even before typical motor disturbances are recognized, and on the other hand they are associated with high morbidity and mortality. A growing body of evidence suggests the existence of a link between inflammatory-immune responses and the occurrence of depression and cognitive impairment in PD patients. However, not all data are equally conclusive and are sometimes even conflicting. The aim of this brief review is to give an overview of the possible role that inflammation and immunomodulation may play in PD together with their putative impact on mood and cognitive alterations. What clearly emerges from this work is the fact that studies performed until now lack standardized and comparable methods to analyze both clinical and biological parameters. It is thus difficult to conclusively link mood and cognitive changes to underlying pathological mechanisms. Additional studies in this direction are warranted to convincingly establish or refute any causative relation.

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“…Cognitive impairment secondary to a comorbid neuropsychiatric disorder, such as depression and Alzheimer's disease, may superimpose to those typically seen in PD dementia, turning difficult the diagnostic process. It is worth mentioning that patients with low educational level are particularly susceptible to the deleterious effect of depression on cognition 111 . Recently, the Movement Disorders Society operationalized the diagnosis of PD dementia.…”

Section: Cognitive Impairment and Dementiamentioning

confidence: 99%

Neuropsychiatry of Parkinson's disease

Kümmer

Teixeira

2009

Arq. Neuro-Psiquiatr.

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-Parkinson's disease (PD) is traditionally regarded as a movement disorder. In recent years, however, non-motor symptoms have been considered significant factors of disability at all stages of the illness. Behavioral and psychological symptoms or neuropsychiatric syndromes associated with PD are frequent and may represent a challenge in the management of these patients. They include anxiety, depression, psychosis, sleep, sexual and impulse control disorders, apathy and cognitive dysfunction. Their pathogenesis in PD is complex, involving neurodegenerative, drug-related and psychological mechanisms. We will review the current knowledge of this growing field, also focusing on the management of theses syndromes.KEY WORDS: Parkinson's disease, neuropsychiatry, psychology, psychiatric disorders. Neuropsiquiatria da doença de ParkinsonResumo -A doença de Parkinson (DP) é tradicionalmente conhecida como um distúrbio do movimento. Entretanto, os sintomas não-motores têm sido considerados recentemente como fatores relevantes de incapacidade em todos os estágios da doença. Sintomas motores e comportamentais ou síndromes neuropsiquiátricas associadas à DP são frequentes e seu manejo pode se tornar um verdadeiro desafio. São comuns quadros de ansiedade, depressão, psicose, distúrbios do sono, transtornos do controle do impulso, apatia e disfunções cognitivas. A patogênese desses transtornos na DP é complexa, envolvendo mecanismos degenerativos, psicológicos e relacionados ao tratamento. Neste artigo, revisamos o estado do conhecimento desse campo de interesse crescente, também enfocando o manejo dessas síndromes. PALAVRAS-CHAVE: doença de Parkinson, neuropsiquiatria, psicologia, transtornos psiquiátricos.

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Depression Impairs Executive Functioning in Parkinson Disease Patients With Low Educational Level

Abstract: Patients with PD present with cognitive impairment even when nondemented. Depression may exacerbate executive dysfunction, especially in subjects with lower educational level.

Cited by 35 publications

References 37 publications

Impact of Frontal Lobe Function and Behavioral Changes on Health-Related Quality of Life in Patients with Parkinson's Disease: A Cross-Sectional Study from Southwest China

Impact of Frontal Lobe Function and Behavioral Changes on Health-Related Quality of Life in Patients with Parkinson's Disease: A Cross-Sectional Study from Southwest China

Depression and Cognitive Impairment in Parkinson's Disease: A Role for Inflammation and Immunomodulation?

Neuropsychiatry of Parkinson's disease

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