Mood Differences Among Parkinson’s Disease Patients With Mild Cognitive Impairment

Abstract

Objective Studies with healthy elderly adults suggest apathy, depression and anxiety are more common among individuals with mild cognitive impairment (MCI). We examined differences in mood/amotivational symptoms among Parkinson’s patients with and without MCI. Methods Parkinson patients (N=214) underwent neurocognitive evaluations including assessment of apathy (Apathy Scale; AS), depression (Beck Depression Inventory-II; BDI-II) and trait anxiety (State-Trait Anxiety Inventory-Trait scale; STAI-T). Results Trait anxiety and depression were more severe in PDs with MCI. Delineation of MCI into amnestic vs non-amnestic subtypes revealed greater depression, apathy and anxiety among amnestic MCI relative to cognitively-intact PD patients. Conclusion Parkinson patients with MCI report greater mood symptoms compared to Parkinson patients who are cognitively intact.

Prevalence and Clinical Aspects of Mild Cognitive Impairment in Parkinson's Disease: A Meta‐Analysis

“…A total of 9 of 25 studies found that patients with PD‐MCI took higher LEDD than patients without PD‐MCI; our meta‐analysis confirmed this association (Supplementary Material 5; Table ), with a significant and positive ES (= 0.25). The heterogeneity among the studies was significant and moderate, but sensitivity analysis indicated stability of ES level, and there was no publication bias.…”

“…Apathy . Of 6 studies, 3 found that patients with PD‐MCI had higher scores on apathy scales than patients without PD‐MCI (Supplementary Material 6). Our meta‐analysis revealed that patients with PD‐MCI were more apathetic than patients without PD‐MCI (Table ), with a significant and positive ES (= 0.41).…”

“…In fact, some studies revealed that depression, apathy, and anxiety are significantly associated with PD-MCI. [8][9][10] However, this association has not always reached statistically significant levels. 11,12 Another aspect that needs to be clarified is the possible higher prevalence of 1 motor phenotype of PD (ie, tremor dominant [TD] or postural instability/gait difficulty [PIGD]) 13 in PD-MCI; in fact, some studies found that the PIGD subtype is more frequent in PD-MCI patients when compared with those without PD-MCI, 14 but this possible relation is still unclear.…”

“…However, the frequency estimates of PD‐MCI may vary even as a result of other contributing factors such as demographic or clinical features and comorbid neuropsychiatric symptoms. In fact, some studies revealed that depression, apathy, and anxiety are significantly associated with PD‐MCI . However, this association has not always reached statistically significant levels .…”

Symptom Dimensions of Depression and Apathy and Their Relationship With Cognition in Parkinson’s Disease

“…L. Cohen, Aita, Mari, & Brandt, 2015; Santangelo, Vitale, et al, 2009), with fewer to no deficits seen in depression alone. On the other hand, a separate study showed that PD participants with mild cognitive impairment (PD-MCI) reported greater symptoms of depression, but not apathy, relative to cognitively intact PD participants (Jones, Mangal, Lafo, Okun, & Bowers, 2016). In addition to these cognitive findings, a recent review of the neuroimaging literature in PD found that depression was associated with increased brain activity in prefrontal regions and decreased functional connectivity between prefrontal-limbic networks, while both positive and negative correlations were reported between apathy and metabolism or brain activity in frontal, limbic, and striatal regions (Wen, Chan, Tan, & Tan, 2016).…”