Spectrum of non-motor neuropsychiatric symptoms among patients with Parkinson’s disease and Parkinson plus syndrome
Abstract
Introduction: Patients with PD often have non motor symptoms in addition to the motor manifestations of bradykinesia, rigidity and tremor. The NMSs are more often seen in patients with longer duration of disease. There is increasing realization that NMSs significantly contribute to the morbidity and increase the burden of the disease far beyond that caused by the classical motor symptoms.
Material and methods: It was a cross sectional study conducted to assess the non-motor dysfunction in 60 patients with Parkinsonism including idiopathic Parkinson’s disease and Parkinson plus syndrome who attended either the outdoor services, or were admitted in the Neurology ward of our tertiary care centre, PGIMER & Dr. RML Hospital, New Delhi, India.
Results: Out of 40 patients with Parkinson’s disease, twenty-five (62.50%) were males and 15 (37.50%) were females with mean age of 55.02 (SD ±13.56) years. Among patients with MSA, six (66.70%) were male and 3 (33.33%) were female with mean age of 62.00 (SD ±11.38) years. Out of 40 patients with PD 19 (47.50%) had minimal depression, 12 (30%) mild depression, 7 (17.50%) moderate depression and 2 (5%) severe depression. Out of 20 patients with Parkinson plus Syndrome 12 (60%), 5 (25%), and 3 (15%) patients had minimal, mild and moderate depression.
Conclusion: Parkinson’s disease and Parkinson plus syndrome are group of sporadic, neurodegenerative diseases of the central nervous system. There are only a few reports about the frequency of neuropsychiatric symptoms in patients with Parkinson disease from India and no such Indian report in patients with Parkinson plus syndrome
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References
2. Chaudhuri KR, Martinez-Martin P, Brown RG, Sethi K, Stocchi F, Odin P, et al. The metric properties of a novel non-motor symptoms scale for PD: results from an international pilot study. Mov Disord 2007;22:1901-11.
3. Delong MR, Juncos JL. PD and other extrapyramidal movement disorders. In: Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al., eds. Harrison’s principles of internal medicine 17th ed. New York (NY): The McGraw-Hill Companies 2008;2549-59.
4. Jankovic J, Shannon KM. Movement Disorders. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, eds. Neurology in clinical practice 5th ed. Philadelphia: Butterworth-Heinemann, Elsevier; 2008;2081-122.
5. Mitra K, Gangopadhyaya PK, Das SK. Parkinsonism plus syndromes - A review. Neurology India 2003;5:183-8. [PubMed]
6. Barone P, Antonini A, Colosimo C, et al., “The PRIAMO study: a multicenter assessment of nonmotor symptoms and their impact on quality of life in PD,” Movement Disorders 2009; 24(11):1641–1649.
7. Witjas T, Kaphan E, Azulay JP. Non-motor fluctuations in PD: Frequent and disabling. Neurology 2002;59:408-413. [PubMed]
8. Berendse HW, Groenewegen HJ. Organization of the thalamostriatal projections in the rat, with a special emphasis on the ventral striatum. J Comp Neurol 1990; 299:187-228. [PubMed]
9. Singer C, Weiner WJ, Sanchez-Ramos J, Ackerman M. Sexual functions in patients with PD. J Neurol Neurourgery & Psychiatry 1991;54(10):942. [PubMed]
10. Visser M, Marinus J, Stiggelbout AM, van Hilten JJ. Assessment of autonomic dysfunction in PD : The SCOPA- AUT. Mov Disord 2004;19(11):1306-1312. [PubMed]
11. Litvan I. Update on atypical parkinsonian disorders. Curr Opin Neurol 2007;20:434-437. [PubMed]
12. Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson’s disease. A clinico-pathological study of 100 cases. JNNP 1992;55:181-184. [PubMed]
13. Beck AT, Steer R, Brown G. Beck Depression Inventory-II. San Antonio, TX: The Psychological Corporation; 1996.
14. Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J. The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994;44: 2308–2314.
15. Schenkman ML, Clark K, Xie T, Kuchibhatla M, Shinberg M, Ray L. Spinal movement and performance of Standing Reach Task in participants with and without Parkinson Disease. Phys Ther. 2001;81(8):1400-11. [PubMed]
16. Reijnders JSAM, Ehrt U, Weber WEJ, Aarsland D, Leentjens AFG. “A systematic review of prevalence studies of depression in PD,” Movement Disorders 2008;23(2):183–189. [PubMed]
17. L. C. S. Tan. Mood disorders in PD, Parkinsonism & Related Disorders, vol. 18, supplement 2012;1:S74–S76. [PubMed]
18. Mayeux R. The mental state in PD, in Handbook of PD, 2nd Edition. Edited by Koller WC. New York, Marcel Dekker 1992;159–184.
19. Cummings JL. Depression and PD. a review. Am J Psychiatry 1992;149:443–454. [PubMed]
20. Ravina B, Camicioli R, Como PG, et al. “The impact of depressive symptoms in early Parkinson disease,” Neurology 2007;69(4):342–347. [PubMed]
21. Goetz CG, Stebbins GT. Risk factors for nursing home placement in advanced PD. Neurology 1993;43:2227–2229. [PubMed]
22. Fenelon G and Alves G. “Epidemiology of psychosis in PD,” Journal of the Neurological Sciences 2010;289(1-2):12–17. [PubMed]
23. Marsh L. “Anxiety disorders in PD,” International Review of Psychiatry 2000;12(4): 307–318.
24. Nuti A, Ceravolo R, Piccini A, et al., “Psychiatric comorbidity in a population of PD patients,” European Journal of Neurology 2004;11(5)315–320. [PubMed]
25. Richard IH, Schiffer RB, Kurlan R. Anxiety and PD. J Neuropsychiatry Clin Neurosci 1996;8:383–392. [PubMed]
26. S. E. Starkstein, H. S. Mayberg, T. J. Preziosi, P. Andrezejewski, R. Leiguarda, and R. G. Robinson, “Reliability, validity, and clinical correlates of apathy in PD ,” Journal of Neuropsychiatry and Clinical Neurosciences 1992;4(2):134–139.
27. P. Sockeel, K. Dujardin, D. Devos, C. Denève, A. Destée, and L. Defebvre. “The Lille apathy rating scale (LARS), a new instrument for detecting and quantifying apathy: validation in PD,” Journal of Neurology, Neurosurgery and Psychiatry2006;77(5):579–584.
28. Kulisevsky J, Pagonabarrag J, Pascual-Sedano B, García-Sánchez C, Gironell A. Prevalence and correlates of neuropsychiatric symptoms in PD without dementia. Movement Disorders 2008;23(13):1889 – 1896.
29. McKeith. Dementia with Lewy bodies.The British Journal of Psychiatry 2002; 180: 144-147. [PubMed]
30. Fritze F, Ehrt U, Sønnesyn H, et al. Depression in mild dementia: associations with diagnosis, APOE genotype and clinical features. International Journal of Geriatric Psychiatry. 2011;26(10):1054-61.
31. Hirono N, Mori E, Imamura T, Shimomura T, Hashimoto M. Neuropsychiatric features in Dementia with Lewy bodies and Alzheimer's disease.No to Shinkei. 1998; 50(1):45-9. [PubMed]
32. Benrud-Larson LM, Sandroni P, Schrag A, Low PA. Depressive symptoms and life satisfaction in patients with multiple system atrophy. Mov Disord 2005; 20(8):951-7. [PubMed]
33. Litvan I., Mega M.S., Cummings J.L., Fairbanks L. Neuropsychiatric aspect of PSP. Neurology 1996; 47:1184-1189.
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