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Parkinson's: Psychological Symptoms & Psychological Interventions--

27 Recent Studies

Kenneth S. Pope, Ph.D., ABPP

The resources I've gathered together on this page are intended to help therapists, counselors, people with Parkinson's disease, and their families and loved one keep up with new research findings on psychological aspects (both symptoms and interventions) of the condition.

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The following recent 27 studies -- each with a complete citation and excerpt -- were published in 2016:

Abe, K., et al. (2016). "A case of Parkinson disease with both visual hallucination and pain improved by Gabapentin." Clinical Neuropharmacology 39(1): 55-56.

EXCERPT: "The positive outcomes of GPT on VH and pain without any adverse effects may offer us a useful alternative treatment for PD."

Buoli, M., et al. (2016). "Psychiatric conditions in Parkinson disease: A comparison with classical psychiatric disorders." Journal of Geriatric Psychiatry and Neurology 29(2): 72-91.

EXCERPT: "Psychiatric conditions in patients with PD present substantial differences with respect to classical psychiatric disorders. Their clinical presentation does not align with the symptom profiles represented by Diagnostic and Statistical Manual for Mental Disorders and International Classification of Diseases. Furthermore, psychiatry treatment guidelines are of poor help in managing psychiatric symptoms of patients with PD."

Cereda, E., et al. (2016). "Dementia in parkinson's disease: Is male gender a risk factor?" Parkinsonism & Related Disorders. Published online before print publication.

EXCERPT: "Prevalence of dementia was 11.5% (95%CI, 10.8–12.3) and 13.5% (95%CI, 12.7–14.5) in the whole population (N = 6599) and in those aged at least 60 years (N = 5373), respectively. Age and disease duration were independently associated with dementia, and the latter was associated with dementia up to 84 years of age. Male gender was an independent risk factor. In addition, while the rate of dementia increased in males over all age strata, we found that in females prevalence began to increase steadily after the age of 65 years, reaching male estimates only after 80 years of age. Higher rates in male gender were observed between 60 and 80 years of age…..Age and PD duration are confirmed risk factors for dementia. However, disease duration appeared to be a less important factor in cognitive decline in patients aged at least 85 years. As opposed to gender-specific estimates in the general population, male gender is likely associated with higher rates of dementia in PD patients."

DeGutis, J., et al. (2016). "Sustained attention training reduces spatial bias in Parkinson's disease: A pilot case series." Neurocase 22(2): 179-186.

EXCERPT: Individuals with Parkinson's disease (PD) commonly demonstrate lateralized spatial biases, which affect daily functioning. Those with PD with initial motor symptoms on the left body side (LPD) have reduced leftward attention, whereas PD with initial motor symptoms on the right side (RPD) may display reduced rightward attention…. Before training, all participants showed a significant spatial bias and after training, all participants' spatial bias was eliminated.

Galtier, I., et al. (2016). "Mild cognitive impairment in Parkinson's disease: Diagnosis and progression to dementia." Journal of Clinical and Experimental Neuropsychology 38(1): 40-50.

EXCERPT: "The results showed that 60.5% of the patients were diagnosed with PD-MCI when a comprehensive assessment was performed (MDS criteria Level 2), while 23.3% of the patients met MCI criteria when a brief assessment was used (MDS criteria Level 1). Multiple domain impairment was the most frequent impairment (96.2%). A total of 42.3% of PD-MCI patients had dementia in the follow-up study. Logistic regression showed that the Hoehn and Yahr stage and education significantly contributed to the prediction of PD-MCI. Moreover, the Hoehn and Yahr stage and memory domain significantly contributed to the prediction of dementia."

Gasca-Salas, C., et al. (2016). "Significance of visual hallucinations and cerebral hypometabolism in the risk of dementia in parkinson's disease patients with mild cognitive impairment." Human Brain Mapping 37(3): 968-977.

EXCERPT: "Even in the absence of significant cognitive differences, PD-MCI patients with VH exhibit more severe cerebral hypometabolism and had a higher rate of progression to dementia than VH-negative patients, supporting the importance of VH and cerebral hypometabolism in establishing the risk of dementia in PD-MCI."

Ghaddar, A., et al. (2016). "Prevalence of depression in Parkinson's disease in a Lebanese tertiary clinic." Journal of Clinical and Experimental Neuropsychology 38(1): 51-58.

EXCERPT: "Depression was diagnosed in 46% of the patients enrolled. Most of these patients were treated with an antidepressant. Young age, female gender, and moderate Parkinson's disease stage were found to be significantly associated with depression (odds ratio of 1.19, 1.23, and 1.22, respectively, p < .05). Conclusion: This study, the first of its kind in Lebanon and the Middle East and North Africa region, highlights the importance of studying depression in Parkinson's disease and the need for identifying and treating depression symptoms when treating Parkinson's disease patients."

Hall, J. M., et al. (2016). "Dysfunction in attentional processing in patients with parkinson's disease and visual hallucinations." Journal of Neural Transmission. Published online in advance of print publication.

EXCERPT: "Hallucinators had significantly lower accuracy rates compared to non-hallucinators, but no differences were found in reaction times. This suggests that hallucinators show deficits in attentional processes and conflict monitoring."

Korczyn, A. D. (2016). "Parkinson's and Alzheimer's diseases: Focus on mild cognitive impairment." Parkinsonism & Related Disorders 22(Suppl 1): S159-S161.

EXCERPT: "Patients with PD have a very high likelihood of developing dementia, insidiously over many years. Cognitive impairment may start even before other symptoms. No constellation of cognitive symptoms in an otherwise healthy individual will herald development of AD or indeed will progress to dementia, including PD-dementia, in high likelihood. At present, identification of subtle cognitive dysfunction even in a person with diagnosed PD does not benefit the patient and should be avoided, except for research purposes."

Lee, W.-J., et al. (2016). "Pdd-5s: A useful screening tool for parkinson's disease dementia." Parkinsonism & Related Disorders. Published online in advance of print publication.

EXCERPT: "We tested this screening tool in another 137 unrelated PD patients and the sensitivity, specificity, and AUC were 77.4%, 96.4%, and 0.869, respectively…. The PDD-5S is a brief and useful screening tool for PDD.

Levin, J., et al. (2016). "Psychosis in Parkinson's disease: Identification, prevention and treatment." Journal of Neural Transmission 123(1): 45-50.

EXCERPT: "Psychosis in Parkinson's disease (PD) is a frequent condition affecting > 20 % of all PD patients. It is characterized by vivid dreams, nightmares, illusions, delusions and mostly visual hallucinations. Typically psychosis occurs in the late stage of PD, affecting up to 70 % of the patients following a disease duration of 20 years or more, and can severely interfere with the care of the patients, especially if the patients develop delusions. Psychosis is the principal cause of admission to a nursing home for PD patients…. As psychosis in PD is a frequent and important problem, [this article presents] a state-of-the-art guideline for its identification and treatment.

Murgia, Mauro, Federica Corona, Roberta Pili, Fabrizio Sors, Tiziano Agostini, Carlo Casula, Massimiliano Pau, and Marco Guicciardi. "Rhythmic Auditory Stimulation (RAS) and motor rehabilitation in Parkinson's disease: new frontiers in assessment and intervention protocols." Open Psychol. J 8 (2015): 220-229.

EXCERPT: "In the present work we describe the neurological bases and perceptual-motor deficits generally associated with Parkinson's disease, with a specific focus on gait disturbances. Within this framework, we review the role of auditory cueing in the modulation of patients' gait, addressing this issue from the cognitive, neurological and biomechanical perspectives. In particular, we focus on the new frontiers of both assessment and intervention. With regards to the assessment, we describe the advantages of the three-dimensional quantitative multifactorial gait analysis."

Navarta-Sánchez, M. V., et al. (2016). "Factors influencing psychosocial adjustment and quality of life in parkinson patients and informal caregivers." Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care & Rehabilitation. Published online in advance of print publication.

EXCERPT: "Regression models showed that severity of PD was the main predictor of psychosocial adjustment and QoL in patients. Nevertheless, multiple regression analyses also revealed that coping was a significant predictor of psychosocial adjustment in patients and caregivers. Furthermore, psychosocial adjustment was significantly related to QoL in patients and caregivers. Also, coping and benefit finding were predictors of QoL in caregivers but not in patients…. Multidisciplinary interventions aimed at improving PD patients' QoL may have more effective outcomes if education about coping skills, and how these can help towards a positive psychosocial adjustment to illness, were included, and targeted not only at patients, but also at informal caregivers."

Park, H.-E., et al. (2016). "Autonomic nervous system dysfunction in patients with Parkinson disease having depression." Journal of Geriatric Psychiatry and Neurology 29(1): 11-17.

EXCERPT: "Depression is associated with neurocirculatory abnormalities—especially orthostatic hypotension—in early PD. Although the association does not imply causation, this result suggests that depression in PD might be associated with functional impairment of the autonomic nervous system and its pathologic substrate."

Prakash, K. M., et al. (2016). "The impact of non-motor symptoms on the quality of life of parkinson's disease patients: A longitudinal study." European Journal of Neurology. Published online in advance of print publication.

EXCERPT: "Unlike motor disabilities, NMSs burden, in particular sleep, mood and attention, have a significant impact on the QoL of PD patients over a 2-year follow-up period."

Putcha, D., et al. (2016). "Salience and default mode network coupling predicts cognition in aging and Parkinson's disease." Journal of the International Neuropsychological Society 22(2): 205-215.

EXCERPT: "PD participants were impaired on tests from all three domains compared to control participants. Our imaging results demonstrated that successful cognition across healthy aging and Parkinson's disease participants was related to anti-correlated coupling between the salience and default mode networks. Individuals with poorer performance scores across groups demonstrated more positive salience network/default-mode network coupling…. Successful cognition relies on healthy coupling between the salience and default mode networks, which may become dysfunctional in PD. These results can help inform non-pharmacological interventions (repetitive transcranial magnetic stimulation) targeting these specific networks before they become vulnerable in early stages of Parkinson's disease."

Rana, A. Q., et al. (2016). "Association of restless legs syndrome, pain, and mood disorders in Parkinson's disease." International Journal of Neuroscience 126(2): 116-120.

EXCERPT: "Parkinson's disease patients had significantly greater anxiety severity, depression severity, pain severity, pain interference, pain disability, and restless legs syndrome prevalence in comparison to controls. In addition, Parkinson's disease patients' comorbid for anxiety and depression had significantly greater pain severity, pain interference, and pain disability, but not RLS prevalence, in comparison to Parkinson's disease only, Parkinson's disease anxiety, and Parkinson's disease depression patients…. Pain interference, pain severity, and pain disability is greater among Parkinson's disease patients with anxiety and depression, in comparison to Parkinson's disease patients without anxiety and depression. On the contrary, the prevalence of restless legs syndrome was not found to be relevant."

Renfroe, J. B., et al. (2016). "Motivational engagement in Parkinson's disease: Preparation for motivated action." International Journal of Psychophysiology 99: 24-32.

EXCERPT: "Whereas PD patients showed similar enhanced action preparation with the addition of incentives to controls, PD patients showed generally reduced action preparation, evidenced by reduced CNV amplitude overall. Results suggest that PD patients may have behavioral issues due to globally impaired action preparation but that this deficit is not emotion-specific, and movement preparation may be aided by incentive in PD patients."

Riedel, O., et al. (2016). "Estimating the prevalence of parkinson's disease (pd) and proportions of patients with associated dementia and depression among the older adults based on secondary claims data." International Journal of Geriatric Psychiatry. Published online in advance of print publication.

EXCERPT: "The standardized prevalence of PD was 1680...cases per 100,000 persons…. Dementia and depression occurred in 26.6%...and 32.6%...of PD cases, respectively."

Straughan, S., et al. (2016). "Visual priming and visual hallucinations in Parkinson's disease. Evidence for normal top-down processes." Journal of Geriatric Psychiatry and Neurology 29(1): 25-30.

EXCERPT: "All tasks showed significant priming effects. The PD + VH group was more impaired at accurately identifying silhouette and fragmented images compared to the PD - VH group. There were no differences in priming between the 2 PD groups…. The study showed that VH in PD are not associated with relatively greater top-down activation, and that the interaction between top-down and bottom-up processes is intact.

Svensson, E., et al. (2016). "Adjustment disorder and risk of parkinson's disease." European Journal of Neurology. Published online in advance of print publication.

EXCERPT: "Adjustment disorder, a diagnosis made in the presence of severe response to stressful life events, was associated with an increased risk of PD."

Tang, H., et al. (2016). "Cognitive profile of Parkinson's disease patients: A comparative study between early-onset and late-onset Parkinson's disease." International Journal of Neuroscience 126(3): 227-234.

EXCERPT: "Although EOPD patients had longer disease duration, their cognitive dysfunction progressed more slowly. The MoCA tests revealed that EOPD patients had higher scores in visuospatial function, attention, delayed recall, and orientation than the LOPD patients. The difference between the two groups on the WMS-RC test did not reach significance, whereas the scores in executive function, visuospatial function and attention as measured on the WAIS-RC test were significantly lower in the LOPD group. In addition, P300 latencies were markedly delayed and P300 amplitudes were reduced in the LOPD group…. The current findings demonstrated that cognitive dysfunction progressed more slowly in the EOPD group. Although the LOPD patients exhibited shorter disease durations, their cognitive abilities, including executive function, visuospatial function and attention, may have been impaired."

Vlagsma, T. T., et al. (2016). "Parkinson's patients' executive profile and goals they set for improvement: Why is cognitive rehabilitation not common practice?" Neuropsychological Rehabilitation 26(2): 216-235.

EXCERPT: "Overall, PD patients' goals and cognitive profile were similar to those of patients with ABI. Therefore, based on the findings of this study, there is no reason to assume that strategic executive training cannot be part of standard therapy in PD. However, when strategic executive training is applied in clinical practice, disease-specific characteristics need to be taken into account."

Yuvaraj, R., et al. (2016). "Brain functional connectivity patterns for emotional state classification in Parkinson's disease patients without dementia." Behavioural Brain Research 298(Part B): 248-260.

EXCERPT: "The experimental results indicate that the BFC change is significantly different among emotional states of PD patients compared with HC. Also, the emotional connectivity pattern classified using Support Vector Machine (SVM) classifier yielded the highest accuracy for the new bispectral functional connectivity index. The PD patients showed emotional impairments as demonstrated by a poor classification performance. This finding suggests that decrease in the functional connectivity indices during emotional stimulation in PD, indicating functional disconnections between cortical areas."

Zeng, B. Y. and K. Zhao (2016). "Effect of acupuncture on the motor and nonmotor symptoms in parkinson's disease—a review of clinical studies." CNS Neuroscience & Therapeutics. Published online in advance of print publication.

EXCERPT: "Acupuncture either manual or electroacupuncture stimulation at specific acupoints relieved some motor symptoms in patients with Parkinson's and markedly improved many nonmotor symptoms such as psychiatric disorders, sleep problems, and gastrointestinal symptoms. When it was used as an adjunct for levodopa, acupuncture improved therapeutic efficacy and reduced dosage and the occurrence of side effects of levodopa. However, the results were constrained by small sample sizes, methodological flaws, and blinding methods of studies. Although the evidence for the effectiveness of acupuncture for treating Parkinson's is inconclusive, therapeutic potential of acupuncture seems quite promising."

Zhu, K., et al. (2016). "Course and risk factors for excessive daytime sleepiness in parkinson's disease." Parkinsonism & Related Disorders.

EXCERPT: "Excessive daytime sleepiness (EDS) is a common feature of Parkinson's disease (PD) that contributes to the disease burden and increases risk of harm….EDS proved a non-persistent symptom, although persistency and the proportion of patients with EDS increased with longer follow-up. At baseline 43% of patients had EDS, while 46% of patients without EDS at baseline developed this symptom during follow-up. Male gender, poorer nighttime sleep, cognitive and autonomic dysfunction, hallucinations, less severe dyskinesias, dose of dopamine agonists and use of antihypertensives were associated with higher EDS scores over time, while use of benzodiazepines was associated with lower scores. Baseline SCOPA-SLEEP-DS score and PIGD phenotype were risk factors for future EDS…. With longer disease duration a large proportion of patients develop EDS. Some risk factors are modifiable and patients should be monitored to improve quality of life and reduce risk of harm."

Zweig, R. M., et al. (2016). "Cognitive and psychiatric disturbances in parkinsonian syndromes." Neurologic Clinics 34(1): 235-246.

EXCERPT: "Parkinsonian syndromes share clinical signs including akinesia/bradykinesia and rigidity, which are consequences of pathology involving dopaminergic substantia nigra neurons. Yet cognitive and psychiatric disturbances are common, even early in the course of disease. Executive dysfunction is often measurable in newly diagnosed Parkinson's disease. Treatment with dopaminergic medications, particularly dopamine agonists, has been associated with hallucinations and impulse control disorder. Older age, presence of APOE-4 gene, and/or other factors result in amyloid plaque deposition that, in turn, accelerates cortical Lewy body plus tau pathology, linking Dementia with Lewy Bodies and Parkinson's disease with early dementia with Alzheimer's disease. [This article discussed] treatments available for cognitive deficits,depression, and psychotic symptoms…."


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