Neurocognitive Psychiatric and Neuropsychological Alterations in Parkinson’s Disease: A Basic and Clinical Approach

Abstract

The main histopathological hallmarks of Parkinson’s disease (PD) are the degeneration of the dopaminergic neurons of the substantia nigra pars compacta and the loss of neuromelanin as a consequence of decreased dopamine synthesis. The destruction of the striatal dopaminergic pathway and blocking of striatal dopamine receptors cause motor deficits in humans and experimental animal models induced by some environmental agents. In addition, neuropsychiatric symptoms such as mood and anxiety disorders, hallucinations, psychosis, cognitive impairment, and dementia are common in PD. These alterations may precede the appearance of motor symptoms and are correlated with neurochemical and structural changes in the brain. This paper reviews the most crucial pathophysiology of neuropsychiatric alterations in PD. It is worth noting that PD patients have global task learning deficits, and cognitive functions are compromised in a way is associated with hypoactivation within the striatum, anterior cingulate cortex, and inferior frontal sulcus regions. An appropriate and extensive neuropsychological screening battery in PD must accurately assess at least five cognitive domains with some tests for each cognitive domain. This neuropsychological screening should consider the pathophysiological and clinical heterogeneity of cognitive dysfunction in PD.

The missing hallmark of health: psychosocial adaptation

“…Mitochondrion-specific autophagy (mitophagy) involves several genes/proteins that mark dysfunctional mitochondria for autophagic destruction and hence serve as “autophagy adaptors” – such as PARK and PINK – that are mutated in Parkinson's disease patients [ 120 ]. Of note, Parkinson's disease is not limited to motor deficits, but is usually preceded and accompanied by neuropsychiatric alterations and cognitive impairment [ 121 ]. Disrupted-in-SCZ-1 (DISC1) – the mutation of which causes behavioral abnormalities – has been identified as a mitophagy receptor [ 122 ].…”

Tiny Carriers, Tremendous Hope: Nanomedicine in the Fight against Parkinson’s

“…The disease is characterized by both motor symptoms (e.g., tremors, slowed movement, muscle rigidity) and non-motor symptoms (e.g., dementia, anxiety, depression), resulting in significant neuronal impairment [3,4]. Current therapy options temporarily alleviate motor symptoms but fail to cure or slow the disease's pathology, largely due to low braintarget-site specificity and significant side effects [5].…”

Sexual Dysfunctions in Females with Parkinson’s Disease: A Cross-Sectional Study with a Psycho-Endocrinological Perspective

“…The relationship between the female gender and pain has been recently confirmed in a large clinical study; indeed, together with affective and autonomic symptoms, motor complications, and younger age, the female gender predicts overall pain severity [ 21 , 22 ]. Regarding PD psychological alterations, the female gender is more susceptible to developing severe, persistent, and episodic anxiety and depression than men [ 23 , 24 , 25 ].…”