scholarly journals Focus on Depression in Parkinson’s Disease: A Delphi Consensus of Experts in Psychiatry, Neurology, and Geriatrics

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Luis Agüera-Ortiz ◽  
Rocío García-Ramos ◽  
Francisco J. Grandas Pérez ◽  
Jorge López-Álvarez ◽  
José Manuel Montes Rodríguez ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Disease Risk ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Motor Symptom ◽  
Mild Depression ◽  
Delphi Consensus ◽  
Serotonergic Drugs

Major and minor forms of depression are significant contributors to Parkinson’s disease morbidity and caregiver burden, affecting up to 50% of these patients. Nonetheless, symptoms of depression are still underrecognized and undertreated in this context due to scarcity of evidence and, consequently, consistent clinical guideline recommendations. Here, we carried out a prospective, multicentre, 2-round modified Delphi survey with 49 questions about the aetiopathological mechanisms of depression in Parkinson’s disease (10), clinical features and connections with motor and nonmotor symptoms (10), diagnostic criteria (5), and therapeutic options (24). Items were assessed by a panel of 37 experts (neurologists, psychiatrists, and a geriatrist), and consensus was achieved in 81.6% of them. Depressive symptoms, enhanced by multiple patient circumstances, were considered Parkinson’s disease risk factors but not clinical indicators of motor symptom and disease progression. These patients should be systematically screened for depression while ruling out both anhedonia and apathy symptoms as they are not necessarily linked to it. Clinical scales (mainly the Geriatric Depression Scale GDS-15) can help establishing the diagnosis of depression, the symptoms of which will require treatment regardless of severity. Efficacious and well-tolerated pharmacological options for Parkinson’s comorbid depression were selective serotonin reuptake inhibitors (especially sertraline), dual-action serotonin and norepinephrine reuptake inhibitors (venlafaxine, desvenlafaxine, and duloxetine), multimodal (vortioxetine, bupropion, mirtazapine, and tianeptine), and anti-Parkinsonian dopamine agonists (pramipexole, ropinirole, and rotigotine). Tricyclic antidepressants and combining type B monoamine oxidase inhibitors with serotonergic drugs have serious side effects in these patients and therefore should not be prescribed. Electroconvulsive therapy was indicated for severe and drug-refractory cases. Cognitive behavioural therapy was recommended in cases of mild depression. Results presented here are useful diagnostic and patient management guidance for other physicians and important considerations to improve future drug trial design.

scholarly journals Is Depression or Apathy Playing a Key Role in Predicting Financial Capacity in Parkinson’s Disease with Dementia and Frontotemporal Dementia?

2021 ◽  
Vol 11 (6) ◽  
pp. 785
Author(s):  
Vaitsa Giannouli ◽  
Magda Tsolaki
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Frontotemporal Dementia ◽  
Cognitive Abilities ◽  
Short Form ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Decisive Role ◽  
Financial Capacity ◽  
Capacity Performance

(1) Background: Depression and apathy both affect cognitive abilities, such as thinking, concentration and making decisions in young and old individuals. Although apathy is claimed to be a “core” feature of Parkinson’s disease (PD) and frontotemporal dementia (FTD), it may occur in the absence of depression and vice versa. Thus, the aim of this study is to explore whether depression or apathy better predict financial capacity performance in PD and FTD as well as in nondemented participants. (2) Methods: Eighty-eight participants divided into three groups (PD, FTD and non-demented participants) were examined with the Mini-Mental State Examination (MMSE) and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS)—Full and short form. The Geriatric Depression Scale informant version (GDS-15) and the Irritability-Apathy Scale (IAS) we completed by caregivers. (3) Results: The results indicated that both PD and FTD patients’ general cognitive functioning and financial capacity performance is negatively influenced by apathy and not by depression. (4) Conclusions: Differences in financial capacity performance indicate that apathy should not be disregarded in clinical assessments. Further studies on larger PD and FTD populations are necessary in order to investigate the decisive role of mood factors on financial capacity impairment.

scholarly journals Effect of age on geriatric depression scale performance in Parkinson's disease

2007 ◽  
Vol 22 (9) ◽  
pp. 1331-1335 ◽  
Author(s):  
Daniel Weintraub ◽  
Kirsten Saboe ◽  
Matthew B. Stern
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Geriatric Depression ◽  
Effect Of Age

Depressive symptoms in Parkinson’s disease are related to decreased left hippocampal volume: correlation with the 15-item shortened version of the Geriatric Depression Scale

2017 ◽  
Vol 59 (3) ◽  
pp. 341-345 ◽  
Author(s):  
Masami Goto ◽  
Koji Kamagata ◽  
Taku Hatano ◽  
Nobutaka Hattori ◽  
Osamu Abe ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Gray Matter ◽  
Gray Matter Volume ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Hippocampal Volume ◽  
Geriatric Depression ◽  
Matter Volume ◽  
The Relationship

Background The relationship between hippocampal and amygdaloid volumes and depression in patients with Parkinson’s disease (PD) is a controversial issue. Purpose To investigate the correlation between the 15-item shortened version of the Geriatric Depression Scale (GDS-15) and gray matter volume in PD. Material and Methods In the present study, 46 participants with PD were scanned with 3 T magnetic resonance imaging (MRI) to obtain three-dimensional (3D) T1-weighted (T1W) images. Neurologists specializing in movement disorders performed clinical evaluations of the participants (e.g. GDS-15, Mini-Mental State Examination, PD duration, age, sex). Statistical Parametric Mapping 8 software was used for image gray matter segmentation and for a correlation analysis between gray matter volume and GDS-15 score. Results The results showed a significant negative correlation between GDS-15 score and left hippocampal volume, and between GDS-15 score and right parahippocampal gyrus volume. No significant positive correlations were found in the whole brain. Conclusion The current results provide new evidence regarding the relationship between depression in PD and hippocampal volume.

scholarly journals The accuracy of diagnosis of major depression in patients with Parkinson's disease: a comparative study among the UPDRS, the geriatric depression scale and the Beck depression inventory

2008 ◽  
Vol 66 (2a) ◽  
pp. 152-156 ◽  
Author(s):  
Vitor Tumas ◽  
Guilherme Gustavo Ricioppo Rodrigues ◽  
Tarsis Leonardo Almeida Farias ◽  
José Alexandre S. Crippa
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Major Depression ◽  
Beck Depression Inventory ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Diagnostic Value ◽  
Geriatric Depression ◽  
Operating Characteristics ◽  
Highly Correlated

OBJECTIVE: Evaluate the accuracy of diagnosis of major depression in patients with Parkinson's disease (PD) using the UPDRS, the 15-item Geriatric Depression Scale (GDS15) and the Beck Depression Inventory (BDI). METHOD: 50 consecutive patients with PD were evaluated. The diagnosis of major depression was made according to the DSM-IV criteria. RESULTS: We found a 24% prevalence of major depression. All depression scales were highly correlated but UPDRS depression item had the lowest diagnostic value. The GDS15 had the more appropriate "receiver operating characteristics" curve. The best cut-off scores for screening depression were 17/18 for BDI and 8/9 for GDS15. We did not find any correlation between the level of depression and intensity of motor symptoms, functional capacity and duration of the disease. CONCLUSION: GDS15 is better than the BDI and the UPDRS for screening depression in PD and depression is not related to the degree of parkinsonian symptoms.

scholarly journals Aberrant Changes in Cortical Complexity in Right-Onset Versus Left-Onset Parkinson’s Disease in Early-Stage

2021 ◽  
Vol 13 ◽  
Author(s):  
Lin Zhang ◽  
Qin Shen ◽  
Haiyan Liao ◽  
Junli Li ◽  
Tianyu Wang ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Early Stage ◽  
Depression Scale ◽  
Peak Level ◽  
Magnetic Resonance Images ◽  
Motor Symptom ◽  
Hamilton Depression Scale ◽  
The Mean ◽  
Sulcal Depth

There is increasing evidence to show that motor symptom lateralization in Parkinson’s disease (PD) is linked to non-motor features, progression, and prognosis of the disease. However, few studies have reported the difference in cortical complexity between patients with left-onset of PD (LPD) and right-onset of PD (RPD). This study aimed to investigate the differences in the cortical complexity between early-stage LPD and RPD. High-resolution T1-weighted magnetic resonance images of the brain were acquired in 24 patients with LPD, 34 patients with RPD, and 37 age- and sex-matched healthy controls (HCs). Cortical complexity including gyrification index, fractal dimension (FD), and sulcal depth was analyzed using surface-based morphometry via CAT12/SPM12. Familywise error (FWE) peak-level correction at p < 0.05 was performed for significance testing. In patients with RPD, we found decreased mean FD and mean sulcal depth in the banks of the left superior temporal sulcus (STS) compared with LPD and HCs. The mean FD in the left superior temporal gyrus (STG) was decreased in RPD compared with HCs. However, in patients with LPD, we did not identify significantly abnormal cortical complex change compared with HCs. Moreover, we observed that the mean FD in STG was negatively correlated with the 17-item Hamilton Depression Scale (HAMD) among the three groups. Our findings support the specific influence of asymmetrical motor symptoms in cortical complexity in early-stage PD and reveal that the banks of left STS and left STG might play a crucial role in RPD.

scholarly journals Reliability and Validity of the Geriatric Depression Scale in Italian Subjects with Parkinson’s Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Perla Massai ◽  
Francesca Colalelli ◽  
Julita Sansoni ◽  
Donatella Valente ◽  
Marco Tofani ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Internal Consistency ◽  
Discriminant Validity ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Reliability And Validity ◽  
Geriatric Depression ◽  
Retest Reliability ◽  
Test Retest Reliability

Introduction. The Geriatric Depression Scale (GDS) is commonly used to assess depressive symptoms, but its psychometric properties have never been examined in Italian people with Parkinson’s disease (PD). The aim of this study was to study the reliability and validity of the Italian version of the GDS in a sample of PD patients. Methods. The GDS was administered to 74 patients with PD in order to study its internal consistency, test-retest reliability, construct, and discriminant validity. Results. The internal consistency of GDS was excellent (α = 0.903), as well as the test-retest reliability (ICC = 0.941 [95% CI: 0.886–0.970]). GDS showed a strong correlation with instruments related to the depression (ρ = 0.880) in PD (ρ = 0.712) and a weak correlation with generic measurement instruments (−0.320 < ρ <−0.217). An area under the curve of 0.892 (95% CI 0.809–0.975) indicated a moderate capability to discriminate depressed patients to nondepressed patient, with a cutoff value between 15 and 16 points that predicts depression (sensitivity = 87%; specificity = 82%). Conclusion. The GDS is a reliable and valid tool in a sample of Italian PD subjects; this scale can be used in clinical and research contexts.

The relationship between specific cognitive defects and burden of care in Parkinson's disease

2015 ◽  
Vol 28 (2) ◽  
pp. 275-281 ◽  
Author(s):  
Michael Zhong ◽  
Richard Peppard ◽  
Dennis Velakoulis ◽  
Andrew H. Evans
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Caregiver Burden ◽  
Assessment Tool ◽  
Linear Regression Analysis ◽  
Depression Scale ◽  
Multiple Linear Regression Analysis ◽  
Motor Symptom ◽  
Depression And Anxiety ◽  
Psychosocial Effects

ABSTRACTBackground:In spite of the recognized physical and psychosocial effects of caring for patients with Parkinson's disease (PD), caregiver burden (CB) in this setting is poorly understood. The objective of this research was to identify factors that were associated with CB in an Australian population of PD caregivers using a novel instrument – the Parkinson's Disease Caregiver Burden (PDCB) questionnaire.Methods:Fifty patient–caregiver couples were recruited from three movement disorders clinics in Melbourne, Australia. Burden on caregivers was rated using the PDCB questionnaire. Burden scores were correlated with patient factors, including motor symptom severity (Unified Parkinson's Disease Ratings Scale and Hoehn & Yahr (H&Y) scale), patient cognition (Neuropsychiatry Unit Cognitive Assessment Tool; NUCOG), presence of impulsive and compulsive behaviors (Questionnaire for Impulsive–Compulsive Disorders in Parkinson's disease), and patient olfaction. Caregiver and patient demographics, as well as results for depression and anxiety (Hospital Anxiety and Depression Scale; HADS), were also examined for their relationship with CB.Results:H&Y stage, depression or anxiety in either caregiver or patient, and decreased patient NUCOG score were significantly associated with higher PDCB score. Multiple linear regression analysis identified caregiver and patient depression score and patient score for the visuoconstructional subscale of NUCOG to predict burden score. In addition, disease duration, duration of caregiving, and increased hours per day spent in giving care were significantly associated with increased burden.Conclusions:We found psychiatric and cognitive factors to be the most relevant factors in the perception of burden in PD caregivers. On top of this, we found deficits in the domain of visuoconstruction predicted burden – a relationship not yet described in literature. Targeting depression and anxiety in this setting as well as identifying caregivers at high risk of burden may give clinicians the chance to optimize care of patients with PD through the caregiver.

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