Mood changes associated with "end-of-dose deterioration" in Parkinson's disease: a controlled study.

Cantello, Roberto; Gilli, M; Riccio, A.; Bergamasco, B.

doi:10.1136/jnnp.49.10.1182

Cited by 84 publications

(48 citation statements)

References 33 publications

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“…A number of workers have suggested that this is the case, implying that the depression is not just a reaction to the illness, but is perhaps more biologically or endogenously determined. 10,20,23,24 Brown and Jahanshahi, however, reviewed relevant studies in this area and concluded that no consistent pattern emerged. They pointed out that in the largest comparative study, no difference in the frequency of depression was found between patients suffering from rheumatoid arthritis and those with PD.…”

Section: Aetiology Of Depression In Pdmentioning

confidence: 90%

Beyond the iron mask: Towards better recognition and treatment of depression associated with Parkinson's disease

2002

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This review examines the frequency of depression complicating Parkinson's disease (PD), its aetiology and clinical features, and also how it may be recognised and treated. Studies investigating the frequency of depression in PD have yielded figures ranging between 2.7% and 70%. Methodological differences account for much of the disparity. The aetiology of depression in PD is complex, and probably relates to both biological and exogenous factors. Dysfunction of multiple neurotransmitter systems, including the serotonergic system, may be involved. Mood disturbances resulting from deep brain stimulation of the subthalamic nucleus may provide a fruitful area for future research, and assist our understanding of the neural networks involved in mediating depression. Several recent studies have confirmed that depression in the PD patient is a major determinant of quality of life and that this is closely related to dysfunction in other clinically important health areas. The validity for many existing scales in the screening, diagnosis, and monitoring of depression in the PD patient has not been established. The Montgomery-Asberg Depression Rating Scale and the Hamilton Rating Scale for Depression appear to have good diagnostic sensitivity and specificity when compared with DSM-IV criteria. Recommendations for the optimal drug treatment of depression in PD are difficult to give, due to an inexplicable dearth of sizeable, placebo-controlled studies. A majority of physicians would probably now opt for a selective serotonin reuptake inhibitor in the depressed PD patient. There is no good evidence that these drugs are associated with a worsening of motor features, but they should probably not be coprescribed with selegiline, because of the risk of causing a potentially serious serotonin syndrome. Several studies have suggested that depression in the PD patient is associated with a more rapid deterioration in cognitive and motor functions, perhaps as a surrogate marker for more extensive brainstem cell loss.

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Section: Aetiology Of Depression In Pdmentioning

confidence: 90%

Beyond the iron mask: Towards better recognition and treatment of depression associated with Parkinson's disease

2002

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“…19,20 This could lead to a situation in which patients with a score above a certain cutoff would falsely be diagnosed as depressed, solely because of parkinsonian symptoms. Indeed, one study showed improvement of diagnostic performance of the BDI when several somatic items were excluded.…”

Section: Discussionmentioning

confidence: 99%

“…Cantello has consistently used a revised version of the BDI, the so-called "shortened BDI" or sBDI, which omits the items "body image," "work inhibition," "fatigability," and "somatic preoccupation." 19,22,23 Another solution to diagnose depression is by combining a certain minimal score on the BDI and the presence of clinical signs of depression or a non-zero score on the first item of the scale. 23,24 Our aim was to validate the original scale, without adaptations, for screening and diagnostic purposes by determining sensitivity and specificity at different cut-off scores.…”

Section: Discussionmentioning

confidence: 99%

The validity of the Beck Depression Inventory as a screening and diagnostic instrument for depression in patients with Parkinson's disease

et al. 2000

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“…The extent of mood change does not correlate tightly with the extent of motor improvement or with baseline severity of motor signs (Maricle et al, 1995a(Maricle et al, , 1998Witjas et al, 2002). Finally, patients with rheumatoid arthritis and similar fluctuations in motor disability have significantly less severe fluctuations of mood (Cantello et al, 1986).…”

Section: Introductionmentioning

confidence: 93%

Levodopa Challenge Neuroimaging of Levodopa-Related Mood Fluctuations in Parkinson's Disease

Black

Hershey

Hartlein

et al. 2004

Neuropsychopharmacol

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Some patients with advanced Parkinson's disease (PD) develop dose-related fluctuations in mood. This may reflect alterations in dopamine-influenced brain circuits that mediate emotion. However, there is no available information to localize which dopamineinfluenced neurons may be most affected. Eight patients with PD and clinically significant levodopa-related mood fluctuations (mania, depression, or anxiety) were compared to 13 patients with similarly severe PD and fluctuations of motor function but not of mood. Regional cerebral blood flow (rCBF) was measured with positron emission tomography before and after levodopa (in the presence of carbidopa). The rCBF response to levodopa in medial frontal gyrus and posterior cingulate cortex (PCC) significantly differed between mood fluctuators and control patients (corrected po0.02). Other regions with uncorrected po0.001 in this comparison were cortical Brodmann areas 22, 40, 13, 11, and 28, hippocampus, and claustrum. The levodopa activation paradigm detected group differences not evident in a comparison of resting rCBF. Abnormalities of dopamine innervation may produce mood fluctuations via effects on PCC, an area strongly linked to mood and anxiety and with known rCBF responsiveness to levodopa or D2-like dopamine receptor agonists. We speculate that mood fluctuations may arise in parkinsonian patients who have abnormal dopaminergic modulation of caudate nucleus, anterior cingulate cortex, or orbital frontal cortex, all of which innervate PCC. The findings require confirmation in larger and bettermatched groups.

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Mood changes associated with "end-of-dose deterioration" in Parkinson's disease: a controlled study.

Cited by 84 publications

References 33 publications

Beyond the iron mask: Towards better recognition and treatment of depression associated with Parkinson's disease

Beyond the iron mask: Towards better recognition and treatment of depression associated with Parkinson's disease

The validity of the Beck Depression Inventory as a screening and diagnostic instrument for depression in patients with Parkinson's disease

Levodopa Challenge Neuroimaging of Levodopa-Related Mood Fluctuations in Parkinson's Disease

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