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Erga AH, Alves G, Leentjens AF. Corrigendum to "The ePark study protocol: A decentralized trial of individual video-assisted cognitive behavioural therapy for depressive disorder in Parkinson's disease" [Contemp. Clinic. Trials Commun. 32 (2023) 101080]. Contemp Clin Trials Commun 2023; 35:101205. [PMID: 37745287 PMCID: PMC10517352 DOI: 10.1016/j.conctc.2023.101205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023] Open
Abstract
[This corrects the article DOI: 10.1016/j.conctc.2023.101080.].
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Affiliation(s)
- Aleksander H. Erga
- The Norwegian Centre for Movement Disorders, Stavanger, Norway
- Institute of Social Sciences, University of Stavanger, Stavanger, Norway
- Center for Alcohol and Drug Research (KORFOR), Stavanger University Hospital, Stavanger, Norway
| | - Guido Alves
- The Norwegian Centre for Movement Disorders, Stavanger, Norway
- Department of Chemistry, Bioscience and Environmental Engineering, University of Stavanger, Stavanger, Norway
- Department of Neurology, Stavanger University Hospital, Stavanger, Norway
| | - Albert F.G. Leentjens
- Department of Psychiatry, Maastricht University Medical Center, Maastricht, the Netherlands
- School of Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
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Erga AH, Alves G, Leentjens AF. The ePark study protocol: A decentralized trial of individual video-assisted cognitive behavioural therapy for depressive disorder in Parkinson's disease. Contemp Clin Trials Commun 2023; 32:101080. [PMID: 36817735 PMCID: PMC9931891 DOI: 10.1016/j.conctc.2023.101080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/06/2023] [Accepted: 01/28/2023] [Indexed: 02/05/2023] Open
Affiliation(s)
- Aleksander H. Erga
- The Norwegian Centre for Movement Disorders, Stavanger, Norway
- Institute of Social Sciences, University of Stavanger, Stavanger, Norway
- Center for Alcohol and Drug Research (KORFOR), Stavanger University Hospital, Stavanger, Norway
| | - Guido Alves
- The Norwegian Centre for Movement Disorders, Stavanger, Norway
- Department of Chemistry, Bioscience and Environmental Engineering, University of Stavanger, Stavanger, Norway
- Department of Neurology, Stavanger University Hospital, Stavanger, Norway
| | - Albert F.G. Leentjens
- Department of Psychiatry, Maastricht University Medical Center, Maastricht, the Netherlands
- School of Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
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Carey G, Lopes R, Moonen AJ, Mulders AE, de Jong JJ, Kuchcinski G, Defebvre L, Kuijf ML, Dujardin K, Leentjens AF. Cognitive Behavioral Therapy for Anxiety in Parkinson's Disease Induces Functional Brain Changes. J Parkinsons Dis 2023; 13:93-103. [PMID: 36591659 PMCID: PMC9912714 DOI: 10.3233/jpd-223527] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Cognitive behavioral therapy (CBT) reduces anxiety symptoms in patients with Parkinson's disease (PD). OBJECTIVE The objective of this study was to identify changes in functional connectivity in the brain after CBT for anxiety in patients with PD. METHODS Thirty-five patients with PD and clinically significant anxiety were randomized over two groups: CBT plus clinical monitoring (10 CBT sessions) or clinical monitoring only (CMO). Changes in severity of anxiety symptoms were assessed with the Parkinson Anxiety Scale (PAS). Resting-state functional brain MRI was performed at baseline and after the intervention. Functional networks were extracted by an Independent Component Analysis (ICA). Functional connectivity (FC) changes between structures involved in the PD-related anxiety circuits, such as the fear circuit (involving limbic, frontal, and cingulate structures) and the cortico-striato-thalamo-cortical limbic circuit, and both within and between functional networks were compared between groups and regressed with anxiety symptoms changes. RESULTS Compared to CMO, CBT reduced the FC between the right thalamus and the bilateral orbitofrontal cortices and increased the striato-frontal FC. CBT also increased the fronto-parietal FC within the central executive network (CEN) and between the CEN and the salience network. After CBT, improvement of PAS-score was associated with an increased striato-cingulate and parieto-temporal FC, and a decreased FC within the default-mode network and between the dorsal attentional network and the language network. CONCLUSION CBT in PD-patients improves anxiety symptoms and is associated with functional changes reversing the imbalance between PD-related anxiety circuits and reinforcing cognitive control on emotional processing.
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Affiliation(s)
- Guillaume Carey
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Lille Neuroscience & Cognition, University of Lille, Lille, France,Department of Neurology and Movement Disorders, Lille University Medical Centre, Lille, France,Correspondence to: Guillaume Carey, MD, CHU de Lille, Hôpital Roger Salengro, Avenue du Professeur Emile Laine, Service de Neurologie A, 59037, Lille, France. E-mail:
| | - Renaud Lopes
- Lille Neuroscience & Cognition, University of Lille, Lille, France,Plateformes Lilloises en Biologie & Santé, University of Lille, Lille, France
| | - Anja J.H. Moonen
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Department of Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Anne E.P. Mulders
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Department of Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Joost J.A. de Jong
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Gregory Kuchcinski
- Lille Neuroscience & Cognition, University of Lille, Lille, France,Department of Neuroradiology, Lille University Medical Centre, Lille, France,Plateformes Lilloises en Biologie & Santé, University of Lille, Lille, France
| | - Luc Defebvre
- Lille Neuroscience & Cognition, University of Lille, Lille, France,Department of Neurology and Movement Disorders, Lille University Medical Centre, Lille, France
| | - Mark L. Kuijf
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Kathy Dujardin
- Lille Neuroscience & Cognition, University of Lille, Lille, France,Department of Neurology and Movement Disorders, Lille University Medical Centre, Lille, France
| | - Albert F.G. Leentjens
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Department of Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands
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Carey G, Viard R, Lopes R, Kuchcinski G, Defebvre L, Leentjens AF, Dujardin K. Anxiety in Parkinson's Disease Is Associated with Changes in Brain Structural Connectivity. J Parkinsons Dis 2023; 13:989-998. [PMID: 37599537 PMCID: PMC10578283 DOI: 10.3233/jpd-230035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/02/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Anxiety in Parkinson's disease (PD) has been associated with grey matter changes and functional changes in anxiety-related neuronal circuits. So far, no study has analyzed white matter (WM) changes in patients with PD and anxiety. OBJECTIVE The aim of this study was to identify WM changes by comparing PD patients with and without anxiety, using diffusion-tensor imaging (DTI). METHODS 108 non-demented PD patients with (n = 31) and without (n = 77) anxiety as defined by their score on the Parkinson Anxiety Scale participated. DTI was used to determine the fractional anisotropy (FA) and mean diffusivity (MD) in specific tracts within anxiety-related neuronal circuits. Mean FA and MD were compared between groups and correlated with the severity of anxiety adjusted by sex, center, Hoehn & Yahr stage, levodopa equivalent daily dosage, and Hamilton depression rating scale. RESULTS Compared to patients without anxiety, PD patients with anxiety showed lower FA within the striato-orbitofrontal, striato-cingulate, cingulate-limbic, and caudate-thalamic tracts; higher FA within the striato-limbic and accumbens-thalamic tracts; higher MD within the striato-thalamic tract and lower MD within the striato-limbic tract. CONCLUSIONS Anxiety in PD is associated with microstructural alterations in anxiety-related neuronal circuits within the WM. This result reinforces the view that PD-related anxiety is linked to structural alteration within the anxiety-related brain circuits.
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Affiliation(s)
- Guillaume Carey
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France
- School for Mental Health and Neurosciences (MHeNS), Maastricht University, Maastricht, The Netherlands
- Department of Neurology and Movement Disorders, Lille University Medical Centre, Lille, France
| | - Romain Viard
- Univ Lille, UMS 2014 – US 41 – PLBS – Plateformes Lilloises en Biologie & Santé, Lille, France
| | - Renaud Lopes
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France
- Univ Lille, UMS 2014 – US 41 – PLBS – Plateformes Lilloises en Biologie & Santé, Lille, France
| | - Gregory Kuchcinski
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France
- Univ Lille, UMS 2014 – US 41 – PLBS – Plateformes Lilloises en Biologie & Santé, Lille, France
- Department of Neuroradiology, Lille University Medical Centre, Lille, France
| | - Luc Defebvre
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France
- Department of Neurology and Movement Disorders, Lille University Medical Centre, Lille, France
| | - Albert F.G. Leentjens
- School for Mental Health and Neurosciences (MHeNS), Maastricht University, Maastricht, The Netherlands
- Department of Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Kathy Dujardin
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France
- Department of Neurology and Movement Disorders, Lille University Medical Centre, Lille, France
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Harvey J, Reijnders RA, Cavill R, Duits A, Köhler S, Eijssen LM, Rutten BP, Shireby G, Torkamani A, Creese B, Leentjens AF, Lunnon K, Pishva E. Machine learning‐based prediction of cognitive outcomes in de novo Parkinson's disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.067067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | | | | | - Sebastian Köhler
- School for Mental Health and Neuroscience, Maastricht University Medical Center Maastricht Netherlands
| | | | | | | | - Ali Torkamani
- Scripps Research Translational Institute La Jolla CA USA
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Bouwens van der Vlis TA, Samanci Y, Ackermans L, Schruers KR, Temel Y, Leentjens AF, Dincer A, Peker S. Network analysis in Gamma Knife capsulotomy for intractable obsessive-compulsive disorder. Brain and Spine 2022; 2:100892. [PMID: 36248148 PMCID: PMC9562250 DOI: 10.1016/j.bas.2022.100892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/18/2022] [Accepted: 04/20/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Tim A.M. Bouwens van der Vlis
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, the Netherlands
- Corresponding author. Department of Neurosurgery, Maastricht University Medical Center, Maastricht (MUMC+) PO Box 5800, 6202 AZ, Maastricht, the Netherlands
| | - Yavuz Samanci
- Department of Neurosurgery, School of Medicine, Koç University, Istanbul, Turkey
| | - Linda Ackermans
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, the Netherlands
- School of Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Koen R.J. Schruers
- School of Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Department of Psychiatry and Psychology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Y. Temel
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, the Netherlands
- School of Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Albert F.G. Leentjens
- School of Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Department of Psychiatry and Psychology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Alp Dincer
- Department of Radiology, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Selçuk Peker
- Department of Neurosurgery, School of Medicine, Koç University, Istanbul, Turkey
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Fischer NM, Hinkle JT, Perepezko K, Bakker CC, Morris M, Broen MP, Butala A, Dawson TM, Leentjens AF, Mari Z, Marvel CL, Mills KA, Rosenthal LS, Shepard MD, Pantelyat A, Bakker A, Pletnikova O, Troncoso JC, Wang J, Pontone GM. Brainstem Pathologies Correlate With Depression and Psychosis in Parkinson's Disease. Am J Geriatr Psychiatry 2021; 29:958-968. [PMID: 33455856 PMCID: PMC8277871 DOI: 10.1016/j.jagp.2020.12.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 11/30/2020] [Accepted: 12/12/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND The pathological hallmarks of Parkinson's disease include intraneuronal Lewy bodies, neuronal loss, and gliosis. We aim to correlate Parkinson's disease neuropsychiatric symptoms, (e.g., depression, psychosis, and anxiety) with the severity of neuropathology in the substantia nigra and locus coeruleus. METHODS The brains of 175 participants with a primary pathologic diagnosis of Parkinson's disease were analyzed semi-quantitatively to ascertain the burden of neuronal loss and gliosis and Lewy body pathology within the locus coeruleus and substantia nigra. Participants' history of anxiety, depression, and psychosis were determined using a chart-extracted medical history or record of formal psychiatric evaluation. RESULTS Of the sample, 56% (n = 98), 50% (n = 88), and 31.25% (n = 55) of subjects had a diagnosis of psychosis, depression, and anxiety, respectively. Psychosis (χ2 = 7.1, p = 0.008, df = 1) and depression (χ2 = 7.2, p = 0.007, df = 1) were associated with severe neuronal loss and gliosis in the substantia nigra but not in the locus coeruleus. No association was observed between anxiety and neuronal loss and gliosis in either region. No neuropsychiatric symptoms were associated with Lewy body score. After controlling for disease duration and dementia, psychosis (odds ratio [OR]: 3.1, 95% confidence interval [CI]: 1.5-6.4, χ2 = 9.4, p = 0.012, df = 1) and depression (OR: 2.6, 95% CI: 1.3-5.0, χ2 = 7.9, p = 0.005, df = 1) remained associated with severe neuronal loss and gliosis in the substantia nigra. CONCLUSION These results suggest that psychosis and depression in Parkinson's disease are associated with the underlying neurodegenerative process and demonstrate that cell loss and gliosis may be a better marker of neuropsychiatric symptoms than Lewy body pathology.
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Affiliation(s)
- Nicole Mercado Fischer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Jared T. Hinkle
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States,Medical Scientist Training Program, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Kate Perepezko
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Catherine C. Bakker
- Morris K. Udall Parkinson’s Disease Research Center of Excellence, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Meaghan Morris
- Clinical and Neuropathology Core, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Martinus P.G. Broen
- Department of Neurology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Ankur Butala
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore MD, United States
| | - Ted M. Dawson
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore MD, United States,Neuroregeneration and Stem Cell Programs, Institute for Cell Engineering, Johns Hopkins School of Medicine, Baltimore, MD, United States,Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD, United States,Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Albert F.G. Leentjens
- Department of Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Zoltan Mari
- Morris K. Udall Parkinson’s Disease Research Center of Excellence, Johns Hopkins School of Medicine, Baltimore, MD, United States,Lou Ruvo Center for Brain Health, Cleveland Clinic, Las Vegas, NV, United States
| | - Cherie L. Marvel
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore MD, United States
| | - Kelly A. Mills
- Morris K. Udall Parkinson’s Disease Research Center of Excellence, Johns Hopkins School of Medicine, Baltimore, MD, United States,Department of Neurology, Johns Hopkins School of Medicine, Baltimore MD, United States
| | - Liana S. Rosenthal
- Morris K. Udall Parkinson’s Disease Research Center of Excellence, Johns Hopkins School of Medicine, Baltimore, MD, United States,Department of Neurology, Johns Hopkins School of Medicine, Baltimore MD, United States
| | - Melissa D. Shepard
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Alexander Pantelyat
- Morris K. Udall Parkinson’s Disease Research Center of Excellence, Johns Hopkins School of Medicine, Baltimore, MD, United States,Department of Neurology, Johns Hopkins School of Medicine, Baltimore MD, United States
| | - Arnold Bakker
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Olga Pletnikova
- Morris K. Udall Parkinson’s Disease Research Center of Excellence, Johns Hopkins School of Medicine, Baltimore, MD, United States,Clinical and Neuropathology Core, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Juan C. Troncoso
- Morris K. Udall Parkinson’s Disease Research Center of Excellence, Johns Hopkins School of Medicine, Baltimore, MD, United States,Clinical and Neuropathology Core, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Jiangxia Wang
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Gregory M. Pontone
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States,Morris K. Udall Parkinson’s Disease Research Center of Excellence, Johns Hopkins School of Medicine, Baltimore, MD, United States,Department of Neurology, Johns Hopkins School of Medicine, Baltimore MD, United States
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Carey G, Görmezoğlu M, de Jong JJ, Hofman PA, Backes WH, Dujardin K, Leentjens AF. Neuroimaging of Anxiety in Parkinson's Disease: A Systematic Review. Mov Disord 2021; 36:327-339. [PMID: 33289195 PMCID: PMC7984351 DOI: 10.1002/mds.28404] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/02/2020] [Accepted: 10/26/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The aim of this systematic review was (1) to identify the brain regions involved in anxiety in Parkinson's disease (PD) based on neuroimaging studies and (2) to interpret the findings against the background of dysfunction of the fear circuit and limbic cortico-striato-thalamocortical circuit. METHODS Studies assessing anxiety symptoms in PD patients and studies using magnetic resonance imaging, positron emission tomography, or single-photon emission computed tomography were included. RESULTS The severity of anxiety was associated with changes in the fear circuit and the cortico-striato-thalamocortical limbic circuit. In the fear circuit, a reduced gray-matter volume of the amygdala and the anterior cingulate cortex (ACC); an increased functional connectivity (FC) between the amygdala and orbitofrontal cortex (OFC) and hippocampus and between the striatum and the medial prefrontal cortex (PFC), temporal cortex, and insula; and a reduced FC between the lateral PFC and the OFC, hippocampus, and amygdala were reported. In the cortico-striato-thalamocortical limbic circuit, a reduced FC between the striatum and ACC; a reduced dopaminergic and noradrenergic activity in striatum, thalamus, and locus coeruleus; and a reduced serotoninergic activity in the thalamus were reported. CONCLUSION To conclude, anxiety is associated with structural and functional changes in both the hypothesized fear and the limbic cortico-striato-thalamocortical circuits. These circuits overlap and may well constitute parts of a more extensive pathway, of which different parts play different roles in anxiety. The neuropathology of PD may affect these circuits in different ways, explaining the high prevalence of anxiety in PD and also the associated cognitive, motor, and psychiatric symptoms. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Guillaume Carey
- School for Mental Health and Neurosciences (MHeNS)Maastricht UniversityMaastrichtthe Netherlands
- Université de Lille, Inserm, CHU Lille, Lille Neurosciences and CognitionLilleFrance
| | - Meltem Görmezoğlu
- Department of PsychiatryMaastricht University Medical CenterMaastrichtthe Netherlands
- Department of Psychiatry, Ondokuz Mayis University HospitalOndokuz Mayıs UniversitySamsunTurkey
| | - Joost J.A. de Jong
- School for Mental Health and Neurosciences (MHeNS)Maastricht UniversityMaastrichtthe Netherlands
- Department of Radiology and Nuclear MedicineMaastricht University Medical CenterMaastrichtthe Netherlands
| | - Paul A.M. Hofman
- School for Mental Health and Neurosciences (MHeNS)Maastricht UniversityMaastrichtthe Netherlands
- Department of Radiology and Nuclear MedicineMaastricht University Medical CenterMaastrichtthe Netherlands
| | - Walter H. Backes
- School for Mental Health and Neurosciences (MHeNS)Maastricht UniversityMaastrichtthe Netherlands
- Department of Radiology and Nuclear MedicineMaastricht University Medical CenterMaastrichtthe Netherlands
| | - Kathy Dujardin
- Université de Lille, Inserm, CHU Lille, Lille Neurosciences and CognitionLilleFrance
| | - Albert F.G. Leentjens
- School for Mental Health and Neurosciences (MHeNS)Maastricht UniversityMaastrichtthe Netherlands
- Department of PsychiatryMaastricht University Medical CenterMaastrichtthe Netherlands
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Mestre TA, Fereshtehnejad SM, Berg D, Bohnen NI, Dujardin K, Erro R, Espay AJ, Halliday G, van Hilten JJ, Hu MT, Jeon B, Klein C, Leentjens AF, Marinus J, Mollenhauer B, Postuma R, Rajalingam R, Rodríguez-Violante M, Simuni T, Surmeier DJ, Weintraub D, McDermott MP, Lawton M, Marras C. Parkinson's Disease Subtypes: Critical Appraisal and Recommendations. J Parkinsons Dis 2021; 11:395-404. [PMID: 33682731 PMCID: PMC8150501 DOI: 10.3233/jpd-202472] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND In Parkinson's disease (PD), there is heterogeneity in the clinical presentation and underlying biology. Research on PD subtypes aims to understand this heterogeneity with potential contribution for the knowledge of disease pathophysiology, natural history and therapeutic development. There have been many studies of PD subtypes but their impact remains unclear with limited application in research or clinical practice. OBJECTIVE To critically evaluate PD subtyping systems. METHODS We conducted a systematic review of PD subtypes, assessing the characteristics of the studies reporting a subtyping system for the first time. We completed a critical appraisal of their methodologic quality and clinical applicability using standardized checklists. RESULTS We included 38 studies. The majority were cross-sectional (n = 26, 68.4%), used a data-driven approach (n = 25, 65.8%), and non-clinical biomarkers were rarely used (n = 5, 13.1%). Motor characteristics were the domain most commonly reported to differentiate PD subtypes. Most of the studies did not achieve the top rating across items of a Methodologic Quality checklist. In a Clinical Applicability Checklist, the clinical importance of differences between subtypes, potential treatment implications and applicability to the general population were rated poorly, and subtype stability over time and prognostic value were largely unknown. CONCLUSION Subtyping studies undertaken to date have significant methodologic shortcomings and most have questionable clinical applicability and unknown biological relevance. The clinical and biological signature of PD may be unique to the individual, rendering PD resistant to meaningful cluster solutions. New approaches that acknowledge the individual-level heterogeneity and that are more aligned with personalized medicine are needed.
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Affiliation(s)
- Tiago A. Mestre
- Parkinson’s disease and Movement Disorders Center, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, The University of Ottawa Brain and Research Institute, Ottawa, ON, Canada
- Division of Neurology, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | | | - Daniela Berg
- Department of Neurology, Christian-Albrechts-University, Kiel, Germany
| | - Nicolaas I. Bohnen
- Departments of Radiology & Neurology, University of Michigan, University of Michigan Udall Center, Ann Arbor VAMC, Ann Arbor, MI, USA
| | - Kathy Dujardin
- Movement Disorders Department, Center of Excellence for Neurodegenerative Diseases LiCEND, Lille, France
| | - Roberto Erro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Neuroscience Section, University of Salerno, Baronissi (SA), Italy
| | - Alberto J. Espay
- James J. and Joan A. Gardner Family Center for Parkinson’s Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, USA
| | - Glenda Halliday
- Brain and Mind Centre and Central Clinical School, Faculty of Medicine and Health, University of Sydney, Australia
| | | | - Michele T. Hu
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Neurology Department, Oxford, United Kingdom
| | - Beomseok Jeon
- Department of Neurology, Seoul National University Hospital, Seoul, Korea
| | - Christine Klein
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany
| | - Albert F.G. Leentjens
- Department of Psychiatry, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Johan Marinus
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Brit Mollenhauer
- Paracelsus-Elena-Klinik, Kassel and University Medical Center Goettingen, Department of Neurology, Kassel, Germany
| | - Ronald Postuma
- Department of Neurology, McGill University, Montreal, Quebec, Canada
| | - Rajasumi Rajalingam
- Edmond J. Safra Program in Parkinson’s Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, Canada
| | | | - Tanya Simuni
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - D. James Surmeier
- Department of Physiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Daniel Weintraub
- Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania; Parkinson’s Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - Michael P. McDermott
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Michael Lawton
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Connie Marras
- Edmond J. Safra Program in Parkinson’s Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, Canada
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Görmezoğlu M, Bouwens van der Vlis T, Schruers K, Ackermans L, Polosan M, Leentjens AF. Effectiveness, Timing and Procedural Aspects of Cognitive Behavioral Therapy after Deep Brain Stimulation for Therapy-Resistant Obsessive Compulsive Disorder: A Systematic Review. J Clin Med 2020; 9:jcm9082383. [PMID: 32722565 PMCID: PMC7464329 DOI: 10.3390/jcm9082383] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 02/07/2023] Open
Abstract
Background and aim: Deep brain stimulation (DBS) is an effective treatment for patients with severe therapy-resistant obsessive-compulsive disorder (OCD). After initiating DBS many patients still require medication and/or behavioral therapy to deal with persisting symptoms and habitual behaviors. The clinical practice of administering postoperative cognitive behavioral therapy (CBT) varies widely, and there are no clinical guidelines for this add-on therapy. The aim of this review is to assess the efficacy, timing and procedural aspects of postoperative CBT in OCD patients treated with DBS. Method: Systematic review of literature. Results: The search yielded 5 original studies, one case series and three reviews. Only two clinical trials have explicitly focused on the effectiveness of CBT added to DBS in patients with therapy-resistant OCD. These two studies both showed effectiveness of CBT. However, they had a distinctly different design, very small sample sizes and different ways of administering the therapy. Therefore, no firm conclusions can be drawn or recommendations made for administering CBT after DBS for therapy-resistant OCD. Conclusion: The effectiveness, timing and procedural aspects of CBT added to DBS in therapy-resistant OCD have hardly been studied. Preliminary evidence indicates that CBT has an added effect in OCD patients being treated with DBS. Since the overall treatment effect is the combined result of DBS, medication and CBT, future trials should be designed in such a way that they allow quantification of the effects of these add-on therapies in OCD patients treated with DBS. Only in this way information can be gathered that contributes to the development of an algorithm and clinical guidelines for concomittant therapies to optimize treatment effects in OCD patients being treated with DBS.
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Affiliation(s)
- Meltem Görmezoğlu
- Department of Psychiatry, Ondokuz Mayıs University, 55270 Samsun, Turkey;
- Department of Neurosurgery, Maastricht University Medical Centre, 6229 Maastricht, The Netherlands; (T.B.v.d.V.); (L.A.)
| | - Tim Bouwens van der Vlis
- Department of Neurosurgery, Maastricht University Medical Centre, 6229 Maastricht, The Netherlands; (T.B.v.d.V.); (L.A.)
| | - Koen Schruers
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, 6229 Maastricht, The Netherlands;
- School of Mental Health and Neuroscience, Maastricht University, 6229 Maastricht, The Netherlands
| | - Linda Ackermans
- Department of Neurosurgery, Maastricht University Medical Centre, 6229 Maastricht, The Netherlands; (T.B.v.d.V.); (L.A.)
- School of Mental Health and Neuroscience, Maastricht University, 6229 Maastricht, The Netherlands
| | - Mircea Polosan
- Grenoble Institute of Neurosciences, University of Grenoble Alpes, 38058 Grenoble, France;
| | - Albert F.G. Leentjens
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, 6229 Maastricht, The Netherlands;
- School of Mental Health and Neuroscience, Maastricht University, 6229 Maastricht, The Netherlands
- Correspondence:
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11
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Wolters AF, van de Weijer SC, Leentjens AF, Duits AA, Jacobs HI, Kuijf ML. “Resting-state fMRI in Parkinson's disease patients with cognitive impairment: A meta-analysis”: Answer to Wang and colleagues. Parkinsonism Relat Disord 2019; 66:253-254. [DOI: 10.1016/j.parkreldis.2019.07.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 07/12/2019] [Indexed: 10/26/2022]
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12
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Handels RL, Joore MA, Vos SJ, Aalten P, Ramakers IH, Rikkert MO, Scheltens P, Jansen WJ, Visser PJ, van Berckel BM, van Domburg P, Smid M, Hoff E, Hoogmoed J, Bouwman F, Claassen J, Leentjens AF, Wolfs CA, Severens JL, Verhey FR. Added Prognostic Value of Cerebrospinal Fluid Biomarkers in Predicting Decline in Memory Clinic Patients in a Prospective Cohort. J Alzheimers Dis 2016; 52:875-85. [DOI: 10.3233/jad-151120] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ron L.H. Handels
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands
- CAPHRI School for Public Health and Primary Care, Faculty of Health Medicine and Life Sciences, Department of Health Organization, Policy and Economics, Maastricht University, Maastricht, the Netherlands
| | - Manuela A. Joore
- CAPHRI School for Public Health and Primary Care, Faculty of Health Medicine and Life Sciences, Department of Health Organization, Policy and Economics, Maastricht University, Maastricht, the Netherlands
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Stephanie J.B. Vos
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands
| | - Pauline Aalten
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands
| | - Inez H.G.B. Ramakers
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands
| | - Marcel Olde Rikkert
- Radboudumc Alzheimer Centre, Department of Geriatrics, Donders Centre for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Philip Scheltens
- Department of Neurology and Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands
| | - Willemijn J. Jansen
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands
| | - Pieter-Jelle Visser
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands
- Department of Neurology and Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands
| | - Bart M.N. van Berckel
- Department of Neurology and Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands
| | - Peter van Domburg
- Department of Neurology, Zuyderland Medical Centre, Sittard, The Netherlands
| | - Machiel Smid
- Department of Geriatrics, Zuyderland Medical Centre, Sittard, The Netherlands
| | - Erik Hoff
- Department of Neurology, Zuyderland Medical Centre, Heerlen, The Netherlands
| | - Jan Hoogmoed
- Department of Geriatrics, Laurentius Hospital Roermond, Roermond, The Netherlands
- Department of Geriatrics, St. Jans Gasthuis Weert, Weert, The Netherlands
| | - Femke Bouwman
- Department of Neurology and Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands
| | - Jurgen Claassen
- Radboudumc Alzheimer Centre, Department of Geriatrics, Donders Centre for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Albert F.G. Leentjens
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands
| | - Claire A.G. Wolfs
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands
| | - Johan L. Severens
- Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Frans R.J. Verhey
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands
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Broen MP, Köhler S, Moonen AJ, Kuijf ML, Dujardin K, Marsh L, Richard IH, Starkstein SE, Martinez-Martin P, Leentjens AF. Modeling anxiety in Parkinson's disease. Mov Disord 2015; 31:310-6. [DOI: 10.1002/mds.26461] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 09/06/2015] [Accepted: 09/10/2015] [Indexed: 11/10/2022] Open
Affiliation(s)
- Martijn P.G. Broen
- Department of Neurology; Maastricht University Medical Center; Maastricht The Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg; Maastricht University Medical Center; Maastricht The Netherlands
| | - Anja J.H. Moonen
- Department of Psychiatry; Maastricht University Medical Center; Maastricht The Netherlands
| | - Mark L. Kuijf
- Department of Neurology; Maastricht University Medical Center; Maastricht The Netherlands
| | - Kathy Dujardin
- Neurology and Movement Disorders Unit; Lille University Medical Center; Lille France
| | - Laura Marsh
- Departments of Psychiatry and Neurology; Johns Hopkins University School of Medicine; Baltimore Maryland USA
| | - Irene H. Richard
- Departments of Neurology and Department of Psychiatry; University of Rochester School of Medicine and Dentistry; Rochester New York USA
| | - Sergio E. Starkstein
- School of Psychiatry, University of Western Australia and Fremantle Hospital; Fremantle Western Australia Australia
| | - Pablo Martinez-Martin
- Area of Applied Epidemiology, National Center for Epidemiology, and CIBERNED, Carlos III Institute of Health; Madrid Spain
| | - Albert F.G. Leentjens
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg; Maastricht University Medical Center; Maastricht The Netherlands
- Department of Psychiatry; Maastricht University Medical Center; Maastricht The Netherlands
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Melse M, Tan SK, Temel Y, van Kroonenburgh MJ, Leentjens AF. Changes in 5-HT2A Receptor Expression in Untreated, de novo Patients with Parkinson's Disease. Journal of Parkinson's Disease 2014; 4:283-7. [DOI: 10.3233/jpd-130300] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Maartje Melse
- Department of Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Sonny K.H. Tan
- Department of Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Neurosurgery, University Hospital RWTH Aachen, Aachen, Germany
| | - Yasin Temel
- Department of Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - Albert F.G. Leentjens
- Department of Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Psychiatry, Maastricht University Medical Center, Maastricht, The Netherlands
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15
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Dujardin K, Leentjens AF, Langlois C, Moonen AJ, Duits AA, Carette AS, Duhamel A. The spectrum of cognitive disorders in Parkinson's disease: A data-driven approach. Mov Disord 2013; 28:183-9. [DOI: 10.1002/mds.25311] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Revised: 11/06/2012] [Accepted: 11/12/2012] [Indexed: 11/08/2022] Open
Affiliation(s)
- Kathy Dujardin
- Laboratoire de Neurosciences Fonctionnelles et Pathologies; University of Lille 2; EA4559 Lille France
- Neurology and Movement Disorders Department; Lille University Medical Center; Lille France
| | - Albert F.G. Leentjens
- Department of Psychiatry; Maastricht University Medical Center; Maastricht the Netherlands
| | - Carole Langlois
- Department of Biostatistics; Lille University Medical Center; Lille France
| | - Anja J.H. Moonen
- Department of Psychiatry; Maastricht University Medical Center; Maastricht the Netherlands
| | - Annelien A. Duits
- Department of Psychiatry; Maastricht University Medical Center; Maastricht the Netherlands
| | - Anne-Sophie Carette
- Neurology and Movement Disorders Department; Lille University Medical Center; Lille France
| | - Alain Duhamel
- Department of Biostatistics; Lille University Medical Center; Lille France
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16
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Drijgers RL, Verhey FR, Tissingh G, van Domburg PH, Aalten P, Leentjens AF. The role of the dopaminergic system in mood, motivation and cognition in Parkinson's disease: A double blind randomized placebo-controlled experimental challenge with pramipexole and methylphenidate. J Neurol Sci 2012; 320:121-6. [DOI: 10.1016/j.jns.2012.07.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Revised: 05/05/2012] [Accepted: 07/06/2012] [Indexed: 10/28/2022]
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17
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Leentjens AF, Rundell JR, Diefenbacher A, Kathol R, Guthrie E. Psychosomatic Medicine and Consultation-Liaison Psychiatry: Scope of Practice, Processes, and Competencies for Psychiatrists or Psychosomatic Medicine Specialists. Psychosomatics 2011; 52:19-25. [PMID: 21300191 DOI: 10.1016/j.psym.2010.11.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2010] [Revised: 10/26/2010] [Accepted: 10/29/2010] [Indexed: 10/14/2022]
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18
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Reijnders JS, Scholtissen B, Weber WE, Aalten P, Verhey FR, Leentjens AF. Neuroanatomical correlates of apathy in Parkinson's disease: A magnetic resonance imaging study using voxel-based morphometry. Mov Disord 2010; 25:2318-25. [DOI: 10.1002/mds.23268] [Citation(s) in RCA: 148] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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19
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Leentjens AF. Reply: The measurement of anhedonia in Parkinson's disease: Psychometric properties of the Snaith-Hamilton Pleasure Scale (SHAPS) and the relevance to distinguish anticipatory and consummatory anhedonias. Mov Disord 2010. [DOI: 10.1002/mds.22973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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20
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Leentjens AF, Koester J, Fruh B, Shephard DTS, Barone P, Houben JJ. The effect of pramipexole on mood and motivational symptoms in parkinson's disease: A meta-analysis of placebo-controlled studies. Clin Ther 2009; 31:89-98. [DOI: 10.1016/j.clinthera.2009.01.012] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2008] [Indexed: 10/21/2022]
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22
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Leentjens AF, Verhey FR, Vreeling FW. [Successful treatment of depression in a Parkinson disease patient with bupropion]. Ned Tijdschr Geneeskd 2000; 144:2157-9. [PMID: 11086491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
A 70-year-old female patient with Parkinson's disease was admitted to hospital with a medication-resistant depression. Electroconvulsion therapy was considered indicated, but it was decided to try treatment with bupropion chloride first. This resulted in a quick and complete remission of depressive symptoms, without any negative effects on motor symptoms. Bupropion has a unique mechanism of action: inhibition of the presynaptic reuptake of dopamine in addition to noradrenergic activity. Furthermore, it lacks the negative adverse effects on the extrapiramidal symptoms, that may be a problem if other antidepressants are used in the treatment. Bupropion is useful as an antidepressant in specific patient groups, notably patients with Parkinson's disease.
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Affiliation(s)
- A F Leentjens
- Afd. Psychiatrie, Academisch Ziekenhuis, Maastricht.
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23
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Leentjens AF, Verhey FR, Luijckx GJ, Troost J. The validity of the Beck Depression Inventory as a screening and diagnostic instrument for depression in patients with Parkinson's disease. Mov Disord 2000; 15:1221-4. [PMID: 11104209 DOI: 10.1002/1531-8257(200011)15:6<1221::aid-mds1024>3.0.co;2-h] [Citation(s) in RCA: 205] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To evaluate the validity of the Beck Depression Inventory (BDI) as a screening and diagnostic scale for depression in Parkinson's disease (PD). PATIENTS AND METHODS Fifty-three nondemented patients with PD were diagnosed according to a standardized protocol consisting of the depression module of the Structured Clinical Interview for DSM axis I disorders (SCID) and the BDI. A "receiver operating characteristics" (ROC) curve was obtained and the sensitivity, specificity, positive and negative predictive values (PPV and NPV, respectively) were calculated for different cut-off points of the BDI. RESULTS Maximum discrimination was obtained with a cut-off score of 13/14. High sensitivity and NPV were obtained with cut-off scores of 8/9 or lower; a high specificity and PPV were obtained with cut-off scores of 16/17 or higher. The area under the ROC curve was 85.67%. CONCLUSION A single cut-off score on the BDI to distinguish nondepressed from depressed patients with PD is not feasible. If one accepts the low specificity, then the BDI can be used as a valid screening instrument for depression in PD with a cut-off of 8/9. With a cut-off score of 16/17, it can be used as a diagnostic scale, at the cost of a low sensitivity. The use of diagnostic criteria for depression remains necessary.
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Affiliation(s)
- A F Leentjens
- Department of Psychiatry, Maastricht University Hospital, The Netherlands
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Leentjens AF, Verhey FR, Lousberg R, Spitsbergen H, Wilmink FW. The validity of the Hamilton and Montgomery-Asberg depression rating scales as screening and diagnostic tools for depression in Parkinson's disease. Int J Geriatr Psychiatry 2000; 15:644-9. [PMID: 10918346 DOI: 10.1002/1099-1166(200007)15:7<644::aid-gps167>3.0.co;2-l] [Citation(s) in RCA: 198] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The concurrent validity of the Hamilton Rating Scale for Depression (HAMD-17) and the Montgomery-Asberg Depression Rating Scale (MADRS) against the DSM-IV diagnosis 'depressive disorder' was assessed in patients with Parkinson's disease (PD). Sixty-three non-demented Parkinson's Disease (PD) patients who attended the outpatient department of an academic hospital were diagnosed according to a standardised research protocol. This protocol consisted of the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) to establish the presence or absence of 'depressive disorder' according to the DSM-IV criteria, as well as the HAMD-17 and the MADRS. Receiver Operating Characteristics curves (ROC curves) were obtained and the positive and negative predictive values (PPV, NPV) were calculated for different cut-off scores. Maximum discrimination between depressed and non-depressed patients was reached at a cut-off score of 13/14 for the HAMD-17, and at 14/15 for the MADRS. At lower cut-offs, like 11/12 for the HAMD-17 and 14/15 for the MADRS, the high sensitivity and NPV make these scales good screening instruments. At higher cut-offs, such as 16/17 for the HAMD-17 and 17/18 for the MADRS, the high specificity and PPV make these instruments good diagnostic instruments. The diagnostics performance of the HAMD-17 is slightly better than that of the MADRS. This study shows that it is justified to use the HAMD-17 and the MADRS to measure depressive symptoms in both non-depressed and depressed PD patients, to diagnose depressive disorder in PD, and to dichotomize patient samples into depressed and non-depressed groups.
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Affiliation(s)
- A F Leentjens
- Department of Psychiatry, Maastricht University Hospital, The Netherlands.
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van den Broek WW, Leentjens AF, Mulder PG, Kusuma A, Bruijn JA. Low-dose esmolol bolus reduces seizure duration during electroconvulsive therapy: a double-blind, placebo-controlled study. Br J Anaesth 1999; 83:271-4. [PMID: 10618942 DOI: 10.1093/bja/83.2.271] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We have measured the effect of a bolus dose of esmolol 80 mg i.v. on heart rate, and systolic (SAP), diastolic (DAP) and mean (MAP) arterial pressures during electroconvulsive therapy (ECT). We also assessed seizure duration using both the cuff method and two-lead EEG. We studied 20 patients in a double-blind, placebo-controlled, within-patient blocked randomized study. No patient was receiving psychotherapeutic drugs or had cardiovascular disease. Esmolol significantly reduced heart rate, SAP and MAP before the stimulus, and also significantly reduced the increases in these variables during the convulsion, compared with placebo. However, seizure duration was also significantly reduced, possibly making ECT less effective. The reduction in seizure duration was 5.83 s when monitored clinically and 9.9 s when measured by the EEG. Because of the reduction in seizure duration, routine administration of esmolol is not advisable because it may interfere with the efficacy of ECT, but administration of esmolol during ECT could be useful to reduce tachycardia and hypertension in high-risk patients.
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Affiliation(s)
- W W van den Broek
- Department of Psychiatry, University Hospital Rotterdam-Dijkzigt, The Netherlands
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Abstract
A patient with central pontine myelinolysis (CPM) underwent neurological and mental status examination, as well as neuropsychological testing, during the acute stage of the disease. After correction of the hyponatremia, a gross change in his neuropsychiatric status was observed. The patient underwent extensive neurological, psychiatric, and neuropsychological testing during the acute phase of the disease and at follow-up 4 months later. All major neurological and neuropsychiatric symptoms present at onset were fully reversible. Neuropsychological examination revealed deficits in the domains of attention and concentration, short-term memory and memory consolidation, visual motor and fine motor speeds, and learning ability. Although improved, neuropsychological testing still revealed remarkable deficits at follow-up. We conclude that neuropsychological deficits can accompany CPM, and that these deficits do not necessarily diminish simultaneously with the radiological or clinical neurological findings but may persist for a longer period of time, or even become permanent. In his recovery the patient started to manifest new neurological symptoms consisting of a mild resting tremor of both hands and slow choreoathetotic movements of the trunk and the head, which we considered to be late neurological sequelae of CPM. The significance of CPM in the differential diagnosis of acute behavioral changes after correction of hyponatremia is stressed, even if correction is achieved slowly and carefully.
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Affiliation(s)
- E Vermetten
- Department of Psychiatry, Maastricht University Hospital, The Netherlands
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27
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Abstract
The objective was to determine whether disturbances of affective prosody constitute part of the symptomatology of schizophrenia. Affective prosody is defined here as a neuropsychological function that encompasses all non-verbal aspects of language that are necessary for recognising and conveying emotions in communication. Twenty six schizophrenic outpatients and twenty four normal controls underwent a standardised prosody test, assessing four different aspects of affective prosody: spontaneous prosody, prosodic recognition, prosodic repetition, and facial affect recognition. Patients scored significantly worse than controls on three of the four subtests: spontaneous prosody, prosodic recognition, and prosodic repetition. There were no significant differences on a subtest for facial affect recognition. Differences in educational level between patients and controls could not account for these differences.
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Affiliation(s)
- A F Leentjens
- General Psychiatric Hospital, Drenthe, Assen, The Netherlands
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28
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Leentjens AF. [Acute dystonia]. Ned Tijdschr Geneeskd 1998; 142:483-4. [PMID: 9562763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Leentjens AF, van den Broek WW, Kusuma A, Bruijn JA. Facilitation of ECT by intravenous administration of theophylline. Convuls Ther 1996; 12:232-7. [PMID: 9034698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Seven patients with major depression who developed seizure inhibition during a course of ECT, were given intravenous theophylline to increase seizure duration. Infusion of 100-200 mg of theophylline, administered slowly over several minutes approximately 30 min before seizure induction, was found to effectively and safely prolong seizure durations. In a total of 55 treatment sessions, no cardiovascular or other complications were seen. On one occasion, seizure duration was prolonged to 220 s.
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Affiliation(s)
- A F Leentjens
- Department of Psychiatry, University Hospital Rotterdam, Dijkzigt, The Netherlands
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Leentjens AF, van den Broek WW, Birkenhäger TK, Moleman P, Bruijn JA. [Effect of adjuvant drug therapy following successful electroconvulsive therapy for therapy-resistant depression is still disappointing]. Ned Tijdschr Geneeskd 1996; 140:241-3. [PMID: 8643129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- A F Leentjens
- Afd. Psychiatrie, Academisch Ziekenhuis Rotterdam-Dijkzigt
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31
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Lemstra A, Leentjens AF, van den Broek WW. [Temporary results only in electroconvulsive therapy in therapy-resistant depression; retrospective study]. Ned Tijdschr Geneeskd 1996; 140:260-4. [PMID: 8643133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To evaluate the use and efficacy of electroconvulsive therapy (ECT) in refractory major depression according to DSM-III-R criteria, and to look for factors predicting response in the acute phase and the occurrence of relapse or recurrence after recovery. DESIGN Retrospective. SETTING University Hospital Rotterdam, The Netherlands. METHODS Of all patients who received ECT between January 1988 and July 1993 data were collected by study of clinical records and of information by treating physicians after discharge. Every patient was visited once, or received an outpatient department appointment, to obtain informed consent, take a follow-up history and evaluate social functioning by scoring Global Assessment of Functioning and Sickness Impact Profile rating scales. RESULTS 35 patients received ECT. In clinical practice, the guidelines of the Netherlands Psychiatric Association were not violated; most patients had received adequate pharmacological pretreatment before the decision to start ECT was made. Two patients died in hospital (not from ECT). In the acute phase 25 of the 33 patients still alive upon discharge showed good recovery. Seven of these suffered relapse within six months. The number of patients with a return of depressive symptoms rose to 12 by the end of the first year of follow-up. Sociodemographic variables and treatment characteristics did not appear to influence the result of treatment in the acute phase, nor the occurrence of relapse or recurrence. With less intensive pre- and post-ECT drug treatment the chances of relapse were increased. CONCLUSIONS ECT is an effective treatment in the acute phase of a depression. Results after a longer period of follow-up are less satisfactory.
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Affiliation(s)
- A Lemstra
- Academisch Ziekenhuis Rotterdam-Dijkzigt, afd. Psychiatrie
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Abstract
The authors present a case history in which cognitive defects caused by hypothyroidism persist after the patient has been rendered euthyroid. Concentration, recall and short-term memory appear to be most severely affected. The scarce literature on the subject is reviewed.
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Affiliation(s)
- A F Leentjens
- Department of Psychiatry, Rotterdam University Hospital, The Netherlands
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Leentjens AF, van der Heijden AM, van Loon NH, Veldhuijsen J, Veldhuijsen-De Vries J, Valkenburg HA, Vos E, Heijnen HA, Bijlmer HA, Heineman E. Malnutrition and diarrhoea in Nepal. J Trop Pediatr 1988; 34:135-6. [PMID: 3404575 DOI: 10.1093/tropej/34.3.135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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