Neuropsychiatric co-morbidities in non-demented Parkinson′s disease

Kumar, Nitish; Goyal, Vinay; Kumar, Nand; Shukla, Geeta; Srivastava, Achal Kumar; Singh, Sumit; Behari, Madhuri

doi:10.4103/0972-2327.144287

Cited by 14 publications

(11 citation statements)

References 46 publications

(58 reference statements)

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“…The activities-specific balance confidence (ABC) scale uses a questionnaire to score the confidence on balance control and estimate the fear of fall [50]. The Schwab and England test also uses a questionnaire to evaluate the patient’s ability to perform activities of daily living in terms of speed and independence [51].…”

Section: Pathophysiologymentioning

confidence: 99%

Postural Instability in Parkinson’s Disease: A Review

Palakurthi

Burugupally

2019

Brain Sciences

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Parkinson’s disease (PD) is a heterogeneous progressive neurodegenerative disorder, which typically affects older adults; it is predicted that by 2030 about 3% of the world population above 65 years of age is likely to be affected. At present, the diagnosis of PD is clinical, subjective, nonspecific, and often inadequate. There is a need to quantify the PD factors for an objective disease assessment. Among the various factors, postural instability (PI) is unresponsive to the existing treatment strategies resulting in morbidity. In this work, we review the physiology and pathophysiology of postural balance that is essential to treat PI among PD patients. Specifically, we discuss some of the reported factors for an early PI diagnosis, including age, nervous system lesions, genetic mutations, abnormal proprioception, impaired reflexes, and altered biomechanics. Though the contributing factors to PI have been identified, how their quantification to grade PI severity in a patient can help in treatment is not fully understood. By contextualizing the contributing factors, we aim to assist the future research efforts that underpin posturographical and histopathological studies to measure PI in PD. Once the pathology of PI is established, effective diagnostic tools and treatment strategies could be developed to curtail patient falls.

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Section: Pathophysiologymentioning

confidence: 99%

Postural Instability in Parkinson’s Disease: A Review

Palakurthi

Burugupally

2019

Brain Sciences

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“…However, in a clinical study by Aarsland et al, no correlation between the prevalence of psychotic symptoms and the type, duration, and dose of antiparkinson drug therapy was found [ 13 ]. More recently Rai et al found no correlation between psychotic symptoms and the class, dose, or duration of antiparkinson medications in patients with PD [ 5 ]. Contrastingly, Papapetropoulos and Mash demonstrated that all antiparkinson drugs can induce psychosis in PD patients [ 14 ].…”

Section: The Role Of Antiparkinson Medication In the Pathogenesis mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Psychotic symptoms are present in up to 50% of patients with PD, but estimates vary widely [ 3 – 5 ]. They are usually associated with other correlates such as older age, more advanced age at the onset of the disease, duration of disease, disease staging, cognitive decline, presence of depression, and the use of antiparkinson medication [ 5 – 7 ]. Psychotic symptoms in PD patients are also associated with increased caregivers' stress, increased rates of nursing home placement, and poor clinical prognosis [ 1 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

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The Efficacy and Safety of Antipsychotic Medications in the Treatment of Psychosis in Patients with Parkinson’s Disease

Divac

Stojanović

Vujović

et al. 2016

Behavioural Neurology

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Psychotic symptoms are present in up to 50% of patients with Parkinson's disease. These symptoms have detrimental effects on patients' and caregivers' quality of life and may predict mortality. The pathogenesis of psychotic symptoms in Parkinson's disease is complex, but the use of dopaminergic medications is one of the risk factors. The treatment of psychotic symptoms in Parkinson's disease is complicated due to the ability of antipsychotic medications to worsen motor symptoms. The efficacy of clozapine in the treatment of psychosis in patients with Parkinson's disease has been confirmed in several clinical trials; however, the adverse effects and the necessity of blood count monitoring are the reasons why the use of this drug is challenging. The studies on safety and efficacy of other antipsychotics conflicting results. The use of antipsychotics in these patients is also associated with increased mortality. Psychotic symptoms in Parkinson's disease per se are also proven predictors of mortality. Thus it is necessary to treat psychotic symptoms but the choice of an antipsychotic should be based on careful risk/benefit assessment. Pimavanserin as a novel therapeutic option with more favorable adverse effects profile is now available for this indication, but careful postmarketing monitoring is necessary to establish the true picture of this drug's long-term safety and efficacy.

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“…Due to the neurological nature of PD, much of the published literature has focused on the psychiatric and neurological comorbidities of PD [7-9]; however, there are fewer studies exploring the systemic diseases present in PD patients. One such study conducted in the United States investigated the comorbid conditions associated with PD [4] but was limited by a relatively small sample size and did not utilize registry data.…”

Section: Introductionmentioning

confidence: 99%

Comorbid Conditions in Parkinson’s Disease: A Population-Based Study of Statewide Parkinson’s Disease Registry

Alnaji

Zhao

et al. 2017

Neuroepidemiology

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Background/Aims: In 1996, Nebraska became the first state in the United States to establish a Parkinson’s disease (PD) Registry. The objectives of this study were to determine the most common comorbid conditions among PD patients receiving inpatient and outpatient services in Nebraska between 2004 and 2012, and to examine whether PD patients had increased risks of these conditions. Methods: Statewide linkage was performed between Nebraska PD Registry data and hospital discharge database. The cohort comprised of 3,852 PD inpatients and 19,260 non-PD inpatients, and 5,217 PD outpatients and 26,085 non-PD outpatients. Referent subjects were matched to PD patients by age at initial hospital admissions or visits, gender, and county of residence using systematic random-sampling method. Results: Compared to non-PD inpatients, PD inpatients were at higher risks for dementia (relative risk [RR] 2.29; 95% CI 2.14–2.45), mood disorders (RR 1.57; 95% CI 1.44–1.70), gastrointestinal disorders (RR 1.15; 95% CI 1.06–1.25), and urinary tract infections (RR 1.33; 95% CI 1.22–1.45), while PD outpatients had higher risks for spondylosis (RR 1.23; 95% CI 1.09–1.38), genitourinary disorders (RR 1.48; 95% CI 1.29–1.69), gastrointestinal disorders (RR 1.59; 95% CI 1.38–1.84), and dementia (RR 2.83; 95% CI 2.38–3.37) than non-PD outpatients. Conclusions: The findings highlight PD as a multisystem neurodegenerative disorder, and this information is crucial for creating strategies to better prevent and manage PD complications.

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Neuropsychiatric co-morbidities in non-demented Parkinson′s disease

Cited by 14 publications

References 46 publications

Postural Instability in Parkinson’s Disease: A Review

Postural Instability in Parkinson’s Disease: A Review

The Efficacy and Safety of Antipsychotic Medications in the Treatment of Psychosis in Patients with Parkinson’s Disease

Comorbid Conditions in Parkinson’s Disease: A Population-Based Study of Statewide Parkinson’s Disease Registry

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