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Relationship between depression and cognitive dysfunctions in Parkinson’s disease without dementia

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Abstract

To explore the relationship between depression and cognitive impairment in non-demented PD patients, we evaluated neurological and neuropsychological asset in 65 patients with a diagnosis of major depressive disorder (dPD) according to DSM-IV criteria and 60 patients without depression (nPD).

Compared with nPD patients, dPD patients had significantly higher scores on behavioral rating scales and performed worse on the Frontal Assessment Battery (FAB), Semantic Fluency Task, Copying Task (CT), and Stroop Test. Three dPD subgroups were identified based on the first two DSM-IV criteria: patients fulfilling criterion 1 (depressed mood; group 1); patients fulfilling criterion 2 (apathy/anhedonia; group 2); patients fulfilling criteria 1 and 2 (group 3). Patients of group 2 scored significantly lower than patients of group 1 on the CT, FAB and phonological fluency task. Patients of groups 2 and 3 scored significantly lower than nPD patients on visuoconstructional and frontal tasks. Similar results were obtained in dPD patients stratified in four subgroups based on cut-off scores of the Apathy Evaluation Scale and the Snaith Hamilton Pleasure Scale. In summary, PD patients with concomitant apathy and anhedonia may show more severe cognitive impairments. Since such patients are diagnosed to be affected by depression according to clinical DSM-IV criteria, we suggest that DSM-IV criteria may not distinguish an affective from a cognitive disorder in PD.

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References

  1. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorder, 4th ed. American Psychiatry Association, Washington

  2. Marsh L, Mc Donald WM, Cummings J, Ravina B; NINDS/NIMH Work Group on Depression and Parkinson’s Disease (2006) NINDS/NIMH Work Group on Depression and Parkinson’s Disease. Provisional diagnostic criteria for depression in Parkinson’s disease: report of an NINDS/NIMH Work Group. Mov Disord 21:148–158

    Article  PubMed  Google Scholar 

  3. Gotham AM, Brown RG, Marsden CD (1986) Depression in Parkinson’s disease: a quantitative and qualitative analysis. J Neurol Neurosurg Psychiatry 49:381–389

    Article  CAS  PubMed  Google Scholar 

  4. Cummings JL (1992) Depression and Parkinson’s disease: a review. Am J Psychiatry 149:443–454

    CAS  PubMed  Google Scholar 

  5. Brown RG, MacCarthy B (1990) Psychiatric morbidity in patients with Parkinson’s disease. Psychol Med 20:77–87

    Article  CAS  PubMed  Google Scholar 

  6. Taylor AE, Saint-Cyr JA (1990) Depression in Parkinson’s disease: reconciling physiological and psychological perspectives. J Neuropsychiatry Clin Neurosci 2:92–98

    CAS  PubMed  Google Scholar 

  7. Starkstein SE, Preziosi TJ, Forrester AW, Robinson RG (1990) Specificity of affective and autonomic symptoms of depression in Parkinson’s disease. J Neurol Neurosurg Psychiatry 53:869–873

    Article  CAS  PubMed  Google Scholar 

  8. Levin BE, Llabre MM, Weiner WJ (1988) Parkinson’s disease and depression: psychometric properties of the Beck Depression Inventory. J Neurol Neurosurg Psychiatry 51:1401–1404

    Article  CAS  PubMed  Google Scholar 

  9. Huber SJ, Freidenberg DL, Paulson GW, Shuttleworth EC, Christy JA (1990) The pattern of depressive symptoms varies with progression of Parkinson’s disease. J Neurol Neurosurg Psychiatry 53:275–278

    Article  CAS  PubMed  Google Scholar 

  10. Hoogendijk WJ, Sommer IE, Tissingh G, Deeg DJ, Wolters EC (1998) Depression in Parkinson’s disease. The impact of symptom overlap on prevalence. Psychosomatics 39:416–421

    CAS  PubMed  Google Scholar 

  11. Leentjens AF, Marinus J, Van Hilten JJ, Lousberg R, Verhey FR (2003) The contribution of somatic symptoms to the diagnosis of depressive disorder in Parkinson’s disease: a discriminant analytic approach. J Neuropsychiatry Clin Neurosci 15:74–77

    CAS  PubMed  Google Scholar 

  12. Beliauskas LA, Glantsz RH (1989) Depression type in Parkinson’s disease. J Clin Exp Neuropsychol 11:597–604

    Article  Google Scholar 

  13. Santamaria J, Tolosa E, Valles A (1986) Parkinson’s disease with depression: a possible subgroup of idiopathic parkinsonism. Neurology 36:1130–1133

    CAS  PubMed  Google Scholar 

  14. Taylor AE, Saint-Cyr JA, Lang AE, Kenny FT (1986) Parkinson’s disease and depression: a critical reevaluation. Brain 109:279–292

    Article  PubMed  Google Scholar 

  15. Taylor AE, Saint-Cyr JA, Lang AE (1988) Idiopathic Parkinson’s disease: revised concepts of cognitive and affective status. Can J Neurol Sci 15:106–113

    CAS  PubMed  Google Scholar 

  16. Huber SJ, Paulson GW, Shuttleworth EC (1988) Relationship of motor symptoms, intellectual impairment, and depression in Parkinson’s disease. J Neurol Neurosurg Psychiatry 51:855–858

    Article  CAS  PubMed  Google Scholar 

  17. Troster AI, Stalp LD, Paolo AM, Fields JA, Koller WC (1995) Neuropsychological impairment in Parkinson’s disease with and without depression. Arch Neurol 52:1164–1169

    CAS  PubMed  Google Scholar 

  18. Troster AI, Paolo AM, Lyons KE, Glatt SL, Hubble JP, Koller WC (1995) The influence of depression on cognition in Parkinson’s disease: a pattern of impairment distinguishable from Alzheimer’s disease. Neurology 45:672–676

    CAS  PubMed  Google Scholar 

  19. Silberman CD, Laks J, Capitao CF, Rodrigues CS, Moreira I, Vasconcellos LF, Engelhardt E (2007) Frontal functions in depressed and nondepressed Parkinson’s disease patients: impact of severity stages. Psychiatry Res 149:285–289

    Article  PubMed  Google Scholar 

  20. Kuzis G, Sabe L, Tiberti C, Leiguarda R, Starkstein SE (1997) Cognitive functions in major depression and Parkinson disease. Arch Neurol 54:982–986

    CAS  PubMed  Google Scholar 

  21. Starkstein SE, Preziosi TJ, Berthier ML, Bolduc PL, Mayberg HS, Robinson RG (1989) Depression and cognitive impairment in Parkinson’s disease. Brain 112:1141–1153

    Article  PubMed  Google Scholar 

  22. Starkstein SE, Preziosi TJ, Bolduc PL, Robinson RG (1990) Depression in Parkinson’s disease. J Nerv Ment Dis 178:27–31

    Article  CAS  PubMed  Google Scholar 

  23. Cubo E, Bernard B, Leurgans S, Raman R (2000) Cognitive and motor function in patients with Parkinson’s disease with and without depression. Clin Neuropharmacol 23:331–334

    Article  CAS  PubMed  Google Scholar 

  24. Anguenot A, Loll PY, Neau JP, Ingrand P, Gil R (2002) Depression and Parkinson’s Disease: study of a series of 135 Parkinson’s patients. Can J Neurol Sci 29:139–146

    CAS  PubMed  Google Scholar 

  25. Norman S, Troster AI, Fields JA, Brooks R (2002) Effects of depression and Parkinson’s disease on cognitive functioning. J Neuropsychiatry Clin Neurosci 14:31–46

    PubMed  Google Scholar 

  26. Stefanova E, Potrebic A, Ziropadja L, Maric J, Ribaric I, Kostic VS (2006) Depression predicts the pattern of cognitive impairment in early Parkinson’s disease. J Neurol Sci 248:131–137

    Article  PubMed  Google Scholar 

  27. Costa A, Peppe A, Carlesimo GA, Pasqualetti P, Caltagirone C (2006) Major and minor depression in Parkinson’s disease: a neuropsychological investigation. Eur J Neurol 13:972–980

    Article  CAS  PubMed  Google Scholar 

  28. Mayeux R, Stern Y, Rosen J, Leventhal J (1981) Depression, intellectual impairment, and Parkinson disease. Neurology 31:645–450

    CAS  PubMed  Google Scholar 

  29. Uekermann J, Daum I, Peters S, Wiebel B, Przuntek H, Muller T (2003) Depressed mood and executive dysfunction in early Parkinson’s disease. Acta Neurol Scand 107:341–348

    Article  CAS  PubMed  Google Scholar 

  30. Gibb WR, Lees AJ (1988) The relevance of the Lewy body in the pathogenesis of idiopathic Parkinson’s disease. J Neurol Neurosur Psychiatry 51:745–752

    Article  CAS  Google Scholar 

  31. Folstein M, Folstein SE, McHugh PR (1975) Mini-mental state: a practical method for grading the cognitive state of patients for the clinicians. J Psychiatr Res 12:189–198

    Article  CAS  PubMed  Google Scholar 

  32. Measso G, Cavarzeran F, Zappala G, Lebowitz BD, Crook TH, Pirozzolo FJ, Amaducci LA, Massari D, Grigoletto F (1993) The Mini-Mental State Examination: normative study of an Italian random sample. Dev Neuropsychol 9:77–85

    Article  Google Scholar 

  33. Fahn S, Elton RL (1987) Members of the UPDRS Development Committee. In: Fahn S, Marsden CD, Calne D, Goldstein M (eds) Recent Developments in Parkinson’s Disease. Florham Park, MacMillan, pp 153–304

  34. Hoehn MM, Yahr MD (1967) Parkinsonism: onset, progression and mortality. Neurology 17:427–442

    CAS  PubMed  Google Scholar 

  35. Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23:56–62

    Article  CAS  PubMed  Google Scholar 

  36. Snaith RP, Hamilton M, Morley S, Humayan A, Hargreaves D, Trigwell P (1995) A scale for the assessment of hedonic tone the Snaith-Hamilton Pleasure Scale. Br J Psychiatry 167:99–103

    Article  CAS  PubMed  Google Scholar 

  37. Marin RS, Biedrzycki RC, Frinciogullari S (1991) Reliability and validity of the apathy evaluation scale. Psychiatry Research 38:143–162

    Article  CAS  PubMed  Google Scholar 

  38. Dubois B, Slachevsky A, Litvan I, Pillon B (2000) The FAB: a Frontal Assessment Battery at bedside. Neurology 55:1621–1626

    CAS  PubMed  Google Scholar 

  39. Spinnler H, Tognoni G (1987) Standardizzazione e taratura italiana di una batteria di test neuropsicologici. Ital J Neurol Sci (Suppl 8):78–80; 97–99

  40. Caltagirone C, Gainotti G, Fasullo C, Miceli G (1979) Validity of some neuropsychological test in the assessment of mental deterioration. Acta Psichiatr Scand 60:50–56

    Article  CAS  Google Scholar 

  41. Barbarotto R, Laiacona M, Frosio R, Vecchio M, Farinato A, Capitani E (1998) A normative study on visual reaction times and two Stroop colourword tests. Ital J Neurol Sci 19:161–170

    Article  CAS  PubMed  Google Scholar 

  42. Pluck GC, Brown RG (2002) Apathy in Parkinson’s disease. J Neurol Neurosurg Psychiatry 54:515–528

    Google Scholar 

  43. Serra-Mestres J, Ring HA (1999) Vulnerability to emotionally negative stimuli in Parkinson’s disease: an investigation using the Emotional Stroop task. Neuropsychiatry Neuropsychol Behav Neurol 12:52–57

    CAS  PubMed  Google Scholar 

  44. Tekin S, Cummings JL (2002) Frontalsubcortical neuronal circuits and clinical neuropsychiatry. An update. J Psychosom Res 53:647–654

    Article  PubMed  Google Scholar 

  45. Cummings JL, Huber SJ (1992) Visuospatial abnormalities in Parkinson’s disease. In: Huber SJ, Cummings JL (eds) Parkinson’s disease: behavioral and neuropsychological aspects. Oxford University Press, New York, pp 59–73

  46. Isella V, Iurlaro S, Piolti R, Ferrarese C, Frattola L, Appollonio I, Melzi P, Grimaldi M (2003) Physical anhedonia in Parkinson’s disease. J Neurol Neurosurg Psychiatry 74:1308–1311

    Article  CAS  PubMed  Google Scholar 

  47. Starkstein SE, Mayberg HS, Preziosi TJ, Andrezejewski P, Leiguarda R, Robinson RG (1992) Reliability, validity, and clinical correlates of apathy in Parkinson’s disease. J Neuropsychiatry Clin Neurosci 4:134–139

    CAS  PubMed  Google Scholar 

  48. Isella V, Melzi P, Grimaldi M, Iurlaro S, Piolti R, Ferrarese C, Frattola L, Appollonio I (2002) Clinical neuropsychological, and morphometric correlates of apathy in Parkinson’s disease. Mov Disord 17:366–371

    Article  PubMed  Google Scholar 

  49. Zgaljardic DJ, Borod JC, Foldi NS, Rocco M, Mattis PJ, Gordon MF, Feigin AS, Eidelberg D (2007) Relationship between self-reported apathy and executive dysfunction in nondemented patients with Parkinson disease. Cogn Behav Neurol 20:184–192

    Article  PubMed  Google Scholar 

  50. Levy R, Dubois B (2006) Apathy and the functional anatomy of the prefrontal cortex-basal ganglia circuits. Cereb Cortex 16:916–928

    Article  PubMed  Google Scholar 

  51. Kirsch-Darrow L, Fernandez HH, Marsiske M, Okun MS, Bowers D (2006) Dissociating apathy and depression in Parkinson disease. Neurology 67:33–38

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Dept. of Neurological Sciences, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy

    Gabriella Santangelo PhD, Carmine Vitale MD, PhD, Katia Longo MD, Autilia Cozzolino MD &  Paolo Barone MD, PhD

  2. Laboratorio di Neuropsicologia, Dipartimento di Psicologia, Seconda Università Studi di Napoli, Naples, Italy

    Gabriella Santangelo PhD, Luigi Trojano MD & Dario Grossi MD

  3. Istituto di Diagnosi e Cura, “Hermitage Capodimonte”, Naples, Italy

    Gabriella Santangelo PhD & Carmine Vitale MD, PhD

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  1. Gabriella Santangelo PhD
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  2. Carmine Vitale MD, PhD
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  3. Luigi Trojano MD
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  7. Paolo Barone MD, PhD
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Correspondence to Paolo Barone MD, PhD.

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Santangelo, G., Vitale, C., Trojano, L. et al. Relationship between depression and cognitive dysfunctions in Parkinson’s disease without dementia. J Neurol 256, 632–638 (2009). https://doi.org/10.1007/s00415-009-0146-5

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  • DOI: https://doi.org/10.1007/s00415-009-0146-5

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