Is there a relationship between Parkinson's disease and obsessive-compulsive disorder?

Harbishettar, Vijaykumar; Pal, Pramod Kumar; Reddy, Y.C. Janardhan; Thennarasu, K.

doi:10.1016/j.parkreldis.2004.07.006

Cited by 32 publications

(23 citation statements)

References 18 publications

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“…This is consistent with the concept that functional breakdown of the fronto-basal gangliathalamocortical systems may cause various neuropsychiatric disorders including OCD (Cummings, 1993;Maia, Cooney, & Peterson, 2008;Saxena, Brody, Schwartz, & Baxter, 1998). There have been controversies concerning the relationship between PD and OCD (Alegret et al, 2001a;Harbishettar, Pal, Janardhan Reddy, & Thennarasu, 2005;Maia, Pinto, Barbosa, Menezes, & Miguel, 2003) and it remains uncertain whether the symptoms in Patient 1 were actually caused by Lewy body pathology. However, it was recently reported that in OCD-associated PD patients, deep brain stimulation of the subthalamic nucleus effectively improved both OCD and PD symptoms (Alegret et al, 2001b;Mallet et al, 2002), suggesting both disorders may share, at least in part, analogous pathophysiological mechanisms, such as aberrant neural signaling in basal ganglia circuitry (Piallat et al, 2010).…”

Section: Discussionsupporting

confidence: 85%

Avoidance of swallowing saliva: A symptom related to aberrant basal ganglia functions?

2013

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We report two patients with avoidance of swallowing saliva despite intact swallowing functions. One, with mild, de novo Parkinson's disease, had a fear that his saliva was contaminated and would harm him. The other, with a history of CNS germinoma in remission for 3 years following chemotherapy, expectorated because his saliva was distasteful and disgusting. He had a lesion involving the left pallidum. Both appeared obsessed with the idea of saliva contamination and both expectorated compulsively, presenting obsessive-compulsive disorder (OCD) symptoms. OCD-like behavior may be induced in association with pathological conditions in which aberrant basal ganglia functions are present.

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Section: Discussionsupporting

confidence: 85%

Avoidance of swallowing saliva: A symptom related to aberrant basal ganglia functions?

2013

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“…In relation to Parkinson's disease, studies have been discordant. Maia [24], and Harbishettar [18] were unable to find significant OCS in their PD patients. Alegret [4], however, found them to be especially prevalent in advanced stage disease.…”

Section: Discussionmentioning

confidence: 90%

Psychiatric symptoms screening in the early stages of Parkinson’s disease

et al. 2011

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Psychiatric complaints are common in Parkinson's disease (PD), and have a significant influence in disease outcome and quality of life. Little attention has been paid to psychiatric symptoms at early stage disease. We aimed to screen a population of early stage PD patients for psychiatric symptoms and to study the relation with motor and cognitive function. Thirty-six early stage PD patients underwent motor [Hoehn and Yahr (HY), Unified Parkinson's Disease Rating Scale] and cognitive [Frontal Assessment Battery, Mini-Mental State Examination (MMSE)] assessment as well as general psychiatric [Symptom Check-List 90 (SCL-90-R)] and psychosis [Brief Psychiatric Rating Scale (BPRS)] screening. Relation between psychiatric domains scores was studied with principal component analysis. Relation between psychiatric, disease related, cognitive and motor function was assessed with bivariate correlation (Pearson). SCL-90-R scores were higher for somatization (significant scores in 66.7% of patients), depression (36.1%), anxiety (27%) and obsessive-compulsive symptoms (OCS) (52.8%). Scores were highly correlated, except for psychosis and phobia. Depression and anxiety were negatively correlated to MMSE score and dopaminergic doses, respectively. BPRS scores were higher for somatic concern, depression, anxiety and hallucinations. There was segregation between depression, anxiety, hallucinations, other positive psychotic symptoms and negative psychotic symptoms. Depression was related to MMSE score. We found a high prevalence of psychiatric complaints in PD patients, mostly related to depression, anxiety, somatization and OCS. Hallucinations were also frequent, but not associated to cognitive function or dopaminergic doses, suggesting a different physiopathological background.

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“…These symptoms were mainly in the checking, doubting and cleaning dimensions. Others, though, found increased obsessive-compulsive symptoms only in a subgroup of PD patients (with left or bilateral motor symptoms) [35], or (using the Yale-Brown Obsessive-Compulsive Scale) not at all [24]. In a recent survey, PD patients had higher scores than controls for both impulsivity and compulsivity, but these scores did not correlate and only the higher impulsivity score was associated with an increased probability of impulse control disorders [27].…”

Section: Impulsive-compulsive Disordersmentioning

confidence: 95%

Parkinson’s disease-related disorders in the impulsive-compulsive spectrum

2008

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In Parkinson's disease (PD), there is increasing evidence for disorders in the impulsive-compulsive spectrum, related to the disease itself, to the pharmacological management of this disease or to both. These disorders comprise dopamine deficiency syndrome (with immediate reward seeking behaviour), dopamine dependency syndrome (with addictive behaviour), dopamine dysregulation syndrome (with both addictive behaviour and stereotyped behaviour) and impulse control disorders (such as pathological gambling, compulsive shopping, binge eating and hypersexuality). These disorders are especially seen in PD patients with young age of onset, higher doses of antiparkinsonian drugs, pre-existent or current depression, pre-existing recreational drug or alcohol use, and high novelty seeking personality traits.Dopamine is not only implicated in voluntary movement control but also plays a significant role in the brain's reward system and the modulation of behaviours. Therefore, most if not all drugnaïve PD patients will suffer dysphoria, leading to mild immediate reward seeking behaviour as a consequence of the striatal dopaminergic denervation. In some of these patients, during treatment, this may even lead to the intake of increasing quantities of levodopa, above those required to adequately treat motor parkinsonism, with all characteristics of a dopamine dependence syndrome. These patients may develop plastic changes in the striatal matrix leading to hyperkinesia, caused by extracellular striatal dopaminergic fluctuations due to pulsatile dopamine replacement therapy. As soon as these changes are also seen in the striatal striosomes, in the framework of a dopamine dysregulation syndrome, stereotyped behaviours (punding) may occur (supposedly due to dorsal versus ventral striatal overactivity). Finally, impulse control disorders are suggested as being pure adverse side-effects of dopamine replacement therapy. Obsessive-compulsive behaviour (caused by ventral to dorsal overactivity) so far has not been described in PD patients.Treatment of impulse control disorders is related to the underlying pathology. In the case of an intrinsic dopamine deficiency syndrome, treatment with dopamine replacement therapy, especially levodopa, will help. In the multifactorial (intrinsic and extrinsic) dopamine dependency and dysregulation syndromes, addictive behaviour might best be helped by psychosocial strategies, and punding by continuous dopaminergic receptor stimulation (or amantadine), hypothesized to reduce the plastic changes-induced hypersensitization. The extrinsic impulse control disorders might be best treated by reducing or replacing dopamine receptor agonists.

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Is there a relationship between Parkinson's disease and obsessive-compulsive disorder?

Cited by 32 publications

References 18 publications

Avoidance of swallowing saliva: A symptom related to aberrant basal ganglia functions?

Avoidance of swallowing saliva: A symptom related to aberrant basal ganglia functions?

Psychiatric symptoms screening in the early stages of Parkinson’s disease

Parkinson’s disease-related disorders in the impulsive-compulsive spectrum

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