Neuropsychiatric aspects of parkinson’s disease

Abstract

Previous studies of the neuropsychiatric aspects of Parkinson"s disease were frequently methodologically inadequate. Small sample sizes, selection bias, lack of diagnostic criteria of Parkinson"s disease, different definitions and assessment of neuropsychiatric symptoms, and lack of control groups seriously questioned the validity of and ability to generalize the results from many studies. During the past decade, however, several of these methodological issues have been addressed. Recent studies have found that mild cognitive impairment is very common, and dementia, depression, and psychotic symptoms develop in a large proportion of patients. Neuropsychiatric symptoms are important determinants of mortality and disease progression, as well as of the patients quality of life and course of disease, caregiver distress, and nursing home admission. Few adequately designed treatment trials have been published, but available evidence suggests that depression and hallucinations may be effectively treated using new antidepressants and atypical antipsychotic agents without worsening of parkinsonism.

Neuropsychiatric Symptoms in Mild Dementia with Lewy Bodies and Alzheimer’s Disease

“…However, the NPI is extremely structured, and training sessions were conducted and found to be high in a study of PD patients [34]. Thus interrater reliability is likely to be high.…”

Beta-Amlyoid 1–42 and Tau-Protein in Cerebrospinal Fluid of Patients with Parkinson’s Disease Dementia

“…The consecutive damage of important limbic structures and neocortical territories at stages 5-6 displays already a final stage of pathological involvement [1] . Clinically a relevant cognitive decline in PD occurs in 20-45% of PD patients after 8-10 years of disease, although the onset of cognitive decline shows a wide range [2][3][4] . Such a cognitive decline precedes an increased mortality and leads to increased caregiver distress [5,6] .…”

Orthostatic hypotension in Parkinson's disease: association with cognitive decline?

“…The cumulative incidence of dementia in PD is up to 80% (Aarsland and Karlsen, 1999), and is characterized by executive and visuospatial dysfunction and impaired attention (Emre, 2003). Predictive clinical factors for incident dementia in PD (PDD) include age, severity of motor disability, postural instabilitygait difficulty phenotype, early dopaminergic psychosis and excessive daytime somnolence (Mortimer et al, 1982;Hietanen and Teravainen, 1988;Ebmeier et al, 1990).…”