Somatization in Parkinson's Disease: A systematic review

Carrozzino, Danilo; Bech, Per; Patierno, Chiara; Onofrj, Marco; Morberg, Bo Mohr; Thomas, Astrid; Bonanni, Laura; Fulcheri, Mario

doi:10.1016/j.pnpbp.2017.05.011

Cited by 27 publications

(30 citation statements)

References 77 publications

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“…Indeed, postencephalitic parkinsonism was the first and unexpected evidence that SFD‐related manifestations were rooted in a pathologically confirmed disease and not the mere result of psychodynamic processes. Today, high scores for SFD‐related items within several neuropsychological scales are found in 29%–67% of PD patients . We suggest that SFD symptoms, identified by neuropsychological scales and described as transient and tolerable phenomena, can be considered equivalent to early simple hallucinations.…”

Section: Somatic Symptom and Functional Disordersmentioning

confidence: 88%

“…Today, high scores for SFDrelated items within several neuropsychological scales are found in 29%-67% of PD patients. 11,15,17,57,58 We suggest that SFD symptoms, identified by neuropsychological scales and described as transient and tolerable phenomena, can be considered equivalent to early simple hallucinations.…”

Section: Somatic Symptom and Functional Disordersmentioning

confidence: 96%

“…Interestingly, several reports have now described patients who displayed signs of functional parkinsonism years before a confirmed PD diagnosis by dopamine transporter scans or l ‐dopa binding . In PD patients who exhibit motor symptoms along with cognitive decline, somatic complaints become more complex and are characterized by the presence of psychotic elements that should be properly classified as somatic delusions . These delusions include ritualized avoidance behavior, perceptions of body deformation, the idea of being physically influenced from external sources, overwhelming allergies or parasitic infestation, or necrotic or liquified internal organs (the last 2 also known as Ekbom and Cotard delusions) …”

Section: Somatic Symptom and Functional Disordersmentioning

confidence: 99%

“…In this review, we propose that SFDs, which lack reality constraints and are “experiences that depart from consensual reality,” as from the last broad definition of psychosis, should be considered, along with hallucinations and delusions, as 1 of the 3 elements of the psychosis complex associated with synucleinopathies. Hallucinations and SFDs share similar associations with cognitive decline, have similar prevalence, and share a similar course of progression …”

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confidence: 93%

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Hallucinations, somatic‐functional disorders of PD‐DLB as expressions of thalamic dysfunction

et al. 2019

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Hallucinations, delusions, and functional neurological manifestations (conversion and somatic symptom disorders) of Parkinson's disease (PD) and dementia with Lewy bodies increase in frequency with disease progression, predict the onset of cognitive decline, and eventually blend with and are concealed by dementia. These symptoms share the absence of reality constraints and can be considered comparable elements of the PD‐dementia with Lewy bodies psychosis. We propose that PD‐dementia with Lewy bodies psychotic disorders depend on thalamic dysfunction promoting a theta burst mode and subsequent thalamocortical dysrhythmia with focal cortical coherence to theta electroencephalogram rhythms. This theta electroencephalogram activity, also called fast‐theta or pre‐alpha, has been shown to predict cognitive decline and fluctuations in Parkinson's disease with dementia and dementia with Lewy bodies. These electroencephalogram alterations are now considered a predictive marker for progression to dementia. The resulting thalamocortical dysrhythmia inhibits the frontal attentional network and favors the decoupling of the default mode network. As the default mode network is involved in integration of self‐referential information into conscious perception, unconstrained default mode network activity, as revealed by recent imaging studies, leads to random formation of connections that link strong autobiographical correlates to trivial stimuli, thereby producing hallucinations, delusions, and functional neurological disorders. The thalamocortical dysrhythmia default mode network decoupling hypothesis provides the rationale for the design and testing of novel therapeutic pharmacological and nonpharmacological interventions in the context of PD, PD with dementia, and dementia with Lewy bodies. © 2019 International Parkinson and Movement Disorder Society

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Section: Somatic Symptom and Functional Disordersmentioning

confidence: 88%

Section: Somatic Symptom and Functional Disordersmentioning

confidence: 96%

Section: Somatic Symptom and Functional Disordersmentioning

confidence: 99%

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confidence: 93%

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Hallucinations, somatic‐functional disorders of PD‐DLB as expressions of thalamic dysfunction

et al. 2019

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“…These drug-induced adverse effects are particularly challenging for clinicians due to their overlap with somatization symptoms. However, they are generally neglected by both physicians (because considered as expected side effects of therapy) and clinical psychologists (because considered as biological-driven symptoms), thereby perpetuating the organic-functional dualism (Sirri et al, 2013 ; Carrozzino et al, 2017 ; Fava et al, 2017 ). Evidence however showed that psychological constructs such as proneness to somatization and higher depressive symptoms may explain not only poorer psychosocial functioning, but also higher perception and the reporting of somatic side effects (Porcelli et al, 2014a ; Cozzolongo et al, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Alexithymia in Gastroenterology and Hepatology: A Systematic Review

Carrozzino

Porcelli

2018

Front. Psychol.

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Background: Alexithymia is a multifaceted personality construct that represents a deficit in the cognitive processing of emotions and is currently understood to be related to a variety of medical and psychiatric conditions. The present review aims to investigate the relationship of alexithymia with gastrointestinal (GI) disorders as functional gastrointestinal disorders (FGID, as irritable bowel syndrome (IBS) and functional dyspepsia) and inflammatory bowel disease (IBD) [ulcerative colitis (UC) and Crohn's disease (CD)] and liver diseases as chronic hepatitis C (CHC), cirrhosis, and liver transplantation.Methods: The articles were selected from the main electronic databases (PsycInfo, Medline, PubMed, Web of Science, Scopus, Cochrane, and ScienceDirect) using multiple combinations of relevant search terms (defined GI and liver diseases, articles in English, use of the Toronto scales [TAS] for alexithymia). The TAS was selected as inclusion criterion because it is the most widely used measure, thus allowing comparisons across studies.Results: Forty-eight studies met the inclusion criteria, of which 38 focused on GI disorders (27 on FGID and 11 on IBD) and 10 on liver diseases. Most studies (n = 30, 62%) were cross-sectional. The prevalence of alexithymia was higher in FGID (two third or more) than IBD and liver diseases (from one third to 50% of patients, consistent with other chronic non-GI diseases) than general population (10–15%). In functional disorders, alexithymia may be viewed as a primary driver for higher visceral perception, symptom reporting, health care use, symptom persistence, and negative treatment outcomes. Also, it has been found associated with psychological distress and specific GI-related forms of anxiety in predicting symptom severity as well as post-treatment outcomes and is associated with several psychological factors increasing the burden of disease and impairing levels of quality of life. A number of critical issues (small sample sizes, patients referred to secondary and tertiary care centers, cross-sectional study design, use of one single scale for alexithymia) constitutes a limitation to the generalization of findings.Conclusions: Alexithymia showed to play different roles in gastroenterology according to the clinical characteristics and the psychological burden of the various disorders, with main relevance in increasing subjective symptom perception and affecting negatively post-treatment outcomes.

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High γ‐Aminobutyric Acid Content Within the Medial Prefrontal Cortex Is a Functional Signature of Somatic Symptoms Disorder in Patients With Parkinson's Disease

et al. 2020

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Background: The dysfunctional activity of the medial prefrontal cortex has been associated with the appearance of the somatic symptom disorder, a key feature of the Parkinson's disease (PD) psychosis complex. Objectives: The objectives of this study were to investigate whether the basal contents of inhibitory γ-aminobutyric acid and excitatory glutamate plus glutamine neurotransmitter levels are changed in the medial prefrontal cortex of patients with PD with somatic symptom disorder and whether this alteration represents a marker of susceptibility of PD to somatic symptom disorder, thus representing a signature of psychosis complex of PD. Methods: Levels of the γ-aminobutyric acid and glutamate plus glutamine were investigated, at rest, with proton magnetic resonance spectroscopy. Total creatine was used as an internal reference. The study cohort included 23 patients with somatic symptom disorder plus PD, 19 patients with PD without somatic symptom disorder, 19 healthy control subjects, and 14 individuals with somatic symptom disorder who did not show other psychiatric or neurological disorders. Results: We found that, compared with patients with PD without somatic symptom disorder or healthy control individuals, patients with somatic symptom disorder, with or without PD, show increased γ-aminobutyric acid/total creatine levels in the medial prefrontal cortex. The medial prefrontal cortex contents of glutamate plus glutamine/ total creatine levels or γ-aminobutyric acid/glutamate plus glutamine were not different among groups. Conclusions: Our findings highlight a crucial pathophysiologic role played by high γ-aminobutyric acid within the medial prefrontal cortex in the production of somatic symptom disorder. This phenomenon represents a signature of psychosis complex in patients with PD.

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Somatization in Parkinson's Disease: A systematic review

Cited by 27 publications

References 77 publications

Hallucinations, somatic‐functional disorders of PD‐DLB as expressions of thalamic dysfunction

Hallucinations, somatic‐functional disorders of PD‐DLB as expressions of thalamic dysfunction

Alexithymia in Gastroenterology and Hepatology: A Systematic Review

High γ‐Aminobutyric Acid Content Within the Medial Prefrontal Cortex Is a Functional Signature of Somatic Symptoms Disorder in Patients With Parkinson's Disease

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