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Fan Y, Ma J, Yang D, Li X, Liang K, She Z, Qi X, Shi X, Gu Q, Zheng J, Li D. Clinical findings of hyperechoic substantia nigra in patients with Parkinson's disease. Eur J Neurosci 2024; 59:2702-2714. [PMID: 38469656 DOI: 10.1111/ejn.16308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 01/06/2024] [Accepted: 02/19/2024] [Indexed: 03/13/2024]
Abstract
This study aims to analyse hyperechoic substantia nigra (HSN) characteristics and the correlation of HSN with clinical features and blood biomarkers in patients with Parkinson's disease (PD). Transcranial sonography (TCS) evaluations of the substantia nigra (SN) were performed in 40 healthy controls and 71 patients with PD, including patients with SN hyperechogenicity (SN+) and those with normal SN echogenicity (SN-). Evaluation of motor and non-motor symptoms was assessed by a series of rating scales. The uricase method was used to determine serum uric acid (UA) levels, and enzyme-linked immunosorbent assay (ELISA) was used to measure plasma interleukin (IL)-1β levels. TCS showed 92.50% specificity and 61.97% sensitivity in differentiating PD patients from controls. The area of SN+ contralateral to the side of initial motor symptoms (SNcontra) was larger than that ipsilateral to the side of initial motor symptoms (SNipsi). The PDSN+ group had lower Argentine Hyposmia Rating Scale (AHRS) scores and UA levels than the PDSN- group. Binary logistic regression analysis revealed that AHRS scores and UA levels could be independent predictors for HSN. The larger SN echogenic area (SNL) sizes positively correlated with plasma IL-1β levels in PD patients with SN+. The present study provides further evidence of the potential of SN echogenicity as an imaging biomarker for PD diagnosis. PD patients with HSN have more severe non-motor symptoms of hyposmia. HSN in PD patients is related to the mechanism of abnormal iron metabolism and microglial activation.
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Affiliation(s)
- Yongyan Fan
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Jianjun Ma
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China
| | - Dawei Yang
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Xiaohuan Li
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Keke Liang
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China
| | - Zonghan She
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Xuelin Qi
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Xiaoxue Shi
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China
| | - Qi Gu
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China
| | - Jinhua Zheng
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China
| | - Dongsheng Li
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China
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Ebrahimzadeh E, Dehghani A, Asgarinejad M, Soltanian-Zadeh H. Non-linear processing and reinforcement learning to predict rTMS treatment response in depression. Psychiatry Res Neuroimaging 2024; 337:111764. [PMID: 38043370 DOI: 10.1016/j.pscychresns.2023.111764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 11/05/2023] [Accepted: 11/09/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Forecasting the efficacy of repetitive transcranial magnetic stimulation (rTMS) therapy can lead to substantial time and cost savings by preventing futile treatments. To achieve this objective, we've formulated a machine learning approach aimed at categorizing patients with major depressive disorder (MDD) into two groups: individuals who respond (R) positively to rTMS treatment and those who do not respond (NR). METHODS Preceding the commencement of treatment, we obtained resting-state EEG data from 106 patients diagnosed with MDD, employing 32 electrodes for data collection. These patients then underwent a 7-week course of rTMS therapy, and 54 of them exhibited positive responses to the treatment. Employing Independent Component Analysis (ICA) on the EEG data, we successfully pinpointed relevant brain sources that could potentially serve as markers of neural activity within the dorsolateral prefrontal cortex (DLPFC). These identified sources were further scrutinized to estimate the sources of activity within the sensor domain. Then, we integrated supplementary physiological data and implemented specific criteria to yield more realistic estimations when compared to conventional EEG analysis. In the end, we selected components corresponding to the DLPFC region within the sensor domain. Features were derived from the time-series data of these relevant independent components. To identify the most significant features, we used Reinforcement Learning (RL). In categorizing patients into two groups - R and NR to rTMS treatment - we utilized three distinct classification algorithms including K-Nearest Neighbor (KNN), Support Vector Machine (SVM), and Multilayer Perceptron (MLP). We assessed the performance of these classifiers through a ten-fold cross-validation method. Additionally, we conducted a statistical test to evaluate the discriminative capacity of these features between responders and non-responders, opening the door for further exploration in this field. RESULTS We identified EEG features that can anticipate the response to rTMS treatment. The most robust discriminators included EEG beta power, the sum of bispectrum diagonal elements in the delta and beta frequency bands. When these features were combined into a single vector, the classification of responders and non-responders achieved impressive performance, with an accuracy of 95.28 %, specificity at 94.23 %, sensitivity reaching 96.29 %, and precision standing at 94.54 %, all achieved using SVM. CONCLUSIONS The results of this study suggest that the proposed approach, utilizing power, non-linear, and bispectral features extracted from relevant independent component time-series, has the capability to forecast the treatment outcome of rTMS for MDD patients based solely on a single pre-treatment EEG recording session. The achieved findings demonstrate the superior performance of our method compared to previous techniques.
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Affiliation(s)
- Elias Ebrahimzadeh
- School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran; School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran.
| | - Amin Dehghani
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA
| | | | - Hamid Soltanian-Zadeh
- School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran; School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
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Liang K, Li X, Guo Q, Ma J, Yang H, Fan Y, Yang D, Shi X, She Z, Qi X, Gu Q, Chen S, Zheng J, Li D. Structural changes in the retina and serum HMGB1 levels are associated with decreased cognitive function in patients with Parkinson's disease. Neurobiol Dis 2024; 190:106379. [PMID: 38104911 DOI: 10.1016/j.nbd.2023.106379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/08/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Cognitive impairment is a serious nonmotor symptom in patients with Parkinson's disease (PD). Currently, there are few studies investigating the relationship of serum markers and retinal structural changes with cognitive function in PD. OBJECTIVE To investigate the relationship between retinal structural changes, serum high mobility group box-1 (HMGB1) levels and cognitive function and motor symptoms in PD patients. METHODS Eighty-nine participants, including 47 PD patients and 42 healthy subjects, were enrolled. PD patients were divided into Parkinson's disease with normal cognitive (PD-NC), Parkinson's disease with mild cognitive impairment (PD-MCI), and Parkinson's disease with dementia (PDD) groups. The motor and nonmotor symptoms of PD patients were evaluated with clinical scale. Serum HMGB1 levels were detected by enzyme-linked immunosorbent assay (ELISA), and ganglion cell-inner plexiform layer complex (GCIPL) thickness changes in the macula were quantitatively analyzed by swept source optical coherence tomography (SS-OCT) in all patients. RESULTS Compared with the control group, the macular GCIPL (t = -2.308, P = 0.023) was thinner and serum HMGB1 (z = -2.285, P = 0.022) was increased in PD patients. Macular GCIPL thickness in patients with PD-MCI and PDD were significantly lower than that in PD-NC patients, but there were no significant difference between the PD-MCI and PDD groups. Serum HMGB1 levels in patients with PD-MCI and PDD were significantly higher than those in PD-NC patients, and serum HMGB1 levels in PDD patients were higher than those in PD-MCI patients. Correlation analysis showed that serum HMGB1 levels in PD patients were positively correlated with disease duration, HY stage, UPDRS-I score, UPDRS-III score, and UPDRS total score and negatively correlated with MOCA score. Macular GCIPL thickness was negatively correlated with HY stage and positively correlated with MOCA score, and macular GCIPL thickness was negatively correlated with serum HMGB1 level. Logistic regression analysis showed that elevated serum HMGB1 level, thinner macular GCIPL thickness, and higher HY stage were independent risk factors for Parkinson's disease with cognitive impairment (PD-CI). The areas under the receiver operating characteristic curve (AUC) for the serum HMGB1 level and macular GCIPL thickness-based diagnosis of PD-MCI, PDD and PD-CI based on in patients with PD were 0.786 and 0.825, 0.915 and 0.856, 0.852 and 0.841, respectively. The AUC for the diagnosis of PD-MCI, PDD and PD-CI with serum HMGB1 level and GCIPL thickness combined were 0.869, 0.967 and 0.916, respectively. CONCLUSION The macular GCIPL thickness and serum HMGB1 level are potential markers of cognitive impairment in PD patients, and their combination can significantly improve the accuracy of the diagnosis of cognitive impairment in PD.
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Affiliation(s)
- Keke Liang
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Xiaohuan Li
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Qingge Guo
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, Zhengzhou, China
| | - Jianjun Ma
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China.
| | - Hongqi Yang
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China.
| | - Yongyan Fan
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Dawei Yang
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Xiaoxue Shi
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Zonghan She
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Xuelin Qi
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Qi Gu
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Siyuan Chen
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Jinhua Zheng
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Dongsheng Li
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
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Jiang G, Sheng C, Yan L, Wang Z, Wang Q, Chen R, Zhao Y. Increased Serum S100β Concentration is Associated with Depression in Parkinson's Disease. Neuropsychiatr Dis Treat 2023; 19:1865-1873. [PMID: 37663392 PMCID: PMC10473424 DOI: 10.2147/ndt.s423312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/14/2023] [Indexed: 09/05/2023] Open
Abstract
Purpose To explore the relationship between the serum level of S100 calcium-binding protein, beta chain (S100β) and Parkinson's disease (PD) with depression. Patients and Methods A total of 145 patients with PD and 60 healthy controls matched for sex, age, and years of education in our hospital were selected. Fluorescence quantitative immunochromatography was used to quantify the level of S100β in serum. Clinical manifestations were assessed by Unified Parkinson's Disease Rating Scale part-III (UPDRS-III), Hoehn & Yahr (H-Y) stage and 17-item Hamilton Rating Scale for Depression (HAMD-17). According to the results of HAMD-17, PD patients were divided into PD with depression group and PD without depression group. The relationship between serum S100β and HAMD-17 scores in PD patients with depression was investigated through correlation analysis and multivariate regression analysis, and receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of serum S100β. Results The level of serum S100β in PD with depression group was significantly higher than that in PD without depression group and control group. In PD patients with depression, serum S100β level was positively correlated with UPDRS-III score, H-Y Scale and HAMD-17 score. The HAMD-17 score was positively correlated with the UPDRS-III and H-Y scales, and the increase in the HAMD-17 score was associated with women. Elevated serum S100β level and UPDRS-III score are independent risk factors for PD with depression. Analysis of receiver operating characteristic (ROC) curves showed that the serum S100β level with a cutoff of 0.28 ng/mL distinguished patients with PD with or without depression with an area under the ROC curve (AUC) of 0.742, sensitivity of 0.696, and specificity of 0.779. Conclusion The serum S100β level could be a biomarker of PD with depression.
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Affiliation(s)
- Guanghui Jiang
- Department of Neurology, The Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, People’s Republic of China
| | - Cuicui Sheng
- Department of Neurology, The Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, People’s Republic of China
| | - Luxia Yan
- Department of Neurology, The Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, People’s Republic of China
| | - Zipeng Wang
- Department of Neurology, The Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, People’s Republic of China
| | - Qing Wang
- Department of Neurology, The Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, People’s Republic of China
| | - Rui Chen
- Department of Neurology, The Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, People’s Republic of China
| | - Ying Zhao
- Department of Neurology, The Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, People’s Republic of China
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5
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Payne T, Appleby M, Buckley E, van Gelder LM, Mullish BH, Sassani M, Dunning MJ, Hernandez D, Scholz S, McNeil A, Libri V, Moll S, Marchesi JR, Taylor R, Su L, Mazzà C, Jenkins TM, Foltynie T, Bandmann O. A Double-Blind, Randomized, Placebo-Controlled Trial of Ursodeoxycholic Acid (UDCA) in Parkinson's Disease. Mov Disord 2023; 38:1493-1502. [PMID: 37246815 PMCID: PMC10527073 DOI: 10.1002/mds.29450] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/01/2023] [Accepted: 05/03/2023] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Rescue of mitochondrial function is a promising neuroprotective strategy for Parkinson's disease (PD). Ursodeoxycholic acid (UDCA) has shown considerable promise as a mitochondrial rescue agent across a range of preclinical in vitro and in vivo models of PD. OBJECTIVES To investigate the safety and tolerability of high-dose UDCA in PD and determine midbrain target engagement. METHODS The UP (UDCA in PD) study was a phase II, randomized, double-blind, placebo-controlled trial of UDCA (30 mg/kg daily, 2:1 randomization UDCA vs. placebo) in 30 participants with PD for 48 weeks. The primary outcome was safety and tolerability. Secondary outcomes included 31-phosphorus magnetic resonance spectroscopy (31 P-MRS) to explore target engagement of UDCA in PD midbrain and assessment of motor progression, applying both the Movement Disorder Society Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS-III) and objective, motion sensor-based quantification of gait impairment. RESULTS UDCA was safe and well tolerated, and only mild transient gastrointestinal adverse events were more frequent in the UDCA treatment group. Midbrain 31 P-MRS demonstrated an increase in both Gibbs free energy and inorganic phosphate levels in the UDCA treatment group compared to placebo, reflecting improved ATP hydrolysis. Sensor-based gait analysis indicated a possible improvement of cadence (steps per minute) and other gait parameters in the UDCA group compared to placebo. In contrast, subjective assessment applying the MDS-UPDRS-III failed to detect a difference between treatment groups. CONCLUSIONS High-dose UDCA is safe and well tolerated in early PD. Larger trials are needed to further evaluate the disease-modifying effect of UDCA in PD. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Thomas Payne
- Sheffield Institute for Translational Neuroscience,
University of Sheffield, Sheffield, S10 2HQ, United Kingdom
| | - Matthew Appleby
- NIHR UCLH Clinical Research Facility – Leonard
Wolfson Experimental Neurology Centre, National Hospital for Neurology &
Neurosurgery, London, WC1N 3BG, United Kingdom
- Department of Clinical and Movement Neurosciences,
Institute of Neurology, University College London, London, WC1N 3BG, United
Kingdom
| | - Ellen Buckley
- Department of Mechanical Engineering and Insigneo Institute
for In Silico Medicine, The University of Sheffield, Sheffield, S1 3JD, United
Kingdom
| | - Linda M.A. van Gelder
- Department of Mechanical Engineering and Insigneo Institute
for In Silico Medicine, The University of Sheffield, Sheffield, S1 3JD, United
Kingdom
| | - Benjamin H. Mullish
- Division of Digestive Diseases, Department of Metabolism,
Digestion and Reproduction, St Mary’s Hospital Campus, Imperial College
London, London, W2 1NY, United Kingdom
| | - Matilde Sassani
- Sheffield Institute for Translational Neuroscience,
University of Sheffield, Sheffield, S10 2HQ, United Kingdom
| | - Mark J. Dunning
- Sheffield Institute for Translational Neuroscience,
University of Sheffield, Sheffield, S10 2HQ, United Kingdom
- The Bioinformatics Core, Sheffield Institute of
Translational Neuroscience, University of Sheffield, Sheffield, S10 2HQ, United
Kingdom
| | - Dena Hernandez
- Molecular Genetics Section, Laboratory of Neurogenetics,
NIA, NIH, Bethesda, Maryland, MD 20814, USA
| | - Sonja Scholz
- Neurodegenerative Diseases Research Unit, Laboratory of
Neurogenetics, National Institute of Neurological Disorders and Stroke, National
Institutes of Health, Bethesda, Maryland, MD 20814, USA
- Department of Neurology, Johns Hopkins University Medical
Center, Baltimore, Maryland, MD 21287, USA
| | - Alisdair McNeil
- Sheffield Institute for Translational Neuroscience,
University of Sheffield, Sheffield, S10 2HQ, United Kingdom
| | - Vincenzo Libri
- NIHR UCLH Clinical Research Facility – Leonard
Wolfson Experimental Neurology Centre, National Hospital for Neurology &
Neurosurgery, London, WC1N 3BG, United Kingdom
| | - Sarah Moll
- NIHR Sheffield Biomedical Research Centre, Royal
Hallamshire Hospital, Sheffield, S10 2JF United Kingdom
| | - Julian R. Marchesi
- Division of Digestive Diseases, Department of Metabolism,
Digestion and Reproduction, St Mary’s Hospital Campus, Imperial College
London, London, W2 1NY, United Kingdom
| | - Rosie Taylor
- Statistical Services Unit, The University of Sheffield,
Sheffield, S3 7RH, United Kingdom
| | - Li Su
- Sheffield Institute for Translational Neuroscience,
University of Sheffield, Sheffield, S10 2HQ, United Kingdom
- Department of Psychiatry, University of Cambridge, CB2
0SP United Kingdom
| | - Claudia Mazzà
- Department of Mechanical Engineering and Insigneo Institute
for In Silico Medicine, The University of Sheffield, Sheffield, S1 3JD, United
Kingdom
| | - Thomas M. Jenkins
- Sheffield Institute for Translational Neuroscience,
University of Sheffield, Sheffield, S10 2HQ, United Kingdom
- Royal Perth Hospital, Victoria Square, Perth, WA 6000,
Australia
| | - Thomas Foltynie
- Department of Clinical and Movement Neurosciences,
Institute of Neurology, University College London, London, WC1N 3BG, United
Kingdom
| | - Oliver Bandmann
- Sheffield Institute for Translational Neuroscience,
University of Sheffield, Sheffield, S10 2HQ, United Kingdom
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Su D, Zhang X, Su Y, Chan P, Xu E. Effects of different levodopa doses on blood pressure in older patients with early and middle stages of Parkinson's disease. Heliyon 2023; 9:e17876. [PMID: 37483692 PMCID: PMC10362309 DOI: 10.1016/j.heliyon.2023.e17876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 05/03/2023] [Accepted: 06/29/2023] [Indexed: 07/25/2023] Open
Abstract
Objective Levodopa is the first-line treatment for patients with Parkinson's disease (PD). However, only a few studies have focused on the tolerance of this drug in older patients with PD in the early and middle stages. Therefore, this study aimed to explore the effects of different levodopa doses on blood pressure (BP) in this subpopulation. Methods This cohort analysis enrolled 83 patients. The levodopa challenge test was used to evaluate drug responsiveness. After at least 12 h following anti-PD drug discontinuation, patients' BPs were measured in a lying position, after 1 min standing, and after 3 min standing, in "off state" and best "on state." Results BP in the 250 mg and 375 mg levodopa/benserazide groups decreased significantly in the lying and standing positions. The 3-min standing-position systolic BP was significantly influenced by the dose of levodopa/benserazide. However, no statistical change was observed in the 125 mg group. The postural-mediated systolic BP disparity was significant at 3 min in the upright position. Nineteen (incidence, 22.9%) and Twenty-five patients (incidence, 30.1%) developed complications of orthostatic hypotension (OH) in the "off state" and best "on state," respectively. Mild cognitive impairment was a risk factor for OH occurrence in the "off state." The OH occurrence in the best "on state" was associated with OH in the "off state" and urinary incontinence. Conclusion Our findings suggest that 250 mg or more of levodopa/benserazide could significantly reduce BP and orthostatic effect in older patients with PD in the early and middle stages. Therefore, they should routinely monitor their BP. Trial registration number ChiCTR2200055707.
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Affiliation(s)
- Dan Su
- Department of Geriatrics, Liangxiang Hospital of Beijing Fangshan District, Beijing 102400, China
- National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
| | - Xiaojun Zhang
- Department of Geriatrics, Occupational Disease Prevention and Control Institute of Chemical Industry, Beijing 100093, China
| | - Yanling Su
- Department of Geriatrics, Liangxiang Hospital of Beijing Fangshan District, Beijing 102400, China
| | - Piu Chan
- National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
- Clinical Center for Parkinson's Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders, Beijing 100053, China
| | - Erhe Xu
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
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Pu Z, Wen H, Jiang H, Hou Q, Yan H. Berberine improves negative symptoms and cognitive function in patients with chronic schizophrenia via anti-inflammatory effect: a randomized clinical trial. Chin Med 2023; 18:41. [PMID: 37069570 PMCID: PMC10108529 DOI: 10.1186/s13020-023-00746-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 04/04/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Based on the neuroinflammation hypothesis in schizophrenia and known anti-inflammatory effects of berberine, the aim of the present study is to investigate the efficacy of berberine in treating negative symptoms and cognitive deficits in adult patients with chronic schizophrenia. METHODS Enrolled participants were randomized to receive berberine or placebo for 3 months. The Scale for the Assessment of Negative Symptoms (SANS), Trail-making Test A (TMT-A), Trail-making Test B (TMT-B), and Hopkins Verbal Learning Test (HVLT) were used to evaluate the negative symptoms and cognitive function at four-time points (baseline, 1st, 2nd, and 3rd month). Serum levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were used as inflammatory markers. 106 patients with per-protocol were analyzed, 56 in the experimental (berberine) group and 50 in the control (placebo) group. RESULTS From baseline to month 3, patients receiving berberine demonstrated a decrease in total scores on clinical scales SANS, TMT-A and TMT-B and showed a serum level reduction of IL-1β, IL-6 and TNF-α comparing with patients in the control group (P < 0.05). There were positive correlations between the change of serum IL-1β level and the change of SANS (r = 0.210, P = 0.039), TMT-A (r = 0.522, P < 0.001), and TMT-B (r = 0.811, P < 0.001); between the change of serum IL-6 level and the change of TMT-A (r = 0.562, P < 0.001), and TMT-B (r = 0.664, P < 0.001); between the change of serum TNF-α level and the change of TMT-B (r = 0.472, P < 0.001) after berberine treatment. CONCLUSIONS Berberine is an anti-inflammatory agent that can potentially mitigate the negative symptoms and cognitive deficits in patients with schizophrenia.
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Affiliation(s)
- Zhengping Pu
- Department of Psychiatry, Kangci Hospital of Jiaxing, No. 3118 Huancheng North Road, Tongxiang, 314500, Zhejiang, China
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Minhang, Shanghai, 201108, China
| | - Hui Wen
- Department of Traditional Chinese Medicine, Second People's Hospital of Tongxiang, Tongxiang, 314500, Zhejiang, China
| | - Hongxia Jiang
- Department of Psychiatry, Kangci Hospital of Jiaxing, No. 3118 Huancheng North Road, Tongxiang, 314500, Zhejiang, China.
| | - Qingmei Hou
- Department of Clinical Psychology, The Second Specialized Hospital of Hegang, Hegang, 154102, Heilongjiang, China
| | - Hui Yan
- Department of Psychiatry, Second People's Hospital of Taizhou, Taizhou, 317200, Zhejiang, China
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Ahmad MH, Rizvi MA, Ali M, Mondal AC. Neurobiology of depression in Parkinson's disease: Insights into epidemiology, molecular mechanisms and treatment strategies. Ageing Res Rev 2023; 85:101840. [PMID: 36603690 DOI: 10.1016/j.arr.2022.101840] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 12/25/2022] [Accepted: 12/31/2022] [Indexed: 01/03/2023]
Abstract
Parkinson's disease (PD) is characterized mainly by motor dysfunctions due to the progressive loss of dopaminergic neurons. However, PD patients experience a multitude of debilitating non-motor symptoms, including depression, which may have deleteriously detrimental effects on life. Depression is multifactorial and exhibits a bimodal progression in PD, but its underlying molecular mechanisms are poorly understood. Studies demonstrating the pathophysiology of depression in PD and the specific treatment strategies for depression-like symptoms in PD patients are largely lacking, often underrated, under-recognized and, consequently, inadequately/under-treated. Nevertheless, reports suggest that the incidence of depression is approximately 20-30% of PD patients and may precede the onset of motor symptoms. Diagnosing depression in PD becomes difficult due to the clinical overlap in symptomatology between the two diseases, and the nigrostriatal dysfunction alone is insufficient to explain depressive symptoms in PD. Therefore, the current study provides an overview of the molecular mechanisms underlying the development of depression in PD and new insights into developing current antidepressant strategies to treat depression in PD. This review will identify and understand the molecular pathological mechanisms of depression in PD that will fundamentally help tailoring therapeutic interventions for depressive symptoms in PD.
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Affiliation(s)
- Mir Hilal Ahmad
- Laboratory of Cellular and Molecular Neurobiology, School of Life Sciences, Jawaharlal Nehru University, New Delhi 110067, India; Genome Biology Lab, Department of Biosciences, Jamia Millia Islamia, New Delhi 110025, India
| | - Moshahid Alam Rizvi
- Genome Biology Lab, Department of Biosciences, Jamia Millia Islamia, New Delhi 110025, India
| | - Mansoor Ali
- Cancer Biology Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi 110067, India
| | - Amal Chandra Mondal
- Laboratory of Cellular and Molecular Neurobiology, School of Life Sciences, Jawaharlal Nehru University, New Delhi 110067, India.
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9
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Mameli F, Ruggiero F, Dini M, Marceglia S, Prenassi M, Borellini L, Cogiamanian F, Pirola E, Remore LG, Fiore G, Reitano MR, Maiorana N, Poletti B, Locatelli M, Barbieri S, Priori A, Ferrucci R. Energy Delivered by Subthalamic Deep Brain Stimulation for Parkinson Disease Correlates With Depressive Personality Trait Shift. Neuromodulation 2023; 26:394-402. [PMID: 35221204 DOI: 10.1016/j.neurom.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/09/2021] [Accepted: 01/07/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Despite the large amount of literature examining the potential influence of subthalamic nucleus deep brain stimulation (STN-DBS) on psychiatric symptoms and cognitive disorders, only a few studies have focused on its effect on personality. We investigated the correlation between total electrical energy delivered (TEED) and the occurrence of depressive traits in patients with Parkinson disease (PD) after one year of DBS. MATERIALS AND METHODS Our study involved 20 patients with PD (12 women, mean [±SD] age 57.60 ± 7.63 years) who underwent bilateral STN-DBS, whose personality characteristics were assessed using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), according to the core assessment program for surgical interventional therapies in Parkinson's disease (CAPSIT-PD) procedure. RESULTS We found that despite a marked improvement in motor functions and quality of life after 12 months, patients showed a significant increase in MMPI-2 subscales for depression (D scale and Depression scale) and in other content component scales (low self-esteem, work interference, and negative treatment indicators). Interestingly, only the TEED on the right side was inversely correlated with the changes in scale D (rs = -0.681, p = 0.007), whereas depressive traits did not correlate with disease duration, levodopa equivalent daily dose (LEDD) reduction, patient's age, or severity of motor symptoms. CONCLUSIONS Our preliminary observations indicate that despite the excellent motor outcome and general improvement in quality of life, DBS treatment can result in patients poorly adjusting to their personal, familiar, and socio-professional life. Different influences and multiple factors (such as TEED, intra/postsurgical procedure, coping mechanisms, and outcome expectations) may affect depressive traits. Further advances are expected to improve stimulation methods.
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Affiliation(s)
- Francesca Mameli
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neuroscience and Mental Health, Milan, Italy
| | - Fabiana Ruggiero
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neuroscience and Mental Health, Milan, Italy
| | - Michelangelo Dini
- "Aldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy
| | - Sara Marceglia
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Marco Prenassi
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Linda Borellini
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neuroscience and Mental Health, Milan, Italy
| | - Filippo Cogiamanian
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neuroscience and Mental Health, Milan, Italy
| | - Elena Pirola
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neuroscience and Mental Health, Milan, Italy
| | - Luigi Gianmaria Remore
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neuroscience and Mental Health, Milan, Italy
| | - Giorgio Fiore
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neuroscience and Mental Health, Milan, Italy
| | - Maria Rita Reitano
- Neurology Unit I, San Paolo University Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Natale Maiorana
- "Aldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy
| | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Marco Locatelli
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neuroscience and Mental Health, Milan, Italy
| | - Sergio Barbieri
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neuroscience and Mental Health, Milan, Italy
| | - Alberto Priori
- "Aldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy; Neurology Unit I, San Paolo University Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Roberta Ferrucci
- "Aldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy; Neurology Unit I, San Paolo University Hospital, ASST Santi Paolo e Carlo, Milan, Italy.
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10
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Koszycki D, Taljaard M, Kogan C, Bradwejn J, Grimes D. Interpersonal Psychotherapy for Depression in Parkinson's Disease: A Feasibility Study. J Geriatr Psychiatry Neurol 2023; 36:52-62. [PMID: 35446178 PMCID: PMC9755694 DOI: 10.1177/08919887221090220] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Individuals living with Parkinson's disease (PD) experience interpersonal stressors that contribute to depressive risk. Interpersonal psychotherapy (IPT) emphasizes the bidirectional relationship between interpersonal stressors and mood may therefore be a suitable treatment for PD-depression. The primary aim of this study was to evaluate the feasibility of delivering 12 sessions of IPT to depressed PD patients and explore the need for modifications. A secondary aim was to obtain descriptive information about efficacy outcomes. The study used a pre-post design without a comparison group. Participants were 12 PD patients with a major depressive disorder. IPT was well accepted and tolerated by patients and required minimal modifications. Compliance with session attendance and completion of study questionnaires were excellent and treatment satisfaction was high. Depression scores declined from baseline to endpoint, with 7 patients meeting criteria for remission at endpoint. Findings are encouraging and a larger randomized controlled trial is currently underway to ascertain if IPT is an efficacious treatment for PD-depression.
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Affiliation(s)
- Diana Koszycki
- University of Ottawa, Ottawa, ON, Canada,Institut du savoir Montfort, Montfort Hospital, Ottawa, ON, Canada,University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada,Diana Koszycki, PhD, University of Ottawa, 145 Jean-Jacques Lussier Ottawa, ON K1N 6N5, Canada.
| | - Monica Taljaard
- University of Ottawa, Ottawa, ON, Canada,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Cary Kogan
- University of Ottawa, Ottawa, ON, Canada
| | - Jacques Bradwejn
- University of Ottawa, Ottawa, ON, Canada,Institut du savoir Montfort, Montfort Hospital, Ottawa, ON, Canada,Université de Montreal, QC, Canada
| | - David Grimes
- University of Ottawa, Ottawa, ON, Canada,University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada,Ottawa Hospital Research Institute, Ottawa, ON, Canada
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11
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Neural correlates of emotional reactivity predict response to cognitive-behavioral therapy in obsessive-compulsive disorder. J Affect Disord 2022; 308:398-406. [PMID: 35427712 DOI: 10.1016/j.jad.2022.04.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Examining predictive biomarkers to identify individuals who will likely benefit from a specific treatment is important for the development of targeted interventions. The late positive potential (LPP) is a neural marker of attention and elaborated stimulus processing, and increased LPP responses to negative stimuli are characteristic of pathological anxiety. The present study investigated whether LPP reactivity would prospectively predict response to cognitive-behavioral therapy (CBT), the first-line treatment for obsessive-compulsive disorder (OCD). METHODS To this end, the LPP in response to negative as compared to neutral pictures was examined in 45 patients with OCD, who underwent CBT in a naturalistic outpatient setting. LPP amplitudes were used as predictors of symptom reduction after CBT. RESULTS We found that higher LPP amplitudes to negative relative to neutral stimuli were predictive of lower self-reported OCD symptoms after completion of CBT, controlling for pre-treatment symptoms. Further, LPP reactivity was negatively correlated with self-reported habitual use of suppression in everyday life. LIMITATIONS Some participants had already begun treatment at the time of study participation. Overall, results need further replication in larger samples and standardized therapy settings. CONCLUSIONS The current findings suggest that patients with increased emotional reactivity benefit more from CBT, possibly through less avoidance of anxiety-provoking stimuli during exposure with response prevention, a crucial component in CBT for OCD. Although its clinical utility still needs to be evaluated further, the LPP constitutes a promising candidate as a prognostic marker for CBT response in OCD.
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12
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Levin JB, Moore DJ, Depp C, Montoya JL, Briggs F, Rahman M, Stange KC, Einstadter D, Weise C, Conroy C, Yala J, Radatz E, Sajatovic M. Using mHealth to improve adherence and reduce blood pressure in individuals with hypertension and bipolar disorder (iTAB-CV): study protocol for a 2-stage randomized clinical trial. Trials 2022; 23:539. [PMID: 35768875 PMCID: PMC9244195 DOI: 10.1186/s13063-022-06449-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 06/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiovascular disease in individuals with mental health conditions such as bipolar disorder is highly prevalent and often poorly managed. Individuals with bipolar disorder face significant medication adherence barriers, especially when they are prescribed multiple medications for other health conditions including hypertension. Poor adherence puts them at a disproportionate risk for poor health outcomes. As such, there is a need for effective interventions to improve hypertension medication adherence, particularly in patients that struggle with adherence due to mental health comorbidity. METHODS This 5-year project uses a 2-stage randomized controlled trial design to evaluate a brief, practical adherence intervention delivered via interactive text messaging (iTAB-CV) along with self-monitoring of medication taking, mood, and home blood pressure (N = 100) compared to self-monitoring alone (N = 100). Prior to randomization, all participants will view an educational video that emphasizes the importance of medication for the treatment of hypertension and bipolar disorder. Those randomized to the texting intervention will receive daily text messages with predetermined content to address 11 salient domains as well as targeted customized messages for 2 months. This group will then be re-randomized to receive either a high (gradual taper from daily to weekly texts) or low booster (weekly texts) phase for an additional 2 months. All participants will be monitored for 52 weeks. The primary outcomes are systolic blood pressure and adherence to antihypertensive medication as determined by a self-reported questionnaire and validated with an automated pill-monitoring device. Secondary outcomes include adherence to bipolar disorder medications, psychiatric symptoms, health status, self-efficacy for medication-taking behavior, illness beliefs, medication attitudes, and habit strength. DISCUSSION This study specifically targets blood pressure and mental health symptom control in people with bipolar and includes implementation elements in the study design intended to inform future scale-up. Promising pilot data and a theoretical model, which views sustained medication-taking behavior in the context of habit formation, suggests that this remotely delivered intervention may help advance care for this high-risk population and is amenable to both scale up and easy adaptation for other groups with poor medication adherence. TRIAL REGISTRATION The study was registered at ClinicalTrials.gov ( NCT04675593 ) on December 19, 2020.
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Affiliation(s)
- Jennifer B Levin
- Department of Psychiatry, Case Western Reserve University School of Medicine, 10524 Euclid Ave. 7th floor, Cleveland, OH, 44106, USA. .,Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA. .,Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
| | - David J Moore
- HIV Neurobehavioral Research Program (HNRP), Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Colin Depp
- HIV Neurobehavioral Research Program (HNRP), Department of Psychiatry, University of California San Diego, San Diego, CA, USA.,Stein Institute for Research on Aging, Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Jessica L Montoya
- HIV Neurobehavioral Research Program (HNRP), Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Farren Briggs
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Mahboob Rahman
- Division of Nephrology and Hypertension, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Kurt C Stange
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Department of Family Medicine and Community Health, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Center for Community Health Integration, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Douglas Einstadter
- Center for Health Care Research and Policy, MetroHealth Medical Center, Cleveland, OH, USA.,Department of Medicine, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Celeste Weise
- Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Carla Conroy
- Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Joy Yala
- Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Ethan Radatz
- Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Martha Sajatovic
- Department of Psychiatry, Case Western Reserve University School of Medicine, 10524 Euclid Ave. 7th floor, Cleveland, OH, 44106, USA.,Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.,Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA
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13
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Wen QH, Liu Y, Chen HD, Wu JL, Liang LJ, He WZ, Wang Y, Huang GP. Relationship Between Depression After Hemorrhagic Stroke and Auditory Event-Related Potentials in a Chinese Patient Group. Neuropsychiatr Dis Treat 2022; 18:1917-1925. [PMID: 36065387 PMCID: PMC9440680 DOI: 10.2147/ndt.s362824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/08/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Post-stroke depression (PSD) is the most common psychiatric sequelae of stroke. Numerous studies revealed that event-related potentials (ERP) can reflect depression severity to a certain extent, while there is almost no research on depression after hemorrhagic stroke. Therefore, we employed a prospective cross-sectional study to explore the relationship between ERP and depression after hemorrhagic stroke. METHODS A total of 74 patients with intracranial hemorrhage were included in this study. Neurological deficits were evaluated using the National Institutes of Health Stroke Scale (NIHSS) on admission. Depression severity and cognitive impairment were measured using the 17-item Hamilton Depression Scale (HAMD-17) and the Chinese version of the Montreal Cognitive Assessment (MoCA) after two weeks of treatment. All patients were conducted auditory Oddball paradigm for event-related potential mismatch negativity (MMN) and P300. RESULTS In total, 36 patients were diagnosed with PSD at the two weeks of treatment, for a percentage of 48.6%. Depression severity of ICH patients correlated positively with both the latency of MMN (r = 0.376, P = 0.001) and P300 (r = 0.325, P = 0.005), and correlated negatively with both the amplitude of MMN (r=-0.385, P = 0.001) and P300 (r=-0.311, P = 0.007). Depression severity was negatively correlated with cognitive function after hemorrhagic stroke (r=-0.347, P = 0.002). CONCLUSION The latency and amplitude of MMN and P300 can well reflect the degree of depression after hemorrhagic stroke, which may help in the early diagnosis and effective treatment of PSD.
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Affiliation(s)
- Qian-Hui Wen
- Department of Neurosurgery, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, People's Republic of China.,Faculty of Psychiatry and Mental Health, North Sichuan Medical College, Nanchong, People's Republic of China
| | - Yang Liu
- Department of Neurosurgery, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, People's Republic of China
| | - Hu-Dan Chen
- Department of Psychiatry, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, People's Republic of China
| | - Jun-Lin Wu
- Department of Psychiatry, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, People's Republic of China
| | - Li-Jun Liang
- Faculty of Psychiatry and Mental Health, North Sichuan Medical College, Nanchong, People's Republic of China
| | - Wen-Zhi He
- Faculty of Psychiatry and Mental Health, North Sichuan Medical College, Nanchong, People's Republic of China
| | - Yao Wang
- Faculty of Psychiatry and Mental Health, North Sichuan Medical College, Nanchong, People's Republic of China
| | - Guo-Ping Huang
- Department of Neurosurgery, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, People's Republic of China.,Faculty of Psychiatry and Mental Health, North Sichuan Medical College, Nanchong, People's Republic of China
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14
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Ge YL, Gong SY, Wang PZ, Yan JH, Li W, Zhang JR, Jin H, Zhuang S, Hu L, Ding CW, Yang YP, Wang F, Li D, Chen J, Mao CJ, Zhang YC, Li K, Liu CF. Cognitive Performance is Associated with Altered Cerebral Hemodynamics Assessed by Transcranial Ultrasound in Parkinson's Disease. Neuropsychiatr Dis Treat 2022; 18:1421-1431. [PMID: 35855751 PMCID: PMC9288215 DOI: 10.2147/ndt.s358150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 05/18/2022] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Cognitive impairment (CI) is a common but debilitating non-motor symptom in Parkinson's disease (PD). Although cerebrovascular functions are related to cognitive performance in healthy individuals, such a relation in PD remains elusive. This study aims to assess the association between cerebrovascular function and cognitive performance in PD individuals. PATIENTS AND METHODS Two-hundred-and-one PD individuals were retrospectively included. They were subsequently divided into two groups: PD with normal cognition (PD-NC) and PD with CI (PD-CI). Cerebral hemodynamic characteristics of the middle cerebral arteries were assessed by transcranial ultrasound. The association between scores in each cognitive domain and cerebral hemodynamic parameters was further analyzed using regression analyses. Additionally, a binary logistic regression model with backward stepwise procedure was applied to build the model for discriminating CI in PD individuals. An independent dataset of additional 46 PD individuals was used further. RESULTS The PD-CI group showed a relatively lower end-diastolic blood flow velocity (EDV, p < 0.05) and a higher resistive index (RI, p < 0.05) compared to the PD-NC group. RI showed significant associations with the memory item score of Montreal Cognitive Assessment (p < 0.05). A model combining clinical and hemodynamic variables was established with optimal efficiency (area under the curve, AUC = 0.651). Further replication of the model in an independent dataset yielded a great consistency (AUC = 0.704). CONCLUSION In our study, cerebrovascular functions were significantly associated with the cognitive performance in PD individuals, especially with the memory task. The established model was effective in identifying CI in PD individuals, which might be a potentially useful tool to screen the cognitive decline in PD individuals at an early stage of the disease. Further studies with larger sample sizes in different populations are warranted.
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Affiliation(s)
- Yi-Lun Ge
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Si-Yi Gong
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Pu-Zhi Wang
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Jia-Hui Yan
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Wen Li
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Jin-Ru Zhang
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Hong Jin
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Sheng Zhuang
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Lei Hu
- Department of Ultrasound, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Chang-Wei Ding
- Department of Ultrasound, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Ya-Ping Yang
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Fen Wang
- Institute of Neuroscience, Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Dan Li
- Department of Neurology, Suqian First Hospital, Suqian, People's Republic of China
| | - Jing Chen
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Cheng-Jie Mao
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China.,Department of Neurology, Suqian First Hospital, Suqian, People's Republic of China
| | - Ying-Chun Zhang
- Department of Ultrasound, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Kai Li
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Chun-Feng Liu
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China.,Institute of Neuroscience, Soochow University, Suzhou, Jiangsu, People's Republic of China.,Department of Neurology, Suqian First Hospital, Suqian, People's Republic of China
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15
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Xiao-ling Q, Yin-zhen D, Xue-kui L, Xue L, Gang C, Zai-li L, Dian-shuai G. Gender Was Associated with Depression but Not with Gastrointestinal Dysfunction in Patients with Parkinson's Disease. PARKINSON'S DISEASE 2021; 2021:3118948. [PMID: 34976368 PMCID: PMC8716198 DOI: 10.1155/2021/3118948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/29/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To investigate the association between gender and gastrointestinal (GI) dysfunctions, as well as gender and other motor symptoms/nonmotor symptoms, in a sample of PD patients. METHODS 186 patients with PD were recruited into this study and divided into male PD group (M-PD) and female PD group (FM-PD). Demographic and PD-related clinical information of the participants were collected by the same neurologist. PD patients were objectively assessed by a spectrum of rating scales of motor symptoms and nonmotor symptoms (including GI dysfunctions). The data were analyzed by SPSS 20 statistical software. RESULTS Totally 95 cases (51.08%) were in the M-PD group and 91 cases (48.92%) in the FM-PD group. There were no significant differences in age, BMI, and lifestyles between the two groups (P > 0.05). Males had higher educational level (P = 0.002). Females were more likely to have early satiety and loss of appetite (P = 0.025, P = 0.001). There were no significant differences in LED disease duration, age of motor symptoms onset, types of motor symptoms onset, location of motor symptoms onset, and phenotype of motor symptoms between the two groups (P > 0.05). Females had significantly higher UPDRS-III and HAMD scores than males (P = 0.037, P = 0.034). There were no significant differences in PQSI, ESS, RLS, RBD, HAMA, HAMD, and MoCA scores between the two groups. Gender was associated with HAMD (OR = 0.682, P = 0.019). CONCLUSIONS Gender is a risk factor for depression, but not for GI dysfunctions in patients with PD.
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Affiliation(s)
- Qin Xiao-ling
- Department of Geriatrics, Shanghai Fourth People's Hospital, Tongji University School of Medicine, Shanghai 200434, China
| | - Du Yin-zhen
- Xuzhou Key Laboratory of Neurobiology, Department of Neurobiology and Anatomy, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Liu Xue-kui
- Xuzhou Clinical School of Xuzhou Medical University, No. 199 Jiefang Road, Xuzhou 221009, Jiangsu, China
| | - Li Xue
- Xuzhou Key Laboratory of Neurobiology, Department of Neurobiology and Anatomy, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Cheng Gang
- Xuzhou Key Laboratory of Neurobiology, Department of Neurobiology and Anatomy, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Li Zai-li
- Xuzhou Clinical School of Xuzhou Medical University, No. 199 Jiefang Road, Xuzhou 221009, Jiangsu, China
| | - Gao Dian-shuai
- Xuzhou Key Laboratory of Neurobiology, Department of Neurobiology and Anatomy, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
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16
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Dan X, Hu Y, Sun J, Gao L, Zhou Y, Ma J, Doyon J, Wu T, Chan P. Altered Cerebellar Resting-State Functional Connectivity in Early-Stage Parkinson's Disease Patients With Cognitive Impairment. Front Neurol 2021; 12:678013. [PMID: 34512503 PMCID: PMC8425347 DOI: 10.3389/fneur.2021.678013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/30/2021] [Indexed: 01/01/2023] Open
Abstract
Background: Cognitive impairment is one of the most prominent non-motor symptoms in Parkinson's disease (PD), due in part to known cerebellar dysfunctions. Furthermore, previous studies have reported altered cerebellar functional connectivity (FC) in PD patients. Yet whether these changes are also due to the cognitive deficits in PD remain unclear. Methods: A total of 122 non-dementia participants, including 64 patients with early PD and 58 age- and gender-matched elderly controls were stratified into four groups based on their cognitive status (normal cognition vs. cognitive impairment). Cerebellar volumetry and FC were investigated by analyzing, respectively, structural and resting-state functional MRI data among groups using quality control and quantitative measures. Correlation analysis between MRI metrics and clinical features (motor and cognitive scores) were performed. Results: Compared to healthy control subjects with no cognitive deficits, altered cerebellar FC were observed in early PD participants with both motor and cognitive deficits, but not in PD patients with normal cognition, nor elderly subjects showing signs of a cognitive impairment. Moreover, connectivity between the "motor" cerebellum and SMA was positively correlated with motor scores, while intracerebellar connectivity was positively correlated with cognitive scores in PD patients with cognitive impairment. No cerebellar volumetric difference was observed between groups. Conclusions: These findings show that altered cerebellar FC during resting state in early PD patients may be driven not solely by the motor deficits, but by cognitive deficits as well, hence highlighting the interplay between motor and cognitive functioning, and possibly reflecting compensatory mechanisms, in the early PD.
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Affiliation(s)
- Xiaojuan Dan
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
- Key Laboratory on Neurodegenerative Disorders of Ministry of Education, Key Laboratory on Parkinson's Disease of Beijing, Beijing, China
| | - Yang Hu
- Laboratory of Psychological Health and Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Junyan Sun
- Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Linlin Gao
- Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Yongtao Zhou
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Jinghong Ma
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Julien Doyon
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Tao Wu
- Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Piu Chan
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
- Key Laboratory on Neurodegenerative Disorders of Ministry of Education, Key Laboratory on Parkinson's Disease of Beijing, Beijing, China
- National Clinical Research Center for Geriatric Disorders, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Beijing Institute for Brain Disorders Parkinson's Disease Center, Capital Medical University, Beijing, China
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17
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Knight MJ, Lyrtzis E, Fourrier C, Aboustate N, Sampson E, Hori H, Cearns M, Morgan J, Toben C, Baune BT. Psychological training to improve psychosocial function in patients with major depressive disorder: A randomised clinical trial. Psychiatry Res 2021; 300:113906. [PMID: 33853014 DOI: 10.1016/j.psychres.2021.113906] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 03/27/2021] [Indexed: 01/04/2023]
Abstract
Cognitive and emotional remediation training for depression (CERT-D): a randomised controlled trial to improve cognitive, emotional and functional outcomes in depression The aim of the current study was to evaluate an experimental treatment designed to improve psychosocial function in patients with Major Depressive Disorder (MDD) by reinforcing cognitive, emotional, and social-cognitive abilities. Participants (N = 112) with current or lifetime MDD were recruited to participate in a randomised, blinded, controlled trial. Exclusion criteria included diagnosis of a substance abuse disorder, bipolar disorder organic, eating disorders, or illness which affect cognitive function. The treatment involved repeated cognitive training designed to improve cognitive, emotional, and social-cognitive abilities. In training sessions, the principles of cognitive training were applied across cognitive, emotional, and social domains, with participants completing repeated mental exercises. Exercises included critically analysing interpretations of social interactions (e.g., body language), exploring emotional reactions to stimuli, and completing game-like cognitive training tasks. Training sessions placed great emphasis on the application of trained cognitive, emotional, and social cognitive skills to psychosocial outcomes. Outcomes demonstrated significant improvement in psychosocial function, symptom severity, self-reported cognition, and social-cognition. Our findings demonstrate the efficacy of multi-domain cognitive training to improve psychosocial functioning in individuals with MDD. We suggest that the present treatment could be deployed at a lower cost and with minimal training in comparison to established psychological therapies.
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Affiliation(s)
- Matthew J Knight
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Ellen Lyrtzis
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Célia Fourrier
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Natalie Aboustate
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Emma Sampson
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Hikaru Hori
- Department of Psychiatry, School of Medicine, University of Occupational and Environmental Health, Kitakyushu City, Japan
| | - Micah Cearns
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Julie Morgan
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Catherine Toben
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Bernhard T Baune
- Department of Psychiatry and Psychotherapy, University Hospital Münster, University of Münster, Münster, Germany; Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Australia; The Florey Institute of Neuroscience and Mental Health, The Universit y of Melbourne, Parkville, VIC, Australia.
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18
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Hu X, Qian L, Zhang Y, Xu Y, Zheng L, Liu Y, Zhang X, Zhang Y, Liu W. Topological changes in white matter connectivity network in patients with Parkinson's disease and depression. Brain Imaging Behav 2021; 14:2559-2568. [PMID: 31909443 DOI: 10.1007/s11682-019-00208-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Depression is the most common non-motor symptom accompanying Parkinson's disease (PD) with high prevalence but unclear pathophysiological mechanism. Relatively little is known about the topological patterns of white matter structural networks in depressed patients with PD. In this study, we used diffusion-tensor imaging (DTI) and graph theory approaches to explore the brain structural connectome in non-depressed patients with PD (n = 47), depressed patients with PD (n = 20) and healthy controls (n = 46). All three groups exhibited small-world topology. Compared with healthy controls, non-depressed patients with PD and depressed patients with PD showed a significant reduction of network efficiency in the cortico-subcortical circuits. Moreover, depressed patients with PD exhibited higher network efficiency in fronto-limbic system, compared to non-depressed patients with PD. To sum up, our data indicated a disrupted integrity in the large-scale brain systems in depressed patients with PD patients. The structural connectome provided a basis for functional alterations in depressed patients with PD that may advance our current understanding of pathophysiological mechanism underlying Parkinson's disease.
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Affiliation(s)
- Xiao Hu
- Department of Radiology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, 210029, China
| | - Long Qian
- Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, 100871, China.,GE Healthcare, MR Research China, Beijing, 100088, China
| | - Yaoyu Zhang
- Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, 100871, China
| | - Yuanyuan Xu
- Department of Neurology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, China
| | - Li Zheng
- Department of Biomedical Engineering, Peking University, Beijing, 100871, China
| | - Yijun Liu
- Department of Biomedical Engineering, Peking University, Beijing, 100871, China
| | - Xiangrong Zhang
- Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, 210029, China.,Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, China
| | - Yi Zhang
- Department of Biomedical Engineering, Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, 710071, Shaanxi, China.
| | - Weiguo Liu
- Department of Neurology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, China.
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19
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Xiao-Ling Q, Gang C, Bo L, Zai-Li L, Xue-Kui L, Xue L, Ming-Yu S, Yin-Zhen D, Xu C, Dian-Shuai G. Depression Is Associated With Constipation in Patients With Parkinson's Disease. Front Neurol 2021; 11:567574. [PMID: 33391144 PMCID: PMC7772414 DOI: 10.3389/fneur.2020.567574] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 09/29/2020] [Indexed: 12/12/2022] Open
Abstract
Objective: Constipation is one of the most frequent non-motor symptoms (NMS) in Parkinson's disease (PD), causing great disturbance to patients. The present study investigated the prevalence and the clinical features of constipation in patients with PD and explored the difference between prodromal and clinical constipation of PD. Methods: A total of 186 patients with PD were recruited into this study. Subjective constipation was defined by ROME III criteria. Demographic and PD-related clinical information of the participants were collected. The PD patients were objectively assessed by a spectrum of rating scales of motor symptoms, non-motor symptoms, and quality of life. Results: In total, 51.61% (96/186) of PD patients suffer from constipation. Compared with patients without constipation, the patients with constipation were prone to have restless leg syndrome, depression, and anxiety and have higher scores of the non-motor symptoms scale. Among patients with constipation, 21.88% (21/96) patients had constipation in prodromal stage. Compared with patients with constipation in clinical stage, patients with prodromal constipation had a lower age of constipation onset (56.48 ± 9.63 and 65.26 ± 8.42, χ2 = 4.091, P < 0.001), longer timespan from constipation onset to motor symptom onset (6.62 ± 3.91 and 3.18 ± 2.13, χ2 = −3.877, P = 0.001). Patients with prodromal constipation were predominantly tremor onset (χ2 = 4.405, P = 0.044) and usually had a better quality of life [28 (14.50–37.5) and 40 (25.0–55.0), χ2 = 2.011, P = 0.046]. Depression was the only risk factor of constipation in PD patients. Body mass index, depression, and anxiety were factors that affected the life quality in patients with constipation. Conclusions: Our results supported the high incidence of constipation in patients with PD and that, in some patients, constipation occurred before the onset of motor symptoms. The specific clinical characteristics of patients with constipation and with prodromal constipation help to make early diagnosis, to discover the relationship between constipation and PD, and to further explore the pathogenesis of this degenerative disease.
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Affiliation(s)
- Qin Xiao-Ling
- Department of Neurology, Shanghai Eighth People's Hospital, Shanghai, China
| | - Chen Gang
- Xuzhou Key Laboratory of Neurobiology, Department of Neurobiology and Anatomy, Xuzhou Medical University, Xuzhou, China
| | - Lu Bo
- Department of Gastroenterology, Shanghai Yangsi Hospital, Shanghai, China
| | - Li Zai-Li
- Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, China
| | - Liu Xue-Kui
- Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, China
| | - Li Xue
- Xuzhou Key Laboratory of Neurobiology, Department of Neurobiology and Anatomy, Xuzhou Medical University, Xuzhou, China
| | - Shi Ming-Yu
- Xuzhou Key Laboratory of Neurobiology, Department of Neurobiology and Anatomy, Xuzhou Medical University, Xuzhou, China
| | - Du Yin-Zhen
- Xuzhou Key Laboratory of Neurobiology, Department of Neurobiology and Anatomy, Xuzhou Medical University, Xuzhou, China
| | - Chen Xu
- Department of Neurology, Shanghai Eighth People's Hospital, Shanghai, China
| | - Gao Dian-Shuai
- Xuzhou Key Laboratory of Neurobiology, Department of Neurobiology and Anatomy, Xuzhou Medical University, Xuzhou, China
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20
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Huang Y, Huang C, Zhang Q, Wu W, Sun J. Serum BDNF discriminates Parkinson's disease patients with depression from without depression and reflect motor severity and gender differences. J Neurol 2020; 268:1411-1418. [PMID: 33179143 DOI: 10.1007/s00415-020-10299-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/29/2020] [Accepted: 11/01/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To evaluate the diagnostic value of serum Brain-derived neurotrophic factor (BDNF) levels for discriminating PD with depression from without depression, and to investigate whether serum BDNF levels were associated with motor severity and gender in depressed PD patients. METHODS Demographic and clinical data were collected from 122 PD patients with depression, 137 without depression and 110 healthy controls. All participants' serum BDNF concentrations were measured. Their motor abilities and activity were assessed by the Unified PD Rating Scale Part III (UPDRS III) score and the Hoehn and Yahr (H-Y) stage. Depression was scored using the 17-item Hamilton Rating Scale for Depression (HAMD-17). Associations were analyzed with multivariate regression. RESULTS The serum BDNF levels were lower in depressed PD patients compared to non-depressed PD patients and controls (p < 0.001). The BDNF levels were negatively correlated with UPDRS III score (r = - 0.54, p < 0.001) and H-Y stage (r = - 0.45, p < 0.001). Decreased BDNF levels were associated with women only among depressed PD patients (r = 0.45, p < 0.001). The HAMD-17 score was negatively correlated with BDNF levels (r = - 0.59, p < 0.001), and positively associated with UPDRS III score (r = 0.51, p < 0.001). Multiple regression analysis demonstrated that in the depressed PD patients, female, H-Y stage and UPDRS III score were independent contributors to the BDNF levels (p < 0.001; p = 0.006; p = 0.03, respectively), BDNF and UPDRS III score were independent contributors to HAMD-17 score (p < 0.001, p = 0.01, respectively). CONCLUSIONS Decreased serum BDNF levels may be a useful clinical biomarker of depression in PD patients. Serum BDNF may serve as a potential biomarker for motor severity of PD patients with depression, especially in female.
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Affiliation(s)
- Yixian Huang
- Department of Neurology, The Second Affiliated Hospital of Soochow University, No. 1055 Sanxiang Road, Suzhou, 215004, China.
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA.
| | - Caili Huang
- Department of Neurology, The Second Affiliated Hospital of Soochow University, No. 1055 Sanxiang Road, Suzhou, 215004, China
| | - Qilin Zhang
- Department of Neurology, The Second Affiliated Hospital of Soochow University, No. 1055 Sanxiang Road, Suzhou, 215004, China
| | - Wenqi Wu
- Department of Neurology, The Second Affiliated Hospital of Soochow University, No. 1055 Sanxiang Road, Suzhou, 215004, China
| | - Jiawei Sun
- Department of Neurology, The Second Affiliated Hospital of Soochow University, No. 1055 Sanxiang Road, Suzhou, 215004, China
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21
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What reveals about depression level? The role of multimodal features at the level of interview questions. INFORMATION & MANAGEMENT 2020. [DOI: 10.1016/j.im.2020.103349] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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22
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Clinical Features and Correlates of Poor Nighttime Sleepiness in Patients with Parkinson's Disease. PARKINSONS DISEASE 2020; 2020:6378673. [PMID: 33005317 PMCID: PMC7509546 DOI: 10.1155/2020/6378673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 05/12/2020] [Indexed: 11/17/2022]
Abstract
Objective The present study investigated the clinical features and correlates of poor nighttime sleepiness (PNS) in patients with Parkinson's disease (PD). Methods One hundred ten patients with PD (divided into PD-PNS group and PD-nPNS group) and forty-seven controls (nPD-PNS group) were enrolled in this study. Demographic information was collected. Patients were assessed according to the unified Parkinson's disease rating scale (UPDRS) and Hoehn–Yahr (H&Y) stage scale. Patients were also evaluated according to the Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), rapid eye movement sleep behavior disorder screening questionnaire (RBD-SQ), restless leg syndrome (RLS) diagnosis, Hamilton's depression scale (HAMD), and Hamilton's anxiety scale (HAMA). Results The prevalence of PNS was 55.45% (61/110) in patients with PD. The PD-PNS group tended to have a longer duration of disease, higher UPDRS-I and UPDRS-III scores, a higher percentage of RLS patients, and higher HAMA and HAMD scores than those of the PD-nPNS group. The PD-PNS group tended to have a higher percentage of RBD and RLS patients and higher HAMA and HAMD scores than those of the nPD-PNS group. Analysis of the PSQI components and PSQI impact factors showed that the PD-PNS group had worse subjective sleep quality (χ2 = −2.267, P = 0.023), shorter sleep latency (χ2 = −2.262, P = 0.024), fewer sleep medications (χ2 = −4.170, P ≤ 0.001), worse daytime functioning (χ2 = −2.347, P = 0.019), and an even higher prevalence of increased nocturia (χ2 = 4.447, P = 0.035), nightmares (χ2 = 7.887, P = 0.005), and pain (χ2 = 9.604, P = 0.002) than those of the nPD-PNS group. Analysis also indicated that the PSQI global score positively correlated with BMI (r = 0.216, P < 0.05), H&Y stage (r = 0.223, P < 0.05), UPDRS-I (r = 0.501, P < 0.01), UPDRS-III (r = 0.425, P < 0.01), ESS (r = −0.296, P < 0.01), RBD (r = 0.227, P < 0.05), RLS (r = 0.254, P < 0.01), HAMA (r = 0.329, P < 0.01), and HAMD (r = 0.466, P < 0.01). In the final model, H&Y stage, RLS, UPDRS-III, and HAMD remained associated with the PQSI score (P ≤ 0.001, P ≤ 0.001, P = 0.049, P ≤ 0.001, respectively). Conclusions Our data showed that PNS was common in patients with PD. H&Y stage, UPDRS-III, HAMD, and RLS were positively associated with PNS. Attention to the management of motor symptoms, RLS, and depression may be beneficial to nighttime sleep quality in patients with PD.
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23
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Li Z, Liu W, Xiao C, Wang X, Zhang X, Yu M, Hu X, Qian L. Abnormal white matter microstructures in Parkinson's disease and comorbid depression: A whole-brain diffusion tensor imaging study. Neurosci Lett 2020; 735:135238. [PMID: 32645398 DOI: 10.1016/j.neulet.2020.135238] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 07/02/2020] [Accepted: 07/05/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Depressive symptoms are the most common non-motor symptom accompanying Parkinson's disease (PD); however, the neural basis of depression in PD remains unclear. The aim of this study was to characterize possible depression-related white matter microstructural differences in patients with PD and comorbid depression compared with PD patients and healthy controls (HC) without depression. METHODS We used diffusion tensor imaging (DTI) to analyze white matter integrity in depressed PD patients (n = 30), non-depressed PD patients (n = 43), and HC (n = 91). Five MRI-derived indices were estimated: fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), and white matter volume (WMV). RESULTS Compared with HC and non-depressed PD, depressed PD patients showed significantly increased AD values in the body of corpus callosum, right anterior corona radiate, and left hippocampal part of the cingulum, as well as increased MD values in the left hippocampal part of the cingulum. CONCLUSIONS Our results show that frontal and limbic white matter integrity is impaired in depressed PD patients. These findings can be used to better understand potential mechanisms of depression in PD.
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Affiliation(s)
- Zonghong Li
- Department of Radiology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Weiguo Liu
- Department of Neurology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chaoyong Xiao
- Department of Radiology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xiao Wang
- Department of Radiology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xiangrong Zhang
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Miao Yu
- Department of Neurology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xiao Hu
- Department of Radiology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Long Qian
- Department of Biomedical Engineering, Peking University, Beijing, 100871, China; Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, 100871, China; McGovern Institute for Brain Research, Peking University, Beijing, 100871, China.
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24
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Dedeken P, Nickenig Vissoci JR, Sebera F, Boon PAJM, Rutembesa E, Teuwen DE. Validity, Reliability, and Diagnostic Cut-off of the Kinyarwandan Version of the Hamilton Depression Rating Scale in Rwanda. Front Psychol 2020; 11:1343. [PMID: 32719632 PMCID: PMC7350898 DOI: 10.3389/fpsyg.2020.01343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 05/20/2020] [Indexed: 12/19/2022] Open
Abstract
Introduction: In Rwanda, major depressive disorder affects 11.9% of the population and up to 35% of genocide survivors. Mental health services remain underutilized due to stigma and lack of awareness. Increasing the ability and capacity to diagnose and treat mental disorders is considered important to close this gap. We describe the translation, validity, and reliability assessment of the Hamilton Depression Rating Scale (HDRS) as a diagnostic tool for moderate to severe depression in Rwanda. Methods: The HDRS-21 was translated by a multi-group taskforce. We validated the translation against expert assessment in a comparative study on a sample of patients living with depression and of healthy volunteers. Psychometric properties, namely internal structure, reliability, and external validity were assessed using confirmatory factor analysis, three reliability calculations, and correlation analysis, respectively. Maximized Youden’s index was used for determining diagnostic cut-off. Results: The translated version demonstrated a kappa of 0.93. We enrolled 105 healthy volunteers and 105 patients with confirmed mild to severe depression. In the confirmatory factor analysis, HDRS had good factor loadings of 0.32–0.80. Reliability coefficients above 0.92 indicated strong internal consistency. External validity was shown by good sensitivity (0.95) and specificity (0.94) to differentiate depression from absence of depression. At a cut-off point of 17 for the diagnosis of depression, sensitivity and specificity were both 0.95 relative to gold standard. Conclusion: The validated HDRS in Kinyarwanda with diagnostic cut-off provides mental healthcare staff with an accurate tool to diagnose moderate to severe depression, enabling closure of the diagnosis and treatment gap.
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Affiliation(s)
- Peter Dedeken
- Department of Neurology, Heilig Hart Hospital, Lier, Belgium.,Corporate Societal Responsibility, UCB Pharma, Brussels, Belgium.,Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Joao Ricardo Nickenig Vissoci
- Division of Emergency Medicine, Department of Surgery, Duke Global Health Institute, Duke University, Durham, NC, United States
| | - Fidele Sebera
- Department of Neurology, Ghent University Hospital, Ghent, Belgium.,Department of Neurology, Neuropsychiatric Hospital, CARAES Ndera, Kigali, Rwanda.,Department of Neurology and Psychiatry, University of Rwanda, Kigali, Rwanda
| | - Paul A J M Boon
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Eugene Rutembesa
- Department of Neurology and Psychiatry, University of Rwanda, Kigali, Rwanda
| | - Dirk E Teuwen
- Corporate Societal Responsibility, UCB Pharma, Brussels, Belgium
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25
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Cederberg KL, Birchall E, Belotserkovkaya N, Memon R, Motl R, Amara A. Does restless legs syndrome impact cognitive function via sleep quality in adults with Parkinson's disease? Int J Neurosci 2020; 130:322-329. [PMID: 31625438 PMCID: PMC7101254 DOI: 10.1080/00207454.2019.1681423] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 06/14/2019] [Accepted: 09/17/2019] [Indexed: 01/21/2023]
Abstract
Purpose: Restless legs syndrome (RLS) is a sleep disorder that results in sleep dysfunction. Sleep disruption can have profound negative consequences in adults with Parkinson's disease (PD), potentially including cognitive dysfunction. This study examined the relationships among RLS, cognition, and sleep quality in persons with PD.Materials and methods: Participants (N = 79) with idiopathic PD completed six questionnaires evaluating RLS, sleep quality, daytime sleepiness, global cognitive function, sleep apnea risk, and depression. Participants were further examined for body mass index composition and motor symptom severity (MDS-UPDRS Part III).Results: Persons with RLS (n = 25) had significantly worse cognitive function (p = 0.035, d = -0.56) and sleep quality (p < 0.0001, d = -1.19), and more daytime sleepiness (p = 0.009, d = 0.67) than those without RLS (n = 54). Cognitive function was not significantly correlated with sleep quality (rs = 0.113) or daytime sleepiness (rs = -0.001). The association between RLS and cognition was not attenuated by controlling for sleep quality or daytime sleepiness.Conclusions: This study is unique as it is the first to consider the possibility that RLS in PD may be associated with cognitive deficits through a pathway involving sleep quality. Persons with RLS and PD have greater deficits in both sleep quality and cognitive function than individuals without RLS; however, cognitive dysfunction among those with PD and RLS in this sample is not accounted for by sleep quality.
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Affiliation(s)
- Katie L. Cederberg
- Department of Physical Therapy, University of Alabama at Birmingham, 1720 2 Avenue South, Birmingham, Alabama USA 35294-0017
| | - E.L. Birchall
- Department of Neurology, University of Alabama at Birmingham, 1720 2 Avenue S. Birmingham, Alabama USA 35294-0017
| | - N. Belotserkovkaya
- Department of Neurology, University of Cincinnati, 260 Stetson Street, Suite 2300, Cincinnati, Ohio USA 45219
| | - R.A. Memon
- Department of Neurology, University of Alabama at Birmingham, 1720 2 Avenue S. Birmingham, Alabama USA 35294-0017
| | - R.W. Motl
- Department of Physical Therapy, University of Alabama at Birmingham, 1720 2 Avenue South, Birmingham, Alabama USA 35294-0017
| | - A. Amara
- Department of Neurology, University of Alabama at Birmingham, 1720 2 Avenue S. Birmingham, Alabama USA 35294-0017
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26
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Heidenblut S, Zank S. Screening for Depression in Old Age With Very Short Instruments: The DIA-S4 Compared to the GDS5 and GDS4. Gerontol Geriatr Med 2020; 6:2333721420981328. [PMID: 33354593 PMCID: PMC7734509 DOI: 10.1177/2333721420981328] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 10/07/2020] [Accepted: 11/10/2020] [Indexed: 11/29/2022] Open
Abstract
Purpose of the Study: This article presents a short form of the Depression in old Age Scale with four items (DIA-S4). The diagnostic accuracy of the DIA-S4 was tested and compared to short forms of the Geriatric Depression Scale (GDS5, GDS4). Methods: Using the Montgomery and Asberg Depression Rating Scale (MADRS) as gold standard, the scales were validated with a sample of N = 331 geriatric inpatients. Results: The DIA-S4 had an internal consistency of .70, the GDS5 of .55, and the GDS4 of .58. The test efficiency considering ROC analyses for the DIAS-4 was AUC = .86, for the GDS5 AUC = .78, and for the GDS4 AUC = .74. The best cut-off score for the DIA-S4 was 1.5 with a sensitivity of 87% and a specificity of 68%, for the GDS4 1.5 with a sensitivity of 58% and a specificity of 81%, and for the GDS5 1.5 with a sensitivity of 88% and a specificity of 49%. Conclusion: Based on the data of this study, the DIA-S4 shows better psychometrical qualities than the GDS5 and the GDS4. It can be used as a very short screening scale for depression in old age in research and clinical practice.
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Affiliation(s)
- Sonja Heidenblut
- Chair of Rehabilitative Gerontology, University of Cologne, Cologne, Germany
| | - Susanne Zank
- Chair of Rehabilitative Gerontology, University of Cologne, Cologne, Germany
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Kwan A, Katz P, Touma Z. The Assessment of Anxiety and Depression and its Associated Factors in SLE. Curr Rheumatol Rev 2019; 15:90-98. [PMID: 30255761 DOI: 10.2174/1573397114666180926101513] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 07/13/2018] [Accepted: 09/23/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Depression and anxiety are common neuropsychiatric complaints in patients with Systemic Lupus Erythematosus (SLE). While numerous studies have been performed to investigate the prevalence, impact, and associated factors of depression and anxiety, current literature presents mixed results. In particular, the prevalence of anxiety and depression varies substantially between studies due to methodological limitations, and heterogeneity in defining anxiety and depression, patient selection, and metrics used. Moreover, there is a lack of studies evaluating the validity, reliability, and interpretability of commonly used screening tools for depression and anxiety in SLE patients. RESULT AND CONCLUSION Further investigations should aim to reach a consensus surrounding the role of controversial associated factors in depression and anxiety of SLE patients, while also focusing on the identification of novel factors that have not yet been highlighted in the literature.
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Affiliation(s)
- Andrew Kwan
- Queen's University, Kingston, Ontario, Canada.,University of Toronto Lupus Clinic, Toronto Western Hospital, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto, Ontario, Canada
| | - Patricia Katz
- Department of Medicine, UCSF, Philip R. Lee Institute for Health Policy Studies, St, San Francisco, CA 94117, United States
| | - Zahi Touma
- University of Toronto Lupus Clinic, Toronto Western Hospital, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto, Ontario, Canada
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Na R, Yang JH, Yeom Y, Kim YJ, Byun S, Kim K, Kim KW. A Systematic Review and Meta-Analysis of Nonpharmacological Interventions for Moderate to Severe Dementia. Psychiatry Investig 2019; 16:325-335. [PMID: 31132836 PMCID: PMC6539264 DOI: 10.30773/pi.2019.02.11.2] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 02/11/2019] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Due to limited efficacy of medications, non-pharmacological interventions (NPI) are frequently co-administered to people with moderate to severe dementia (PWMSD). This systematic review and meta-analysis investigated the effects of NPI on activities of daily living (ADL), behavioral and psychological symptoms of dementia (BPSD), and cognition and quality of life (QoL) of PWMSD. METHODS A literature search was conducted in the following databases: Cochrane CENTRAL, EMBASE, Medline, CIHNAL, PsycINFO, KoreaMED, KMbase, and KISS. We conducted a meta-analysis on randomized controlled trials and used the generic inverse variance method with a fixed-effects model to calculate the standardized mean difference (SMD). The protocol had been registered (CRD42017058020). RESULTS Ten randomized controlled trials met the inclusion criteria of the current meta-analysis. NPI were effective in improving ADL [SMD=0.28, 95% confidence interval (CI)=0.11-0.45] and reducing depression (SMD=-0.44, 95% CI=-0.70- -0.19). However, NPI were not effective in reducing agitation, anxiety, or overall, or improving cognitive function. In a subgroup analysis, music therapy was effective in reducing overall BPSD (SMD=-0.52, 95% CI=-0.90- -0.13). CONCLUSION Albeit the number of studies was limited, NPI improved ADL and depression in PWMSD.
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Affiliation(s)
- Riyoung Na
- National Institute of Dementia, Seongnam, Republic of Korea
| | - Ji-Hye Yang
- National Institute of Dementia, Seongnam, Republic of Korea
| | - Yusung Yeom
- National Institute of Dementia, Seongnam, Republic of Korea
| | - You Joung Kim
- National Institute of Dementia, Seongnam, Republic of Korea
| | - Seonjeong Byun
- National Institute of Dementia, Seongnam, Republic of Korea.,Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Kiwon Kim
- National Institute of Dementia, Seongnam, Republic of Korea.,Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Ki Woong Kim
- National Institute of Dementia, Seongnam, Republic of Korea.,Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
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29
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Xiang YQ, Xu Q, Sun QY, Wang ZQ, Tian Y, Fang LJ, Yang Y, Tan JQ, Yan XX, Tang BS, Guo JF. Clinical Features and Correlates of Excessive Daytime Sleepiness in Parkinson's Disease. Front Neurol 2019; 10:121. [PMID: 30837940 PMCID: PMC6389626 DOI: 10.3389/fneur.2019.00121] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 01/29/2019] [Indexed: 12/28/2022] Open
Abstract
Objective: To explore the clinical features and correlates of excessive daytime sleepiness (EDS) in a Chinese population of Parkinson's disease (PD) patients. Methods: Patients with clinically established or clinically probable PD were recruited. Clinical and demographic data were collected, and participants were evaluated using standardized assessment protocols. Patients were divided into PD with EDS and PD without EDS groups based on the Epworth sleepiness scale (ESS) scores, with a cutoff score of 10. Clinical manifestations were compared between patients with and without EDS, and correlates of EDS were also studied. In addition, the relationship between EDS and poor nighttime sleep quality was analyzed. Results: A total of 1,221 PD patients were recruited in our study. The mean ESS (min, max) score was 7.6 ± 6.1 (0, 24), and 34.1% of the patients had ESS scores ≥10. No difference was seen in lifestyle (except for alcohol consumption), environmental factors, BMI, levodopa equivalent dose (LED), initial presentation of motor symptoms, motor subtype, and wearing off between patients with and without EDS. The PD with EDS group had a higher proportion of male patients and a higher average patient age. Moreover, the PD with EDS group showed older age at PD onset, lower educational level, and longer disease duration. Patients with EDS had higher scores on the Hoehn-Yahr scale and the Unified Parkinson's Disease Rating Scale (UPDRS) parts I, II, and III score, more severe non-motor symptoms, and poorer quality of sleep and life. Logistic regression analyses demonstrated that EDS was associated with male sex, age, cognitive impairment, PD-related sleep problems, rapid eye movement sleep behavior disorder (RBD), and worse quality of life (QoL). Conclusion: EDS is a general clinical manifestation in PD, and there were significant differences in clinical features between patients with and without EDS. Moreover, our study proved that many factors were associated with EDS, including male sex, age, cognitive impairment, PD-related sleep problems, RBD, and worse QoL. Understanding the clinical characteristics of EDS in PD patients may help identify EDS early, improve QoL, and reduce the occurrence of accidents.
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Affiliation(s)
- Ya-Qin Xiang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Qian Xu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Qi-Ying Sun
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Zhi-Qin Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yun Tian
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Liang-Juan Fang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yang Yang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Jie-Qiong Tan
- Laboratory of Medical Genetics, Central South University, Changsha, China
| | - Xin-Xiang Yan
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Bei-Sha Tang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.,Laboratory of Medical Genetics, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Changsha, China.,Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China.,Collaborative Innovation Center for Brain Science, Shanghai, China.,Parkinson's Disease Center of Beijing Institute for Brain Disorders, Beijing, China.,Collaborative Innovation Center for Genetics and Development, Shanghai, China
| | - Ji-Feng Guo
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.,Laboratory of Medical Genetics, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Changsha, China.,Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
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30
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Shen YT, Wang JW, Wang M, Zhi Y, Li JY, Yuan YS, Wang XX, Zhang H, Zhang KZ. BST1 rs4698412 allelic variant increases the risk of gait or balance deficits in patients with Parkinson's disease. CNS Neurosci Ther 2019; 25:422-429. [PMID: 30676692 PMCID: PMC6488919 DOI: 10.1111/cns.13099] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 12/12/2018] [Accepted: 12/17/2018] [Indexed: 01/04/2023] Open
Abstract
Aims We aimed to explore effects of bone marrow stromal cell antigen‐1 (BST1) rs4698412 allelic variant on brain activation and associative clinical symptoms in Parkinson’s disease (PD). Methods A total of 49 PD patients and 47 healthy control (HC) subjects were recruited for clinical evaluations, blood samples collection for genotypes, and resting‐state functional MRI (rs‐fMRI) scans. Based on BST1 rs4698412 allelic variant (G → A), participants were further divided into 18 PD‐GG, 31 PD‐GA/AA, 20 HC‐GG, and 27 HC‐GA/AA carriers, which respectively indicated subjects carrying ancestral or risk allele in that locus in PD or HC. Two‐way analysis of covariance (ANCOVA) was applied to investigate main effects and interactions between PD and BST1 rs4698412 allelic variant on brain function via amplitude of low‐frequency fluctuations (ALFF). Spearman’s correlations were then utilized to detect associations between interactive brain regions and clinical symptoms. Results Compared to HC subjects, PD patients exhibited increased ALFF values in left cerebellum_8 and cerebellum_9. Significant interaction was in right lingual gyrus, where there were the lowest ALFF values and ALFF values were only negatively associated with Timed Up and Go (TUG) test time in PD‐GA/AA subgroup. Conclusion BST1 rs4698412‐modulated lingual gyrus functional alterations could be related to gait and balance dysfunction in PD.
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Affiliation(s)
- Yu-Ting Shen
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jian-Wei Wang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Min Wang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yan Zhi
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jun-Yi Li
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yong-Sheng Yuan
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xi-Xi Wang
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hui Zhang
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ke-Zhong Zhang
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Tommasi M, Ferrara G, Saggino A. Application of Bayes' Theorem in Valuating Depression Tests Performance. Front Psychol 2018; 9:1240. [PMID: 30083119 PMCID: PMC6064972 DOI: 10.3389/fpsyg.2018.01240] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 06/28/2018] [Indexed: 11/13/2022] Open
Abstract
The validity of clinical diagnoses is a fundamental topic in clinical psychology, because now there are some political administrations, as the IOM or the U.K. government, which are focusing on best evidence-based practice in clinical psychology. The most problematic issue in clinical psychology is to avoid wrong diagnoses which can have negative consequences on individual life and on the utility of clinical treatments. In the case of diagnoses based on self-report tests, the diagnostic decision about individual health is based on the comparison between its score and the cutoff, according to the frequentist approach to probability. However, the frequentist approach underestimates the possible risks of incorrect diagnoses based on cutoffs only. The Bayesian approach is a valid alternative to make diagnoses on the basis of the scores from psychological tests. The Bayes' theorem estimates the posterior probability of the presence of a pathology on the basis of the knowledge about the diffusion of this pathology (prior probability) and of the knowledge of sensitivity and specificity values of the test. With all this information, it is possible to estimate the diagnostic accuracy of some self-report tests used for assessing depression. We analyzed the diagnostic accuracy of the most used psychological tests of depression (Zung's Self-Rating Depression Scale, Hamilton Rating Scale for Depression, Center for Epidemiological Studies for Depression and the Beck Depression Inventory), together with a new scale (Teate Depression Inventory) developed with the IRT procedure, by analyzing the published works in which data about sensitivity and specificity of these scales are reported. Except the TDI, none of these scales can reach a satisfactory level of diagnostic accuracy, probably for the absence of an optimal procedure to select test items and subjects with clearly defined pathological symptoms which could allow the reduction of false positives in test scoring.
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Affiliation(s)
- Marco Tommasi
- Department of Psychological, Health and Territorial Sciences, Università degli Studi G. d'Annunzio Chieti e Pescara, Chieti, Italy
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Ma X, Su W, Li S, Li C, Wang R, Chen M, Chen H. Cerebellar atrophy in different subtypes of Parkinson's disease. J Neurol Sci 2018; 392:105-112. [PMID: 30036781 DOI: 10.1016/j.jns.2018.06.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 06/27/2018] [Accepted: 06/28/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND To investigate, using Magnetic Resonance Imaging (MRI) and voxel-based morphometry (VBM), morphometric changes of cerebellum in Parkinson's disease with different motor and affective subtypes. METHODS Fifty-four patients with idiopathic Parkinson's disease (PD) were classified into tremor-predominant-PD (PDT) (n = 37) and akinetic/rigidity-predominant-PD (PDAR) (n = 17). Moreover, PD groups were divided into four affective subtypes, including depressive but not anxious PD (dPD, n = 5), anxious but not depressive PD (aPD, n = 8), comorbid depressive and anxious PD (coPD, n = 8), and PD patients without depressive or anxious symptoms (nPD, n = 33). They were additionally compared at a group level with thirty-nine normal controls (NCs). An analysis of covariance followed by post hoc tests was performed to examine the alterations of cerebellar grey matter volume (GMV) in different groups of PD. RESULTS Compared with NCs, PD showed grey matter (GM) atrophy in the right Crus II, pyramis, culmen, the right lobules IV, and V, and the left lobule VI. PDT, PDAR and NCs did not differ in the volume of the cerebellum. Relative to nPD group, dPD group exhibited GMV reduction in the left Crus I, while aPD group showed GMV reduction in the tonsil and the right lobule VIII. The GM atrophy was also found in the coPD group compared to NCs, including the tonsil, the left lobule VIII, the right lobule VI, the left Crus I, and vermis IV, and V. There was a significant negative correlation between the Hamilton Rating Scale for Depression (HAMD) score and the right lobule IX volume, and a significant negative correlation between the Hamilton Rating Scale for Anxiety (HAMA) score and the right lobule VIII volume. CONCLUSIONS These findings suggest that cerebellar changes are involved in PD. It also supports a possible role of the cerebellum in the depressive and anxious symptoms in PD.
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Affiliation(s)
- Xinxin Ma
- Department of Neurology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing 100730, China
| | - Wen Su
- Department of Neurology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing 100730, China
| | - Shuhua Li
- Department of Neurology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing 100730, China
| | - Chunmei Li
- Department of Radiology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing 100730, China
| | - Rui Wang
- Department of Radiology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing 100730, China
| | - Min Chen
- Department of Radiology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing 100730, China
| | - Haibo Chen
- Department of Neurology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing 100730, China.
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Abstract
The topological organization underlying the human brain was extensively investigated using resting-state functional magnetic resonance imaging, focusing on a low frequency of signal oscillation from 0.01 to 0.1 Hz. However, the frequency specificities with regard to the topological properties of the brain networks have not been fully revealed. In this study, a novel complementary ensemble empirical mode decomposition (CEEMD) method was used to separate the fMRI time series into five characteristic oscillations with distinct frequencies. Then, the small world properties of brain networks were analyzed for each of these five oscillations in patients (n = 67) with depressed Parkinson’s disease (DPD, n = 20) , non-depressed Parkinson’s disease (NDPD, n = 47) and healthy controls (HC, n = 46). Compared with HC, the results showed decreased network efficiency in characteristic oscillations from 0.05 to 0.12 Hz and from 0.02 to 0.05 Hz for the DPD and NDPD patients, respectively. Furthermore, compared with HC, the most significant inter-group difference across five brain oscillations was found in the basal ganglia (0.01 to 0.05 Hz) and paralimbic-limbic network (0.02 to 0.22 Hz) for the DPD patients, and in the visual cortex (0.02 to 0.05 Hz) for the NDPD patients. Compared with NDPD, the DPD patients showed reduced efficiency of nodes in the basal ganglia network (0.01 to 0.05 Hz). Our results demonstrated that DPD is characterized by a disrupted topological organization in large-scale brain functional networks. Moreover, the CEEMD analysis suggested a prominent dissociation in the topological organization of brain networks between DPD and NDPD in both space and frequency domains. Our findings indicated that these characteristic oscillatory activities in different functional circuits may contribute to distinct motor and non-motor components of clinical impairments in Parkinson’s disease.
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34
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Wurm M, Klein Strandberg E, Lorenz C, Tillfors M, Buhrman M, Holländare F, Boersma K. Internet delivered transdiagnostic treatment with telephone support for pain patients with emotional comorbidity: a replicated single case study. Internet Interv 2017; 10:54-64. [PMID: 30135753 PMCID: PMC6084869 DOI: 10.1016/j.invent.2017.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 10/06/2017] [Accepted: 10/24/2017] [Indexed: 11/24/2022] Open
Abstract
In pain patients, comorbid emotional problems have been linked to negative outcomes, including suboptimal treatment gains. Developing parsimonious and accessible treatment options is therefore important. The overarching aim of this study was to test an internet delivered therapist guided transdiagnostic treatment with telephone support. An adapted version of the Unified Protocol for Transdiagnostic Treatments of Emotional Disorders was used as an intervention for pain patients with residual pain problems and comorbid emotional problems after having received a multimodal pain rehabilitation. The study used a replicated AB single case experimental design (N = 5; 3 females). Outcome measures were depressive and general anxiety symptoms, pain intensity, pain coping problems, and diagnostic status. Feasibility measures (completion and compliance) and patient satisfaction were also assessed. Scores on Nonoverlap of All Pairs (NAP) indicate a decrease of anxiety for three participants and a decrease of depression for four participants. Decreases were small and did not always reach statistical significance. Also, Tau-U scores could only confirm a reliable trend for one participant. Two out of four patients who were diagnosed with psychiatric disorders before treatment did no longer fulfill diagnostic criteria posttreatment. No improvements could be seen on pain problems. The treatment was feasible and patient satisfaction was high. Hence, while an internet delivered transdiagnostic treatment with telephone support may be a feasible and accepted secondary intervention for pain patients with comorbid emotional problems, the effects are unclear. The gap between high patient satisfaction and small changes in symptomatology should be explored further.
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Affiliation(s)
- Matilda Wurm
- Center for Health and Medical Psychology (CHAMP), Örebro University, Sweden
| | | | - Caroline Lorenz
- Center for Health and Medical Psychology (CHAMP), Örebro University, Sweden
| | - Maria Tillfors
- Center for Health and Medical Psychology (CHAMP), Örebro University, Sweden
| | | | - Fredrik Holländare
- University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Sweden
| | - Katja Boersma
- Center for Health and Medical Psychology (CHAMP), Örebro University, Sweden
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35
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The natural history of depressive symptoms in patients with incident Parkinson’s disease: a prospective cohort study. J Neurol 2017; 264:2401-2408. [DOI: 10.1007/s00415-017-8638-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 09/28/2017] [Accepted: 10/01/2017] [Indexed: 10/18/2022]
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36
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Risk of depression enhances auditory Pitch discrimination in the brain as indexed by the mismatch negativity. Clin Neurophysiol 2017; 128:1923-1936. [DOI: 10.1016/j.clinph.2017.07.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/08/2017] [Accepted: 07/01/2017] [Indexed: 11/19/2022]
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Hobden B, Schwandt ML, Carey M, Lee MR, Farokhnia M, Bouhlal S, Oldmeadow C, Leggio L. The Validity of the Montgomery-Asberg Depression Rating Scale in an Inpatient Sample with Alcohol Dependence. Alcohol Clin Exp Res 2017; 41:1220-1227. [PMID: 28421616 DOI: 10.1111/acer.13400] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 04/10/2017] [Indexed: 01/19/2023]
Abstract
BACKGROUND The Montgomery-Asberg Depression Rating Scale (MADRS) is commonly used to examine depressive symptoms in clinical settings, including facilities treating patients for alcohol addiction. No studies have examined the validity of the MADRS compared to an established clinical diagnostic tool of depression in this population. This study aimed to examine the following: (i) the validity of the MADRS compared to a clinical diagnosis of a depressive disorder (using the Structured Clinical Interview for DSM-IV-TR [SCID-IV-TR]) in patients seeking treatment for alcohol dependence (AD); (ii) whether the validity of the MADRS differs by type of SCID-IV-TR-based diagnosis of depression; and (iii) which items contribute to the optimal predictive model of the MADRS compared to a SCID-IV-TR diagnosis of a depressive disorder. METHODS Individuals seeking treatment for AD and admitted to an inpatient unit were administered the MADRS at day 2 of their detoxification program. Clinical diagnoses of AD and depression were made via the SCID-IV-TR at the beginning of treatment. RESULTS In total, 803 participants were included in the study. The MADRS demonstrated low overall accuracy relative to the clinical diagnosis of depression with an area under the receiver operating characteristic curve of 0.68. The optimal threshold for balancing sensitivity and specificity identified by the Euclidean distance was >14. This cut-point demonstrated a sensitivity of 66%, a specificity of 60%, a positive predictive value of 50%, and a negative predictive value of 75%. The MADRS performed slightly better for major depressive disorders compared to alcohol-induced depression. Items related to lassitude, concentration, and appetite slightly decreased the accuracy of the MADRS. CONCLUSIONS The MADRS does not appear to be an appropriate substitute for a diagnostic tool among alcohol-dependent patients. The MADRS may, however, still be a useful screening tool assuming careful consideration of cut-points.
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Affiliation(s)
- Breanne Hobden
- Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland.,Health Behaviour Research Group, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre in Health Behaviour and Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia
| | - Melanie L Schwandt
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland
| | - Mariko Carey
- Health Behaviour Research Group, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre in Health Behaviour and Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia
| | - Mary R Lee
- Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Mehdi Farokhnia
- Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Sofia Bouhlal
- Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Christopher Oldmeadow
- Public Health Stream, Hunter Medical Research Institute, New Lambton, New South Wales, Australia.,Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Callaghan, New South Wales, Australia
| | - Lorenzo Leggio
- Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland.,Center for Alcohol and Addiction Studies , Department of Behavioral and Social Sciences, Brown University, Providence, Rhode Island
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Kluger BM, Pedersen KF, Tysnes OB, Ongre SO, Øygarden B, Herlofson K. Is fatigue associated with cognitive dysfunction in early Parkinson's disease? Parkinsonism Relat Disord 2017; 37:87-91. [PMID: 28202373 DOI: 10.1016/j.parkreldis.2017.02.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 01/10/2017] [Accepted: 02/05/2017] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Fatigue is a common and disabling symptom which may be seen in early Parkinson's disease (PD). Our understanding of the phenomenology and etiology of fatigue in PD is limited. The objective of this study was to determine whether fatigue was related to cognition in early PD patients. METHODS The study is part of the Norwegian ParkWest project, a population-based cohort study, comprising 184 de novo, drug-naïve patients with PD. PD was diagnosed according to the Gelb criteria. Fatigue was assessed by the Fatigue Severity Scale (FSS). Cognition was assessed by a battery of tests evaluating functions in the domains of verbal memory, processing speed, executive function and visuospatial abilities. RESULTS 107 of the cohort had moderate to severe fatigue (FSS ≥ 4). In univariate correlation analyses high fatigue score was correlated to disease severity, presence of sleep problems, depressive symptoms, apathy, reduced processing speed and reduced visuospatial abilities. In a multiple regression analysis only disease severity (measured by the UPDRS part 3), sleep problems, depressive symptoms and reduced visuospatial abilities contributed to the model. CONCLUSION Fatigue is associated with visuospatial function in early PD patients. Further studies are needed to determine the pathophysiologic relevance of this association.
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Affiliation(s)
- Benzi M Kluger
- Department of Neurology, University of Colorado Anschutz Medical Campus, 12631 E 17thAvenue, Aurora, CO 80045, USA.
| | - Kenn Freddy Pedersen
- Department of Neurology, The Norwegian Centre for Movement Disorders, Stavanger University Hospital, Gerd-Ragna Bloch Thorsens gate 8, 4011 Stavanger, Norway
| | - Ole-Bjorn Tysnes
- Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, 5021 Bergen, Norway
| | - Solgunn O Ongre
- Department of Neurology, Sorlandet Hospital, Sykehusveien 1, 4838 Arendal, Norway
| | - Bjørg Øygarden
- Department of Rehabilitation, Sorlandet Hospital, Sykehusveien 1, 4838 Arendal, Norway
| | - Karen Herlofson
- Department of Neurology, Sorlandet Hospital, Sykehusveien 1, 4838 Arendal, Norway
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Schrag A, Taddei RN. Depression and Anxiety in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 133:623-655. [DOI: 10.1016/bs.irn.2017.05.024] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Birchall EL, Walker HC, Cutter G, Guthrie S, Joop A, Memon RA, Watts RL, Standaert DG, Amara AW. The effect of unilateral subthalamic nucleus deep brain stimulation on depression in Parkinson's disease. Brain Stimul 2016; 10:651-656. [PMID: 28065487 DOI: 10.1016/j.brs.2016.12.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 12/21/2016] [Accepted: 12/23/2016] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Depression is common in Parkinson's disease (PD) and adversely affects quality of life. Both unilateral and bilateral subthalamic (STN) deep brain stimulation (DBS) effectively treat the motor symptoms of PD, but questions remain regarding the impact of unilateral STN DBS on non-motor symptoms, such as depression. METHODS We report changes in depression, as measured by the Hamilton Depression Rating Scale (HAMD-17), in 50 consecutive PD patients who underwent unilateral STN DBS. Participants were also evaluated with UPDRS part III, Parkinson's Disease Questionnaire-39, and Pittsburgh Sleep Quality Index. The primary outcome was change in HAMD-17 at 6 months versus pre-operative baseline, using repeated measures analysis of variance (ANOVA). Secondary outcomes included the change in HAMD-17 at 3, 12, 18, and 24 months post-operatively and correlations amongst outcome variables using Pearson correlation coefficients. As a control, we also evaluated changes in HAMD-17 in 25 advanced PD patients who did not undergo DBS. RESULTS Participants with unilateral STN DBS experienced significant improvement in depression 6 months post-operatively (4.94 ± 4.02) compared to preoperative baseline (7.90 ± 4.44) (mean ± SD) (p = <0.0001). HAMD-17 scores did not correlate with UPDRS part III at any time-point. Interestingly, the HAMD-17 was significantly correlated with sleep quality and quality of life at baseline, 3 months, and 6 months post-operatively. Participants without DBS experienced no significant change in HAMD-17 over the same interval. CONCLUSION Unilateral STN DBS improves depression 6 months post-operatively in patients with PD. Improvement in depression is maintained over time and correlates with improvement in sleep quality and quality of life.
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Affiliation(s)
- Elizabeth L Birchall
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Harrison C Walker
- Division of Movement Disorders, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States; Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Gary Cutter
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Stephanie Guthrie
- Division of Movement Disorders, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Allen Joop
- Division of Movement Disorders, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Raima A Memon
- Division of Movement Disorders, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Ray L Watts
- Division of Movement Disorders, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - David G Standaert
- Division of Movement Disorders, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Amy W Amara
- Division of Movement Disorders, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States.
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Parkinson's Disease and Cognitive Impairment. PARKINSONS DISEASE 2016; 2016:6734678. [PMID: 28058128 PMCID: PMC5183770 DOI: 10.1155/2016/6734678] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 11/14/2016] [Indexed: 11/21/2022]
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disease primarily characterized by the hallmarks of motor symptoms, such as tremor, bradykinesia, rigidity, and postural instability. However, through clinical investigations in patients and experimental findings in animal models of Parkinson's disease for years, it is now well recognized that Parkinson's disease is more than just a motor-deficit disorder. The majority of Parkinson's disease patients suffer from nonmotor disabilities, for instance, cognitive impairment, autonomic dysfunction, sensory dysfunction, and sleep disorder. So far, anti-PD prescriptions and surgical treatments have been mainly focusing on motor dysfunctions, leaving cognitive impairment a marginal clinical field. Within the nonmotor symptoms, cognitive impairment is one of the most common and significant aspects of Parkinson's disease, and cognitive deficits such as dysexecutive syndrome and visuospatial disturbances could seriously affect the quality of life, reduce life expectancy, prolong the duration of hospitalization, and therefore increase burdens of caregiver and medical costs. In this review, we have done a retrospective study of the recent related researches on epidemiology, clinical manifestation and diagnosis, genetics, and potential treatment of cognitive deficits in Parkinson's disease, aiming to provide a summary of cognitive impairment in Parkinson's disease and make it easy for clinicians to tackle this challenging issue in their future practice.
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Dan X, Wang C, Zhang J, Gu Z, Zhou Y, Ma J, Chan P. Association between common genetic risk variants and depression in Parkinson's disease: A dPD study in Chinese. Parkinsonism Relat Disord 2016; 33:122-126. [DOI: 10.1016/j.parkreldis.2016.09.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 08/29/2016] [Accepted: 09/28/2016] [Indexed: 01/18/2023]
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Ongre SO, Larsen JP, Tysnes OB, Herlofson K. Fatigue in early Parkinson's disease: the Norwegian ParkWest study. Eur J Neurol 2016; 24:105-111. [DOI: 10.1111/ene.13161] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 08/09/2016] [Indexed: 11/30/2022]
Affiliation(s)
- S. O. Ongre
- Department of Neurology; Sorlandet Hospital; Arendal Norway
| | - J. P. Larsen
- Network for Medical Sciences; University of Stavanger; Stavanger Norway
| | - O. B. Tysnes
- Department of Neurology; Haukeland University Hospital; Bergen Norway
| | - K. Herlofson
- Department of Neurology; Sorlandet Hospital; Arendal Norway
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Wiglusz MS, Landowski J, Michalak L, Cubała WJ. Validation of the Polish Version of the Hamilton Rating Scale for Depression in patients with epilepsy. Epilepsy Behav 2016; 62:81-4. [PMID: 27450310 DOI: 10.1016/j.yebeh.2016.06.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 06/19/2016] [Accepted: 06/23/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Depressive disorders are the most common comorbidities among patients with epilepsy (PWE). The availability of standardized clinical instruments for PWE is limited with scarce validation studies available so far. The aim of the study was to validate the Polish Version of the Hamilton Rating Scale for Depression (HRSD) in adult PWE. METHODS A group of 96 outpatient PWE were examined by a trained psychiatrist using the Structured Clinical Interview (SCID-I) for DSM-IV-TR and the 17-item Polish Version of HRSD (HRSD-17). Receiver operating characteristic (ROC) curves were used to determine the optimal threshold scores. RESULTS The ROC analyses showed areas under the curve approximately 0.9. For diagnoses of MDD, HRSD-17 demonstrated the best psychometric properties for a cutoff score of 11 with sensitivity of 100%, specificity of 89.3%, positive predictive value of 72.4%, and negative predictive value of 100%. CONCLUSIONS The 17-item Polish Version of HRSD proved to be reliable and valid in the epilepsy setting with a cutoff score of 11 points.
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Affiliation(s)
| | - Jerzy Landowski
- Department of Psychiatry, Medical University of Gdańsk, Poland
| | - Lidia Michalak
- Regional Epilepsy Outpatient Unit, Copernicus Hospital, Gdańsk, Poland
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Abstract
Patients benefit from the presence of empathic caregivers (CGs). In this regard, empathy toward the patient is one of the clinical targets for improving patient outcomes. However, relatively little is known about the impact of patients' empathic responses on the CGs' burden. Among people living with Parkinson's disease (PwP), care partners play a major role. This study involved 28 spouse-patient couples. Empathy, stress burden, and mood disorders (such as anxiety and depression) were assessed over a 6-month period, before and after the reported intervention. Our observation points out that the improvement of patient empathy is necessary for a significant burden reduction among spouses caring for PwP.
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Salehi B, Mohammadbeigi A, Kamali AR, Taheri-Nejad MR, Moshiri I. Impact comparison of ketamine and sodium thiopental on anesthesia during electroconvulsive therapy in major depression patients with drug-resistant; a double-blind randomized clinical trial. Ann Card Anaesth 2016; 18:486-90. [PMID: 26440233 PMCID: PMC4881669 DOI: 10.4103/0971-9784.166444] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Electroconvulsive therapy (ECT) is one of the available and the most effective therapies for the treatment of resistant depression. Considering the crucial role of seizure duration on therapeutic response in patients treated with ECT, this study aimed to compare the effect of ketamine and sodium thiopental anesthesia during ECT for treatment of patients with drug-resistant major depression (DRMD). MATERIALS AND METHODS In a double-blind randomized clinical trial, 160 patients with DRMD were selected consequently and were assigned randomly into two groups including ketamine 0.8 mg/kg and sodium thiopental 1.5 mg/kg. The seizure duration, recovery time, and the side effects of anesthesia were evaluated after 1-h after anesthesia. Data of recovery time and complication collected in 2 nd , 4 th , 6 th , and 8 th ECT. Depression was assessed by Hamilton depression scale. RESULTS The results indicated that ketamine and sodium thiopental had a significant effect on the reduction of depression scores in patients with DRMD (P < 0.05). Complications such as a headache, nausea, pain at the injection site, short-term delirium, and long-term delirium were higher in ketamine group (P > 0.05). But ketamine was more effective in improvement of depression score and increasing systolic and diastolic blood pressure (P < 0.05). The mean of seizure duration showed a decreasing trend and was significant between two study groups (P < 0.05). CONCLUSION Anesthesia induced by ketamine during ECT therapy increased blood pressure and seizure duration. Therefore, due to lower medical complication and attack rate of seizure, ketamine is an appropriate option for anesthesia with ECT in patients with DRMD.
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Affiliation(s)
| | | | | | | | - I Moshiri
- Department of Anesthesiology, Arak University of Medical Sciences, Arak, Iran
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Goodarzi Z, Mrklas KJ, Roberts DJ, Jette N, Pringsheim T, Holroyd-Leduc J. Detecting depression in Parkinson disease: A systematic review and meta-analysis. Neurology 2016; 87:426-37. [PMID: 27358339 DOI: 10.1212/wnl.0000000000002898] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 04/18/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Failure to detect depression in patients with Parkinson disease (PD) can lead to worsened outcomes for patients and caregivers. Accurate identification of depression would enable practitioners to provide comprehensive care for their patients with PD. METHODS Our objective was to examine the diagnostic accuracy of tools for detecting depression in adult outpatients with PD. We searched MEDLINE, PsycINFO, and EMBASE (inception to December 1, 2015), gray literature, and bibliographies of included studies. The pooled prevalence of depression across studies and diagnostic accuracy estimates were calculated using random-effects models. Diagnostic accuracy estimates were calculated across the best-reported cutoffs from each study and across specific cutoffs, when feasible. RESULTS Out of 8,184 citations, 21 studies were included, evaluating 24 tools, with 4 amenable to meta-analysis. The pooled prevalence of major depression was 22.9% (95% confidence interval [CI] 18.1-27.7). The 15-item Geriatric Depression Scale (GDS-15) had a pooled sensitivity of 0.81 (95% CI 0.64-0.91) and specificity of 0.91 (95% CI 0.87-0.94). The most sensitive cutoff for the GDS-15 was 5 at 0.91 (95% CI 0.83-1.00). The Beck Depression Inventory I/Ia had a pooled sensitivity of 0.79 (95% CI 0.61-0.90) and specificity of 0.85 (95% CI 0.79-0.90). The Montgomery-Åsberg Depression Rating Scale yielded a pooled sensitivity of 0.77 (95% CI 0.69-0.83) and specificity of 0.92 (95% CI 0.79-0.97). The Unified Parkinson's Disease Rating Scale had a pooled sensitivity of 0.72 (95% CI 0.64-0.79) and specificity of 0.80 (95% CI 0.70-0.87). All estimates had heterogeneity. CONCLUSIONS There are several valid tools for detecting depression in patients with PD. Practitioners should choose one that fits their clinical practice.
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Affiliation(s)
- Zahra Goodarzi
- From the Departments of Community Health Sciences (Z.G., K.J.M., D.J.R., N.J., T.P., J.H.-L.) and Clinical Neurosciences (N.J., T.P.), University of Calgary; Research Priorities and Implementation (K.J.M.), Alberta Health Services, Edmonton; Departments of Critical Care Medicine (D.J.R.) and Surgery (D.J.R.), Hotchkiss Brain Institute and O'Brien Institute for Public Health (N.J., T.P., J.H.-L.), and Departments of Psychiatry and Pediatrics (T.P.) and Medicine (Z.G., J.H.-L.), University of Calgary and Alberta Health Services, Canada.
| | - Kelly J Mrklas
- From the Departments of Community Health Sciences (Z.G., K.J.M., D.J.R., N.J., T.P., J.H.-L.) and Clinical Neurosciences (N.J., T.P.), University of Calgary; Research Priorities and Implementation (K.J.M.), Alberta Health Services, Edmonton; Departments of Critical Care Medicine (D.J.R.) and Surgery (D.J.R.), Hotchkiss Brain Institute and O'Brien Institute for Public Health (N.J., T.P., J.H.-L.), and Departments of Psychiatry and Pediatrics (T.P.) and Medicine (Z.G., J.H.-L.), University of Calgary and Alberta Health Services, Canada
| | - Derek J Roberts
- From the Departments of Community Health Sciences (Z.G., K.J.M., D.J.R., N.J., T.P., J.H.-L.) and Clinical Neurosciences (N.J., T.P.), University of Calgary; Research Priorities and Implementation (K.J.M.), Alberta Health Services, Edmonton; Departments of Critical Care Medicine (D.J.R.) and Surgery (D.J.R.), Hotchkiss Brain Institute and O'Brien Institute for Public Health (N.J., T.P., J.H.-L.), and Departments of Psychiatry and Pediatrics (T.P.) and Medicine (Z.G., J.H.-L.), University of Calgary and Alberta Health Services, Canada
| | - Nathalie Jette
- From the Departments of Community Health Sciences (Z.G., K.J.M., D.J.R., N.J., T.P., J.H.-L.) and Clinical Neurosciences (N.J., T.P.), University of Calgary; Research Priorities and Implementation (K.J.M.), Alberta Health Services, Edmonton; Departments of Critical Care Medicine (D.J.R.) and Surgery (D.J.R.), Hotchkiss Brain Institute and O'Brien Institute for Public Health (N.J., T.P., J.H.-L.), and Departments of Psychiatry and Pediatrics (T.P.) and Medicine (Z.G., J.H.-L.), University of Calgary and Alberta Health Services, Canada
| | - Tamara Pringsheim
- From the Departments of Community Health Sciences (Z.G., K.J.M., D.J.R., N.J., T.P., J.H.-L.) and Clinical Neurosciences (N.J., T.P.), University of Calgary; Research Priorities and Implementation (K.J.M.), Alberta Health Services, Edmonton; Departments of Critical Care Medicine (D.J.R.) and Surgery (D.J.R.), Hotchkiss Brain Institute and O'Brien Institute for Public Health (N.J., T.P., J.H.-L.), and Departments of Psychiatry and Pediatrics (T.P.) and Medicine (Z.G., J.H.-L.), University of Calgary and Alberta Health Services, Canada
| | - Jayna Holroyd-Leduc
- From the Departments of Community Health Sciences (Z.G., K.J.M., D.J.R., N.J., T.P., J.H.-L.) and Clinical Neurosciences (N.J., T.P.), University of Calgary; Research Priorities and Implementation (K.J.M.), Alberta Health Services, Edmonton; Departments of Critical Care Medicine (D.J.R.) and Surgery (D.J.R.), Hotchkiss Brain Institute and O'Brien Institute for Public Health (N.J., T.P., J.H.-L.), and Departments of Psychiatry and Pediatrics (T.P.) and Medicine (Z.G., J.H.-L.), University of Calgary and Alberta Health Services, Canada
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Herath TB, Withana M, Rodrigo C, Gamage R, Gamage C. Prevalence and associations for symptoms of depression in patients with Parkinson's disease: a Sri Lankan experience. Int J Ment Health Syst 2016; 10:47. [PMID: 27313660 PMCID: PMC4910221 DOI: 10.1186/s13033-016-0079-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 06/07/2016] [Indexed: 12/30/2022] Open
Abstract
Background The prevalence and associations for depression in patients with Parkinson’s disease vary widely between studies. This reflects the influence of cultural, demographic and socioeconomic confounders within communities that make generalizations invalid. Therefore it is important to identify unique attributes within a community on this phenomenon. This is the first study from Sri Lanka on the prevalence and associations for co-morbid depression in patients with Parkinson’s disease. Methods We conducted this cross sectional study at the Institute of Neurology, National Hospital of Sri Lanka. All patients with a diagnosis of idiopathic Parkinson’s disease followed up at the movement disorder clinic of the institute were enrolled. The patients were interviewed by investigators (medical practitioners) with an interviewer administered questionnaire that collected data on (a) demography, (b) clinical symptoms of Parkinson’s disease and (c) socioeconomic background. Symptoms of depression were assessed with Hamilton rating scale for depression. Results We enrolled 75 patients [males; 54 (75 %), mean age; 63.6 years, SD ± 6.8]. Forty-six (61.3 %) patients had been either formally diagnosed with depression or showed symptoms of depression. Bradykinesia, monthly income below Rs. 10,000 and having a family history of depression were significantly associated with a diagnosis of life-time post Parkinson’s disease depression (p < 0.05). Conclusion Given the potential benefit in treatment (for depression), all patients with Parkinson’s disease should be screened for depression regularly. HAM-D would be a good screening tool for this purpose as it has good reliability, validity and can be administered within a reasonable time limit.
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Affiliation(s)
- Tharaka B Herath
- Institute of Neurology, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | - Milinda Withana
- University Medical Unit, National Hospital of Sri Lanka, Colombo 10, Sri Lanka
| | - Chaturaka Rodrigo
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Ranjani Gamage
- Institute of Neurology, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | - Chanika Gamage
- Institute of Neurology, National Hospital of Sri Lanka, Colombo, Sri Lanka
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Impaired interhemispheric synchrony in Parkinson's disease with depression. Sci Rep 2016; 6:27477. [PMID: 27265427 PMCID: PMC4893739 DOI: 10.1038/srep27477] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 05/19/2016] [Indexed: 01/11/2023] Open
Abstract
The alterations of interhemispheric resting-state functional connectivity (FC) in Parkinson’s disease (PD) with depression remain unclear, so we aimed to explore the differences of interhemispheric FC between PD with and without depression. Twenty-one depressed PD (DPD) patients, 49 non-depressed PD (NDPD) patients and 50 matched healthy controls (HC) participated in this study. Resting-state functional magnetic resonance imaging (fMRI) data were analyzed with the voxel-mirrored homotopic connectivity (VMHC) approach. The DPD patients showed lower VMHC values in the bilateral dorsolateral prefrontal cortex (DLPFC) and calcarine cortex compared to both NDPD and HC groups, and further receiver operating characteristic curves (ROC) analyses revealed that the VMHC in these two brain areas could be used as biomarkers to distinguish DPD from NDPD and from HC. The pooled PD patients (both DPD and NDPD) exhibited decreased VMHC in the bilateral putamen, middle occipital gyrus (MOG), postcentral gyrus (PoCG), paracentral lobule (PCL) and cerebellum posterior lobe when compared with HC. Decreased VMHC values within the DLPFC and calcarine cortex appeared to be unique features for DPD and might be used as potential neuroimaging markers to distinguish DPD patients from NDPD and HC groups. These findings may underlie the neural mechanisms of depression in PD.
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Bouwmans AEP, Weber WEJ, Leentjens AFG, Mess WH. Transcranial sonography findings related to depression in parkinsonian disorders: cross-sectional study in 126 patients. PeerJ 2016; 4:e2037. [PMID: 27231659 PMCID: PMC4878362 DOI: 10.7717/peerj.2037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 04/23/2016] [Indexed: 12/02/2022] Open
Abstract
Background. Transcranial sonography (TCS) has emerged as a potential diagnostic tool for Parkinson’s disease. Recent research has suggested that abnormal echogenicity of substantia nigra, raphe nuclei and third ventricle is associated with increased risk of depression among these patients. We sought to reproduce these findings in an ongoing larger study of patients with parkinsonian syndromes. Methods. A total of 126 patients with parkinsonian symptoms underwent the Hamilton Depression Scale, and TCS of the substantia nigra (SN) (n = 126), the raphe nuclei (RN) (n = 80) and the third ventricle (n = 57). We then calculated the correlation between depression and hyper-echogenic SN, hypo-echogenic RN and a wider third ventricle. Results. In patients with PD we found no significant difference of the SN between non-depressed and depressed patients (46% vs. 22%; p = 0.18). Non-depressed patients with other parkinsonisms more often had hyperechogenicity of the SN than depressed patients (51% vs. 0%; p = 0.01). We found no relation between depression and the echogenicity of the RN or the width of the third ventricle. Conclusions. In patients with parkinsonian syndromes, we found no association between depression and hyper-echogenic SN, hypo-echogenic RN or a wider third ventricle, as determined by transcranial sonography.
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Affiliation(s)
| | - Wim E J Weber
- Department of Neurology, Maastricht University Medical Centre , Maastricht , Netherlands
| | - Albert F G Leentjens
- Department of Psychiatry, Maastricht University Medical Centre , Maastricht , Netherlands
| | - Werner H Mess
- Department of Clinical Neurophysiology, Maastricht University Medical Centre , Maastricht , Netherlands
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