Patients with depression in the early stages of Parkinson's disease: A cross-sectional observational study

Cover Page

Cite item

Full Text

Abstract

Background. Depression is one of the most maladaptive manifestations of Parkinson's disease (PD). The relationship between depression and motor, cognitive, and other affective disorders in the early stages of PD remains debatable.

Aim. To assess the frequency and severity of depression, to clarify the features of motor, affective disorders, and cognitive functions in patients with depression in the early stages of PD.

Materials and methods. We observed 61 patients diagnosed with PD at stages I–II according to the Hoehn–Yahr scale. The average age was 62.2±9.6 years, the average duration of PD was 2.5±1.6 years. Data were analyzed using the Unified PD Scale, the Beck Depression Inventory, the Apathy Scale, the Spielberger Anxiety Inventory, the PD Cognitive Assessment Scale (SCOPA-COG), the digital character substitution test (the «symbols–numbers» test), the Montreal the Cognitive Function Assessment Scale (MoCA), the number-to-letter combination test, the Stroop test.

Results. Symptoms of depression were detected in 48 (79%) patients with PD; 20 (33%) patients had subdepression, 24 (39%) had moderate and severe depression, and 4 (7%) had severe depression. In patients at stage I PD according to Hoehn–Yahr, the frequency of moderate depression was 28%, at stage II (moderate and severe) – 45%, and severe – 10%. Patients with depression were characterized by a greater severity of motor symptoms, disturbances in daily activities, anxiety, apathy, as well as a decrease in executive cognitive functions. An inverse correlation was noted between the duration of depressive symptoms and deterioration in performance on tests to assess attention and control cognitive functions.

Conclusion. Depression is a characteristic feature of the early stages of PD. Its frequency and severity increase from stage I to stage II of PD. Depression can be considered as an indicator of a more severe course of the disease, the progression of impairments in controlling cognitive functions. The possibility of assessing the prognosis of the course of the disease additionally substantiates the need to diagnose depression in patients with PD in the early stages of the disease.

About the authors

Marina R. Nodel’

Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: nodell_m@yahoo.com
ORCID iD: 0000-0003-2511-5560

D. Sci. (Med.), Sechenov First Moscow State Medical University (Sechenov University)

Russian Federation, Moscow

Gyulnara Zh. Mahmudova

Sechenov First Moscow State Medical University (Sechenov University)

Email: makhmudovagzh@mail.ru
ORCID iD: 0000-0002-9766-7084

Graduate Student, Sechenov First Moscow State Medical University (Sechenov University)

Russian Federation, Moscow

Ilmar Nikolas V. Niinoja

Sechenov First Moscow State Medical University (Sechenov University)

Email: niinoja.inv@gmail.com
ORCID iD: 0000-0003-3088-4321

Graduate Student, Sechenov First Moscow State Medical University (Sechenov University)

Russian Federation, Moscow

Dmitry V. Romanov

Sechenov First Moscow State Medical University (Sechenov University)

Email: dm.v.romanov@mail.ru
ORCID iD: 0000-0002-1822-8973

D. Sci. (Med.), Sechenov First Moscow State Medical University (Sechenov University)

Russian Federation, Moscow

References

  1. Postuma RB, Berg D, Stern M, et al. MDS clinical diagnostic criteria for Parkinson’s disease. Mov Disord. 2015;30(12):1591-9. doi: 10.1002/mds.26424
  2. Нодель М.Р., Яхно Н.Н. Нервно-психические нарушения при болезни Паркинсона. Неврология, нейропсихиатрия, психосоматика. 2009;1(2):3-8 [Nodel' MR, Yakhno NN. Nervous and mental disorders of Parkinson’s disease. Neurology, Neuropsychiatry, Psychosomatics. 2009;1(2):3-8 (in Russian)]. doi: 10.14412/2074-2711-2009-30
  3. Нодель М.Р. Болезнь Паркинсона: фокус на нейропсихиатрические нарушения. Российский журнал гериатрической медицины. 2020;3:205-11 [Nodel' MR. Parkinson's disease: focus on neuropsychiatric disorders. Russian Journal of Geriatric Medicine. 2020;3:205-11 (in Russian)]. doi: 10.37586/2686-8636-3-2020-205-211
  4. Alzahrani H, Antonini A, Venneri A. Apathy in mild Parkinson's disease: Neuropsychological and neuroimaging evidence. J Parkinsons Dis. 2016;6(4):821-32. doi: 10.3233/JPD-160809
  5. Scaravilli T, Gasparoli E, Rinaldi F, et al. Health-related quality of life and sleep disorders in Parkinson’s disease. Neurol Sci. 2003;24(3):209-10. doi: 10.1007/s10072-003-0134-y
  6. McKinlay A, Grace RC, Dalrymple-Alford JC, et al. A profile of neuropsychiatric problems and their relationship to quality of life for Parkinson’s disease. Parkinsonism Relat Disord. 2008;14(1):37-42. doi: 10.1016/j.parkreldis.2007.05.009
  7. Нодель М.Р. Влияние нервно-психических нарушений на качество жизни пациентов с болезнью Паркинсона. Неврологический журнал. 2015;1:20-5 [Nodel' MR. The impact of neuropsychiatric symptoms on quality of life of patients with Parkinson’s disease. Nevrologicheskiy Zhurnal (Neurological Journal). 2015;1:20-5 (in Russian)]. doi: 10.18821/1560-9545-2015-20-1-20-27
  8. Hughes TA, Ross HF, Mindham RH, Spokes EG. Mortality in Parkinson's disease and its association with dementia and depression. Acta Neurol Scand. 2004;110(2):118-23. doi: 10.1111/j.1600-0404.2004.00292.x
  9. Marsh L, McDonald WM, Cummings J, et al. Provisional diagnostic criteria for depression in Parkinson’s disease: report of an NINDS/NIMH Work Group. Mov Disord. 2006;21(2):148-58. doi: 10.1002/mds.20723
  10. Leentjens AF, Dujardin K, Marsh L, et al. Anxiety and motor fluctuations in Parkinson's disease: a cross-sectional observational study. Parkinsonism Relat Disord. 2012;18(10):1084-8. doi: 10.1016/j.parkreldis.2012.06.007
  11. Skorvanek M, Martinez-Martin P, Kovacs N. Relationship between the MDS-UPDRS and quality of life: A large multicenter study of 3206 patients. Parkinsonism Relat Disord. 2018;52:83-9. doi: 10.1016/j.parkreldis.2018.03.027
  12. МКБ-10 – Международная классификация болезней 10-го пересмотра, 2019. Режим доступа: https://mkb-10.com/index.php?pid=4211. Ссылка активна на 26.04.2022 [MKB-10 – Mezhdunarodnaya klassifikatsiya boleznei 10-go peresmotra, 2019. Available at: https://mkb-10.com/index.php?pid=4211. Accessed: 26.04.2022 (in Russian)].
  13. Beck AT. Thinking and depression. I. Idiosyncratic content and cognitive distortions. Arch Gen Psychiatry. 1963;9:324-33. doi: 10.1001/archpsyc.1963.01720160014002
  14. Starkstein SE, Mayberg HS, Preziosi TJ, et al. Reliability, validity, and clinical correlates of apathy in Parkinson’s disease. J Neuropsychiatry Clin Neurosci. 1992;4(2):134-9. doi: 10.1176/jnp.4.2.134
  15. Spielberger CD. Manual for the State-Trait-Anxiety Inventory: STAI (form Y). Palo Alto, CA: Consulting Psychologists Press, 1983.
  16. Marinus J, Visser M, Martínez-Martín P, et al. A short psychosocial questionnaire for patients with Parkinson's disease: the SCOPA-PS. J Clin Epidemiol. 2003;56(1):61-7. doi: 10.1016/s0895-4356(02)00569-3
  17. Strauss E, Sherman E, Spreen O. A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary. 3rd ed. New York: Oxford University Press, 2006.
  18. Nasreddine Z, Phillips NA, Bedirian V, et al. MoCa – Cognitive Assessment. 2004. Available at: https://mocatest.org. Accessed: 26.04.2022.
  19. Lezak MD. Neuropsychological Assessment. 2nd ed. New York: Oxford University Press, 1983.
  20. Stroop JR. Studies of interference in serial verbal reactions. J Exp Psychol. 1935;18(6):643-62. doi: 10.1037/h0054651
  21. Яхно Н.Н., Нодель М.Р. Особенности депрессии при болезни Паркинсона. Доктор.Ру. 2013;5(83):50-4 [Yakhno NN, Nodel' MR. Depression in Parkinson’s disease: Specific features. Doktor.Ru. 2013;5(83):50-4 (in Russian)].
  22. Нодель М.Р., Яхно Н.Н. К вопросу о гетерогенности депрессии при болезни Паркинсона. Неврология, нейропсихиатрия, психосоматика. 2020;12(5):46-52 [Nodel' MR, Yakhno NN. On the heterogeneity of depression in Parkinson’s disease. Neurology, Neuropsychiatry, Psychosomatics. 2020;12(5):46-52 (in Russian)]. doi: 10.14412/2074-2711-2020-5-46-52
  23. Aarsland D, Londos E, Ballard C. Parkinson's disease dementia and dementia with Lewy bodies: different aspects of one entity. Int Psychogeriatr. 2009;21(2):216-9. doi: 10.1017/S1041610208008612
  24. Reiff J, Schmidt N, Riebe B, et al. Subthreshold depression in Parkinson's disease. Mov Disord. 2011;26(9):1741-4. doi: 10.1002/mds.23699
  25. Huang C, Ravdin L, Nirenberg M, et al. Neuroimaging markers of motor and nonmotor features of Parkinson's disease: an 18F fluorodeoxyglucose positron emission computed tomography study. Dement Geriatr Cogn Disord. 2013;35(3-4):183-96. doi: 10.1159/000345987
  26. Нийноя И.В., Романов Д.В., Махмудова Г.Ж., Нодель М.Р. Депрессия при болезни Паркинсона: аспекты психопатологической структуры и нозологической квалификации. Психиатрия. 2019;17(4):38-48 [Niinoja IV, Romanov DV, Makhmudova GZ, Nodel MR. Depression in Parkinson’s disease: Aspects of the psychopathological structure and nosological qualification. Psikhiatriya. 2019;17(4):38-48 (in Russian)]. doi: 10.30629/2618-6667-2019-17-4-38-48
  27. Dissanayaka NNW, White E, O’Sullivan JD, et al. The clinical spectrum of anxiety in Parkinson’s disease. Mov Disord. 2014;29(8):967-75. doi: 10.1002/mds.25937
  28. Нодель М.Р. Тревога при болезни Паркинсона. Неврологический журнал. 2018;23(4):176-83 [Nodel MR. Anxiety in Parkinson’s disease. Nevrologicheskiy Zhurnal (Neurological Journal). 2018;23(4):176-83 (in Russian)]. doi: 10.18821/1560-9545-2018-23-4-176-183
  29. Thobois S, Prange S, Sgambato-Faure V, et al. Imaging the etiology of apathy, anxiety and depression in Parkinson’s disease: Implication for treatment. Curr Neurol Neurosci Rep. 2017;17(10):76. doi: 10.1007/s11910-017-0788-0
  30. Нодель М.Р., Яхно Н.Н. Апатия при болезни Паркинсона. Неврологический журнал. 2014;1:9-15 [Nodel' MR, Yakhno NN. Apathy in Parkinson's disease. Nevrologicheskiy Zhurnal (Neurological Journal). 2014;1:9-15 (in Russian)].
  31. Deng X, Tang CY, Zhang J, et al. The cortical thickness correlates of clinical manifestations in the mid-stage sporadic Parkinson's disease. Neurosci Lett. 2016;633:279-89. doi: 10.1016/j.neulet.2016.09.042
  32. Alzahrani H, Venneri A. Cognitive and neuroanatomical correlates of neuropsychiatric symptoms in Parkinson's disease: A systematic review. J Neurol Sci. 2015;356(1-2):32-44. doi: 10.1016/j.jns.2015.06.037

Copyright (c) 2022 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies