pISSN 1738-1495   eISSN 2384-0757
Open Access, Peer-reviewed
    Dement Neurocogn Disord. 2012 Sep;11(3):104-110. Korean.
    Published online Sep 30, 2012.
    https://doi.org/10.12779/dnd.2012.11.3.104
    Copyright© 2012 Korean Dementia Association
    Original Article

    Behavioral and Psychological Symptoms in Patients with Parkinson's Disease According to Cognitive Function

    Im-Tae Han, M.D., Choong Kun Ha, M.D., Chang-Gi Hong, M.D., Jun Yong Choi, M.D., Jong-Hyun Ahn, M.D., Jeong Jin Park, M.D., Na Young Ryoo, M.D., Byung-Nam Yoon, M.D. and Seong Hye Choi, M.D.
      • Department of Neurology, Inha University School of Medicine, Incheon, Korea.
    • Address for correspondence: Seong Hye Choi, MD. Department of Neurology, Inha University School of Medicine, 27 Inhang-ro, Jung-gu, Incheon 400-711, Korea. Tel: +82-32-890-3659, Fax: +82-32-890-3864, Email: seonghye@inha.ac.kr
    Received June 26, 2012; Revised August 07, 2012; Accepted August 07, 2012.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Background

    Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor and nonmotor symptoms such as cognitive impairment and neuropsychiatric symptoms. The aim of this study was to investigate the spectrum of neuropsychiatric symptoms in PD according to cognitive function.

    Methods

    One hundred twenty seven patients with PD were consecutively recruited. They had undergone an intensive interview with a neurologist and the Seoul Neuropsychological Screening Battery-dementia version, and were divided into three groups: 27 patients in PD with normal cognition (PDNC), 57 in PD with mild cognitive impairment (PDMCI), and 43 in PD with Dementia (PDD). Forty five healthy controls without memory complaints were also recruited. The caregivers of all participants administered the Caregiver-Administered Neuropsychiatric Inventory (CGA-NPI).

    Results

    There were significant differences in the CGA-NPI score (22.8±20.9 vs. 6.4±10.1 vs. 1.7±3.9 vs. 1.0±1.6, p<0.001), and the prevalence of neuropsychiatric symptoms (100% vs. 64.9% vs. 37.0% vs. 44.4%, p<0.001) among PDD, PDMCI, PDNC and control groups. Depression was the most common symptom (43.3%), followed by anxiety (31.5%), apathy (26.8%), and night-time behavior (26.8%) in all PD patients. Delusion, hallucination, and aberrant motor behavior were observed frequently in PDD, but were rare in PDMCI.

    Conclusions

    Depression was the most common neuropsychiatric symptom in PD. The presence of delusion, hallucination, or aberrant motor behavior may suggest PDD. The neuropsychiatric symptoms were not prevalent in PD with normal cognition.

    Keywords
    Parkinson's disease; Cognitive impairment; Neuropsychiatric symptoms

    Figures

    Fig. 1
    Prevalence of behavioral and psychiatric symptoms in the patients with dementia associated with Parkinson's disease (PPD), those with PD with mild cognitive impairment (PDMCI), those with PD with normal cognition (PDNC), and normal controls.

    *Items which were significantly different among four groups (p<0.05).

    Tables

    Table 1
    Clinical characteristics of the patients with dementia associated with Parkinson's disease (PPD), those with PD with mild cognitive impairment (PDMCI), those with PD with normal cognition (PDNC), and normal controls

    Table 2
    Subscale scores of CGA-NPI in patients with PDD, PDMCI, and PDNC, and controls

    Table 3
    Prevalence of behavioral and psychiatric symptoms in patients with PDD, PDMCI, and PDNC, and controls

    References

      1. de Rijk MC, Launer LJ, Berger K, Breteler MM, Dartigues JF, Baldereschi M, et al. Prevalence of Parkinson's disease in Europe: a collaborative study of population-based cohorts. Neurologic Diseases in the Elderly Research Group. Neurology 2000;54 11 Suppl 5:S21–S23.
      1. Aarsland D, Bronnick K, Williams-Gray C, Weintraub D, Marder K, Kulisevsky J, et al. Mild cognitive impairment in Parkinson disease: a multicenter pooled analysis. Neurology 2010;75:1062–1069.
      1. Aarsland D, Andersen K, Larsen JP, Lolk A, Kragh-Sorensen P. Prevalence and characteristics of dementia in parkinson disease: an 8-year prospective study. Arch Neurol 2003;60:387–392.
      1. Emre M. Dementia associated with parkinson's disease. Lancet Neurol 2003;2:229–237.
      1. Henry LP, Matthew BS. Clinical manifestations of Parkinson's disease. In: Ray LW, William CK, editors. Movement Disorders. 2nd ed. USA: McGraw-Hill Co; 2004. pp. 233-245.
      1. Shulman LM, Taback RL, Bean J, Weiner WJ. Comorbidity of the nonmotor symptoms of Parkinson's disease. Mov Disord 2001;16:507–510.
      1. Aarsland D, Påhlhagen S, Ballard CG, Ehrt U, Svenningsson P. Depression in Parkinson disease--epidemiology, mechanisms and management. Nat Rev Neurol 2011;8:35–47.
      1. Aarsland D, Brønnick K, Ehrt U, De Deyn PP, Tekin S, Emre M, et al. Neuropsychiatric symptoms in patients with Parkinson's disease and dementia: frequency, profile and associated care giver stress. J Neurol Neurosurg Psychiatry 2007;78:36–42.
      1. McKinlay A, Grace RC, Dalrymple-Alford JC, Anderson T, Fink J, Roger D. A profile of neuropsychiatric problems and their relationship to quality of life for Parkinson's disease patients without dementia. Parkinsonism Relat Disord 2008;14:37–42.
      1. Aarsland D, Brønnick K, Alves G, Tysnes OB, Pedersen KF, Ehrt U, et al. The spectrum of neuropsychiatric symptoms in patients with early untreated Parkinson's disease. J Neurol Neurosurg Psychiatry 2009;80:928–930.
      1. Stella F, Banzato CE, Quagliato EM, Viana MA, Christofoletti G. Psychopathological features in patients with Parkinson's disease and related caregivers' burden. Int J Geriatr Psychiatry 2009;24:1158–1165.
      1. Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinicopathological study of 100 cases. J Neurol Neurosurg Psychiatry 1992;55:181–184.
      1. Kang SJ, Choi SH, Lee BH, Jeong Y, Hahm DS, Han IW, et al. Caregiver-Administered Neuropsychiatric Inventory (CGA-NPI). J Geriatr Psychiatry Neurol 2004;17:32–35.
      1. Emre M, Aarsland D, Brown R, Burn DJ, Duyckaerts C, Mizuno Y, et al. Clinical diagnostic criteria for dementia associated with Parkinson's disease. Mov Disord 2007;22:1689–1707.
      1. Winblad B, Palmer K, Kivipelto M, Jelic V, Fratiglioni L, Wahlund LO, et al. Mild cognitive impairment--beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. J Intern Med 2004;256:240–246.
      1. Ahn HJ, Chin J, Park A, Lee BH, Suh MK, Seo SW, et al. Seoul Neuropsychological Screening Battery-dementia version (SNSB-D): a useful tool for assessing and monitoring cognitive impairments in dementia patients. J Korean Med Sci 2010;25:1071–1076.
      1. Kang Y. Normative data on the Korean Mini-Mental State Examination (K-MMSE) in Korean elderly. Korean J Psychol Gen 2006;25:1–12.
      1. Choi SH, Na DL, Lee BH, Hahm D, Jeong JH, Yoon SJ, et al. Dementia Research Group. Estimating the validity of the Korean version of Expanded Clinical Dementia Rating (CDR) scale. J Korean Neurol Assoc 2001;19:585–591.
      1. Ku HM, Kim J, Kwon EJ, Kim SH, Lee HS, Ko H, et al. A study on the reliability and validity of Seoul-Instrumental Activities of Daily Living. J Korean Neuropsychiatr Assoc 2004;43:189–199.
      1. Spalletta G, Musicco M, Padovani A, Rozzini L, Perri R, Fadda L, et al. Neuropsychiatric symptoms and syndromes in a large cohort of newly diagnosed, untreated patients with Alzheimer disease. Am J Geriatr Psychiatry 2010;18:1026–1035.
      1. Choi SH, Na DL, Kwon HM, Yoon SJ, Jeong J, Ha CK. The Korean version of the Neuropsychiatric Inventory: A Scoring Tool of Neuropsychiatric Disturbance in Dementia Patients. J Korean Med Sci 2000;15:609–615.
      1. Burn DJ, Troster AI. Neuropsychiatric complications of medical and surgical therapies of Parkinson's disease. J Geriatr Psychiatry Neurol 2004;17:172–180.
    Cited by
    Crossref 1
    Google Scholar 
    Metrics
    Share
    Figures
    slide

    1 / 1

    Tables
    slide
    slide
    slide

    1 / 3

    PERMALINK