Neuropsychiatric non-motor aspects of Parkinson’s disease

Thanvi, Bhomraj; Munshi, S K; Vijaykumar, Nagalakshmi; Lo, T C N

doi:10.1136/pmj.79.936.561

Cited by 57 publications

(34 citation statements)

References 28 publications

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“…The therapeutic approach in PD has often privileged the treatment of motor aspects of disease, whereas non-motor aspects have received little attention from researchers. Although the literature stresses the contribution of non-pharmacological approaches such as CBT or psychosocial support in PD [17,18,44,45], to our knowledge this is the first study that analyzed the effectiveness of CBT in PD with PG.…”

Section: Discussionmentioning

confidence: 99%

Cognitive-Behavioral Therapy for Pathological Gambling in Parkinson’s Disease: A Pilot Controlled Study

et al. 2012

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Objectives: The main objective of this study was to compare the clinical characteristics and differences in response to treatment of two groups of pathological gamblers: with comorbid Parkinson’s disease (PG + PD) and without (PG – PD). Methods: Clinical and psychopathological profiles and response to cognitive-behavioral treatment were assessed in 15 PG + PD and 45 PG – PD individuals consulting a specialized hospital Unit. Results: Statistically significant differences were observed between the two groups on a series of clinical variables. PG + PD patients were older and presented later onset of problematic gambling behaviors, lower alcohol consumption and higher bingo playing than PG – PD patients. No significant differences were noted in psychopathology except for lower measures of hostility in the PG + PD group. No statistical differences were detected between groups in terms of response to treatment. Conclusion: These results may provide guidance for obtaining accurate diagnostic information in pathological gamblers by properly identifying patients with specific needs that may be targeted with treatment.

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Section: Discussionmentioning

confidence: 99%

Cognitive-Behavioral Therapy for Pathological Gambling in Parkinson’s Disease: A Pilot Controlled Study

et al. 2012

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“…18 F]fluorodopa uptake in the caudate nucleus and frontal cortex, indicating an involvement of dopaminergic dysfunctions in these areas (Thanvi et al, 2003). Magnetic resonance imaging studies have shown in naïve monkeys marked changes of the regional cerebral blood volume in striatal, limbic and midbrain regions following administration of the dopamine releaser and dopamine re-uptake blocker amphetamine (Jenkins et al, 2004), reflecting the direct release of dopamine in these areas with a high density of dopamine receptors.…”

Section: Abnormalities Of Neuronal Circuits In Pd: Psychotic and Cognmentioning

confidence: 98%

Dopaminergic dysbalance in distinct basal ganglia neurocircuits: Implications for the pathophysiology of parkinson’s disease, schizophrenia and attention deficit hyperactivity disorder

Riederer²,

2006

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The basal ganglia form a forebrain system that collects signals from a large part of the neocortex, redistributes these cortical inputs both with respect to one another and with respect to inputs from the limbic system, and then focuses the inputs of this redistributed, integrated signals into particular regions of the frontal lobes and brainstem involved in aspects of motor planning and motor memory. Movement disorders associated with basal ganglia dysfunction comprise a spectrum of abnormalities that range from the hypokinetic disorder (from which Parkinson's disease, PD, is the best-known-example) at one extreme to the hyperkinetic disorder (exemplified by Huntington's disease and hemiballism) at the other. In addition to disorders of movement, major mental disorders including schizophrenic-like states and attention deficit hyperactivity disorder (ADHD) have been linked to abnormalities in the basal ganglia and their allied nuclei. In this paper we discuss recent evidence indicating that a dopamine-induced dysbalance of basal ganglia neurocircuitries may be an important pathophysiological component in PD, schizophrenia and ADHD. According to our model, the deprivation of dopaminergic nigro-striatal input, as in PD, reduces the positive feedback via the direct system, and increases the negative feedback via the indirect system. The critical consequences are an overactivity of the basal ganglia output sites with the resulting inhibition of thalamo-cortical drive. In schizophrenia the serious cognitive deficits might be partly a result of a hyperactivity of the inhibitory dopamine D(2) transmission system. Through this dysinhibition, the thalamus exhibits hyperactivity that overstimulates the cortex resulting in dysfunctions of perception, attention, stimulus distinction, information processing and affective regulation (inducing hallucinations and delusions) and motor disabilities. Recent studies have strongly suggested that a disturbance of the dopaminergic system is also involved in the pathophysiology of ADHD. The most convincing evidence comes from the demonstration of the efficacy of psychostimulants such as the dopamine transporter (DAT) blocker methylphenidate in the symptomatic treatment of ADHD. Genetic studies have shown an association between ADHD and genes involved in dopaminergic neurotransmission (for example the dopamine receptor genes DRD4 and DRD5, and the DAT gene DAT1). DAT knockout mice display a phenotype with increased locomotor activity, which is normalized by psychostimulant treatment. Finally, imaging studies demonstrated an increased density of DAT in the striatum of ADHD patients. Which system is disturbed and whether this system is hyper- or hypoactive is not unambiguously known yet.

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“…As disease progresses, NMSs lead to increased limitations to perform activities of daily living and greater dependence. Among the various NMSs, the prevalence of depression in PD patients has been reported to be 11-44% [18]. Previous studies revealed that depression is correlated with HRQoL in PD, accounting for up to 60% of impairment of the PDQ-39 [19].…”

Section: Discussionmentioning

confidence: 99%

Gender Differences of Nonmotor Symptoms Affecting Quality of Life in Parkinson Disease

et al. 2017

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Background/Aims: Gender differences of health-related quality of life (HRQoL) in patients with various disorders have been reported. Various nonmotor symptoms (NMSs) also affect the patients' lives and HRQoL, even in the early stages of Parkinson disease (PD). Our study aimed to identify whether there are gender differences of HRQoL in PD patients in the early stages, and which NMSs are associated with HRQoL depending on gender. Method: Eighty-nine PD patients (47 males, 42 females) and 36 healthy controls were enrolled. We evaluated HRQoL, NMSs, and their associations in each gender. Result: The total Parkinson Disease Quality of Life Questionnaire and Beck Anxiety Inventory scores were higher in female patients than in male patients. The correlation analysis revealed no association between NMSs and HRQoL in male patients. In female patients, HRQoL was highly correlated with depression, and moderately associated with fatigue. Conclusions: Gender differences of an association between HRQoL and NMSs exist in PD. We found that fatigue and depression were the main determinants of poor HRQoL in female patients even in the early stages. We suggest that a gender-specific therapeutic approach is important, and it is necessary to pay special attention to the predictors associated with causing poor HRQoL.

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Neuropsychiatric non-motor aspects of Parkinson’s disease

Cited by 57 publications

References 28 publications

Cognitive-Behavioral Therapy for Pathological Gambling in Parkinson’s Disease: A Pilot Controlled Study

Cognitive-Behavioral Therapy for Pathological Gambling in Parkinson’s Disease: A Pilot Controlled Study

Dopaminergic dysbalance in distinct basal ganglia neurocircuits: Implications for the pathophysiology of parkinson’s disease, schizophrenia and attention deficit hyperactivity disorder

Gender Differences of Nonmotor Symptoms Affecting Quality of Life in Parkinson Disease

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