Discordance Between Physician Assessment and Patient-Reported Depressive Symptoms in Parkinson Disease

Lachner, Christian; Armstrong, Melissa J.; Gruber‐Baldini, Ann L.; Rezvani, Zahra; Reich, Stephen G.; Fishman, Paul S.; Salazar, Richard; Shulman, Lisa M.

doi:10.1177/0891988717710335

Cited by 24 publications

(14 citation statements)

References 32 publications

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“…According to the Unified Parkinson's Disease Rating Scale (UPDRS), over half DPD patients were not recognized by neurologists (Lachner et al. 2017), while the incidence of PD with depression was already substantially elevated recently (Kay et al., 2018). Clearly, physician recognition and current understanding for comorbidity of depression in PD are not enough.…”

Section: Introductionmentioning

confidence: 99%

Aberrant functional connectivity and activity in Parkinson’s disease and comorbidity with depression based on radiomic analysis

et al. 2021

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Introduction The current diagnosis of Parkinson's disease (PD) comorbidity with depression (DPD) largely depends on clinical evaluation. However, the modality may tend to lack precision in detecting PD with depression. A radiomic approach that combines functional connectivity and activity with clinical scores has the potential to achieve accurate and differential diagnosis between PD and DPD. Methods In this study, we aimed to employ the radiomic approach to extract large‐scale features of functional connectivity and activity for differentiating among DPD, PD with no depression (NDPD), and healthy controls (HC). We extracted 6,557 features of five types from all subjects including clinical characteristics, resting‐state functional connectivity (RSFC), amplitude of low‐frequency fluctuation (ALFF), regional homogeneity (ReHo), and voxel‐mirrored homotopic connectivity (VMHC). Lasso, random forest, and support vector machine (SVM) were implemented for feature selection and dimension reduction based on the training sets, and the prediction performance for different methods in the testing sets was compared. Results The results showed that nineteen features were selected for the group of DPD versus HC, 34 features were selected for the group of NDPD versus HC, and 17 features were retained for the group of DPD versus NDPD. In the testing sets, Lasso prediction achieved the accuracies of 0.95, 0.96, and 0.85 for distinguishing between DPD and HC, NDPD and HC, and DPD and NDPD, respectively. Random forest achieved the accuracies of 0.90, 0.82, and 0.90 for distinguishing between DPD and HC, NDPD and HC, and DPD and NDPD, respectively, while SVM yielded the accuracies of 1, 0.86 and 0.65 for distinguishing between DPD and HC, NDPD and HC, and DPD and NDPD, respectively. Conclusions By identifying aberrant functional connectivity and activity as potential biomarkers, the radiomic approach facilitates a deeper understanding and provides new insights into the pathophysiology of DPD to support the clinical diagnosis with high prediction accuracy.

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Section: Introductionmentioning

confidence: 99%

Aberrant functional connectivity and activity in Parkinson’s disease and comorbidity with depression based on radiomic analysis

et al. 2021

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“…Despite the impact on patient life, depression in PD patients is often underdiagnosed [13][14][15], in part due to overlapping somatic symptoms [10,16,17] and lack of systematic screening [18], and may contribute to undertreatment of this condition [15]. In a German study, 75% of patients suffering from moderate to severe depression were not prescribed antidepressants [18].…”

Section: Introductionmentioning

confidence: 99%

Exploring Treatment for Depression in Parkinson’s Patients: A Cross-Sectional Analysis

DeMarco

Al-Hammadi

Hinyard

2021

IJERPH

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Depression is a highly prevalent, often underrecognized and undertreated comorbidity of Parkinson’s disease closely correlated to health-related quality of life. National trends in depression care for patients with Parkinson’s disease are not well documented. This paper identifies a cohort of patients with Parkinson’s disease from nationally representative survey data and analyzes trends in depression care. Using data from the 2005–2006 through 2015–2016 waves of the National Health and Nutrition Examination Survey (NHANES), individuals were classified as Parkinson’s patients by reported medication use. PHQ-9 scores were used to identify individuals screening positive for depression. A composite treatment variable examined the reported use of mental health services and antidepressant medication. Survey participants with probable PD screened positive for depression, reported the use of antidepressant medication, and reported visits to mental health services more frequently than the control group. Survey participants with PD who screened positive for depression were more likely to report limitations in physical functioning due to an emotional problem than controls. While depression is highly prevalent among individuals with Parkinson’s disease, they are more likely to receive any treatment. Further research is required to investigate differences in patterns of treatment, contributing factors of emotions to limitations in physical functioning, and appropriate interventions.

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“…11 Studies that have been conducted have had some methodological limitations including such as having utilized clinical interviews, such as the neuropsychiatric inventory (NPI) 12 or the unified Parkinson's disease rating scale (UPDRS), 13 which may not be sensitive enough to capture subtle variability of these psychiatric symptoms. 14 In addition, the limited studies examining anxiety and cognitive performance in PD have utilized measures that emphasize somatic symptoms, such as the Beck anxiety inventory (BAI), which can be confounded with the physical symptoms common of PD. 15 Some studies have failed to see any association between psychiatric symptoms and cognitive performance.…”

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confidence: 99%

Mild cognitive impairment, psychiatric symptoms, and executive functioning in patients with Parkinson's disease

Petkus

Filoteo

Schiehser

et al. 2020

Int J Geriat Psychiatry

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Objective Mild cognitive impairment (MCI) and psychiatric symptoms (anxiety, depression, and apathy) are common in Parkinson's disease (PD). While studies have supported the association between psychiatric symptoms and cognitive performance in PD, it is unclear if the magnitude of link between psychiatric symptoms and cognitive health is stronger by MCI status. The purpose of this study was to examine the association between cognitive performance and psychiatric symptoms in PD and whether MCI status moderates this association. Methods/Design Participants (N = 187) completed a comprehensive neuropsychological assessment that included measures of attention, language, executive function (EF), visuospatial ability, episodic memory, and psychiatric symptoms. Participants were classified as PD‐MCI (N = 73) or PD‐normal cognition (NC; N = 114). Linear regression analyses were conducted to examine the association between psychiatric symptoms and cognitive performance and the moderating effect of PD‐MCI status. Results There were no differences in mean psychiatric symptoms between PD‐MCI and PD‐NC. Psychiatric symptoms were predominantly associated with worse EF. The magnitude of the association between anxiety and worse EF was larger in participants with PD‐MCI compared with PD‐NC. A multivariable regression analysis examining the independent contributions of each symptom demonstrated the most robust association between EF and anxiety. Conclusions Symptoms of anxiety, depression, and apathy are associated with worse executive functioning in individuals with PD. PD‐MCI may be important in moderating the association between cognitive performance, specifically anxiety, and EF. Factors that promote cognitive resilience may serve as key therapeutic modalities in managing neuropsychiatric symptoms in PD.

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Discordance Between Physician Assessment and Patient-Reported Depressive Symptoms in Parkinson Disease

Abstract: More than 60% of patients screening positive for depression on self-report were not recognized by neurologists on the UPDRS. A patient-reported screening tool for depression may improve recognition and management of dPD.

Cited by 24 publications

References 32 publications

Aberrant functional connectivity and activity in Parkinson’s disease and comorbidity with depression based on radiomic analysis

Aberrant functional connectivity and activity in Parkinson’s disease and comorbidity with depression based on radiomic analysis

Exploring Treatment for Depression in Parkinson’s Patients: A Cross-Sectional Analysis

Mild cognitive impairment, psychiatric symptoms, and executive functioning in patients with Parkinson's disease

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