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Motion and emotion: anxiety–axial connections in Parkinson’s disease

  • Neurology and Preclinical Neurological Studies - Original Article
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Abstract

Anxiety is a serious and frequent complication in Parkinson’s disease (PD) that significantly affects the quality of life of patients. Multiple neuroanatomical, experimental, and clinical studies suggest its close association with axial disturbances. However, whether this relation applies for PD patients (commonly suffering from axial difficulties, such as balance and gait disturbance) has not been properly tested yet. The purpose of this study was to determine whether PD patients suffering from axial symptoms have higher levels of anxiety than others and to identify other factors associated with anxiety–axial connections. In this questionnaire study, 212 patients with PD were assessed by standardized scales, such as Hamilton Anxiety Scale, Montgomery–Asberg Depression Rating Scale, Montreal Cognitive Assessment, examining their mood and cognitive status. These data were correlated to dominant motor symptoms of these patients, such as tremor, rigidity, bradykinesia, and axial symptoms. Unlike other motor symptoms, only axial symptoms showed to be significantly related to higher levels of anxiety. The patients suffering from anxiety and axial problems have also shown significantly higher depression levels. Axial disturbances are related to higher anxiety levels in PD patients. It is crucial to pay high attention to symptoms of anxiety in patients having postural instability or gait disorder. Further clinical studies are desirable to investigate new, practical implications of anxiety–axial connection to provide complex management options of these serious symptoms.

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Acknowledgements

This work was supported by Novartis s.r.o., Czech Republic.

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Authors and Affiliations

  1. First Department of Neurology, Faculty of Medicine, Masaryk University and St. Anne’s University Hospital, Pekařská 53, 656 91, Brno, Czech Republic

    Rastislav Šumec, Irena Rektorová, Ivan Rektor, Pavel Filip & Martin Bareš

  2. International Clinical Research Center (ICRC), St. Anne’s University Hospital Brno, Pekařská 53, 656 91, Brno, Czech Republic

    Rastislav Šumec & Dana Sochorová

  3. Central European Institute of Technology (CEITEC), Kamenice 753/5, 625 00, Brno, Czech Republic

    Irena Rektorová & Ivan Rektor

  4. Department of Neurology and Center of Clinical Neuroscience, 1st Faculty of Medicine and General University Hospital, Charles University in Prague, Katerinska 30, 120 00, Praha 2, Czech Republic

    Robert Jech, Jan Roth & Evžen Růžička

  5. Department of Neurology, Faculty of Medicine, Palacký University and University Hospital, I.P. Pavlova 185/6, 779 00, Olomouc, Czech Republic

    Kateřina Menšíková & Petr Kaňovský

  6. Faculty of Medicine, Institute of Biostatistics and Analyses, Masaryk University, Kamenice 126/3, 625 00, Brno, Czech Republic

    Ladislav Dušek & Tomáš Pavlík

  7. Department of Neurology, Medical School, University of Minnesota, 516 Delaware Street SE, Minneapolis, MN, 55455, USA

    Martin Bareš

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  1. Rastislav Šumec
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  2. Irena Rektorová
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  3. Robert Jech
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  4. Kateřina Menšíková
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  5. Jan Roth
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  6. Evžen Růžička
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  7. Dana Sochorová
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  8. Ladislav Dušek
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  9. Petr Kaňovský
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  10. Ivan Rektor
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  11. Tomáš Pavlík
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  12. Pavel Filip
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  13. Martin Bareš
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Corresponding author

Correspondence to Martin Bareš.

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Conflict of interest

No compensation was provided to Dr. Šumec for his writing of this manuscript. No compensation was provided to Drs. Rektorová, Jech, Menšíková, Roth, Růžička, Sochorová, Dušek, Kaňovský, Rektor, Pavlík, Filip, and Bareš for their revision of the manuscript. Drs. Bareš, Rektorová, Jech, Menšíková, Roth, and Růžička received compensation from Novartis for their sites’ conduct of the study.

Financial disclosures

Rastislav Šumec, MD: Employment: University Hospital of St. Anne, Brno, Czech Republic, Masaryk University; ICRC-International Clinical Research Center. Irena Rektorová, MD, PhD: Employment: Faculty of Medicine, Masaryk University, Brno, Czech Republic, Central European Institute of Technology, CEITEC MU, Masaryk University, Brno, Czech Republic, St Anne’s University Hospital, Brno, Czech Republic. Consultancies: none. Advisory boards: none. Honoraria: none. Grants: JPND grants (Joint Programme in Neurodegeneration), Grants of the Czech Ministry of Health, mentor for a postdoc Marie Curie grant/SoMoPro. Clinical trials: none for the last 2 years. Robert Jech, MD, PhD: Employment: Charles University in Prague, General Teaching hospital, Prague, Na Homolce Hospital, Prague. Honoraria: co-organized received consultancy fees and organized teaching courses for Abbvie, Cardion, Ipsen and Medtronic. Kateřina Menšíková, MD: Employment: Palacky University in Olomouc, General University Hospital in Olomouc. Honoraria: Lectures for GSK and Novartis. Jan Roth, MD, CSc.: Employment: Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital in Prague, Katerinska 30, 12000 Prague 2, Czech Republic. Honoraria: from Abbvie, UCB, AOP Orphan. Grants:PRVOUK-P26/LF1/4, NT11190-6/2010, NT11331-6/2010, KONTAKT II LH13256, Česko- Norský výzkumný program 7F14308. Clinical Trials: Teva-Legato. Evžen Růžička, MD, DrSc., FCMA. Employment: Charles University in Prague, General University Hospital in Prague. Grants from: EU Horizon 2020, Grant agency of the Czech Republic, Czech Ministry of Health and Charles University in Prague. In the preceding 12 months, he has received honoraria or consulting fees from Merz. Clinical trials: Kyowa, Solvay, Abbvie. Dana Sochorová: Employment: ICRC-International Clinical Research Center. Grants: ICRC project of specific research MUNI/A/1270/2015. Ladislav Dušek, Employment: Institute of Biostatistics and Analyses, Masaryk University, Brno. Petr Kaňovský, MD, CSc.: Employment: Palacky University in Olomouc, University Hospital Olomouc. Consultancies: Merz, Allergan, Medtronic. Advisory boards: Merz. Honoraria: Merz, Ipsen, Medtronic, Lundbeck, Actavis. Grants: IGA MZ CR NT-14407, NT-13575, NT-12221, AZV NV15-31921A. Clinical trials: Kyowa, Merz, Biogen, Novartis, ONO Pharma, Merck Serono. Ivan Rektor, MD, CSc.: Employment: Masaryk University in Brno, St. Anne’s Hospital Brno. Grants: CEITEC. Tomáš Pavlík, MSc, PhD: Employment: Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic. Honoraria: Sanofi-Aventis. Pavel Filip, MD: Employment: University Hospital of St. Anne, Brno, Czech Republic, Masaryk University; Clinical trials: investigator in INREST 1VIT14037. Martin Bareš, MD, PhD: Employment: Masaryk University Anne’s Hospital Brno. Advisory boards: Boehringer Ingelheim. Honoraria: personal compensations for activities with Ipsen, Neomed, Medtronic, Abbvie. Grants: Czech Ministry of Health, Masaryk University. Clinical Trials: Kyowa, Abbvie.

Ethical standards

This study has been approved by ethics committee of St. Anne’s University Hospitál and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All participants gave their informed consent prior to their inclusion in the study.

Appendix

Appendix

The other members of the EWO Study Group are: Marek Baláž, Brno; Jan Bartoník, Kroměříž; Petra Bártová, Ostrava; Michal Bednář, Hradec Králové; Jiří Blažej, Kutná Hora; Martina Bočková, Brno; Jaroslava Budínská, Litoměřice; Vladko Bydžovský, České Budějovice; Eliška Debefová, Kroměříž; Václav Dostál, Pardubice; Klára Drugová, Praha; Petr Dušek, Praha; Naděžda Fišerová, Vyškov; Eva Formánková, České Budějovice; Martin Havlán, Chodov; Petra Havránková, Praha; Lenka Hlinková, Praha; Jakub Hort, Praha; Jaromír Houser, České Budějovice; Pavel Houška, Strakonice; Lucie Hrušková, Karlovy Vary; Helena Hyclová, Kladno; Zuzana Chovancová, Olomouc; Helena Chybová, Náchod; Michael Inneman, Kladno; Pavel Janouškovec, Plzeň; Markéta Jirásková, Praha; Kristina Jonsztová, Karviná; Zbyněk Kalita, Zlín; Gabriela Kamencová, Vsetín; Dagmar Kazdová, Žďár nad Sázavou; Jiří Klempíř, Praha; Lucie Kozlová, Ústínad Labem; Andrea Krompolcová, Nový Jičín; Margareta Krupová, Nový Jičín; Blanka Kykalová, Praha; Jana Letáková, Praha; Pavel Lindovský, Praha; Vojtěch Mach, Plzeň; Taťjana Majorová, Praha; Jarmila Maňhalov, Trutnov; Zuzana Matoušová, Praha; Hana Melšová, Děčín; Blanka Mistríková, Zlín; Jiří Neumann, Chomutov; Martin Nevrlý, Olomouc; Dana Nováčková, Český Krumlov; Lucie Nováková, Praha; Václav Ondřich, Brno; Eva Paseková, Praha; Kateřina Pavlosková, Ostrava; Lenka Peníšková, Liberec; Jan Peregrin, Praha; Alena Pospíšilová, Praha; Irena Pozděnová, Plzeň; Jozef Pribula, Litoměřice; Petr Procházka, Zlín; Jaroslav Rach, Strakonice; Daniel Rosol, Prachatice; Danuše Roubcová, Ostrava; Tereza Serranová, Praha; Světlana Skutilová, Brno; Stanislav Slavík, Most; Jana Sobotová, Plzeň; Helena Straková, Chomutov; Hana Streitová, Brno; Lenka Svatíková, Přerov; Jindra Svátová, Praha; Věnceslava Svobodová, Praha; Dáša Sýkorová, Ostrava; Radim Szotkowski, Přerov; Monika Šimečková, Kadaň; Václav Tomášek, Praha; Zdeněk Topinka, Kolín; Leona Uhlířová, Praha; Olga Ulmanová, Praha; Martina Vančurová, Teplice; Tomáš Vodvářka, Ostrava; Hana Vránová, Olomouc; Jaroslav Vydlák, Praha; Dana Vyskočilová, Praha; Oldřich Vyšata, Rychnov nad Kněžnou; Antonín Wierer, České Budějovice; Kateřina Zárubová, Praha; Richard Zindr, Karlovy Vary.

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Šumec, R., Rektorová, I., Jech, R. et al. Motion and emotion: anxiety–axial connections in Parkinson’s disease. J Neural Transm 124, 369–377 (2017). https://doi.org/10.1007/s00702-016-1652-0

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