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Parkinson's disease motor subtypes and mood

Lookup NU author(s): Professor David Burn

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Abstract

Parkinson's disease is heterogeneous, both in terms of motor symptoms and mood. Identifying associations between phenotypic variants of motor and mood subtypes may provide clues to understand mechanisms underlying mood disorder and symptoms in Parkinson's disease. A total of 513 patients were assessed using the Hospital Anxiety and Depression Scale, and separately classified into anxious, depressed, and anxious-depressed mood classes based on latent class analysis of a semistructured interview. Motor subtypes assessed related to age-of-onset, rate of progression, presence of motor fluctuations, lateralization of motor symptoms, tremor dominance, and the presence of postural instability and gait symptoms and falls. The directions of observed associations tended to support previous findings with the exception of lateralization of symptoms, for which there were no consistent or significant results. Regression models examining a range of motor subtypes together indicated increased risk of anxiety in patients with younger age-of-onset and motor fluctuations. In contrast, depression was most strongly related to axial motor symptoms. Different risk factors were observed for depressed patients with and without anxiety, suggesting heterogeneity within Parkinson's disease depression. Such association data may suggest possible underlying common risk factors for motor subtype and mood. Combined with convergent evidence from other sources, possible mechanisms may include cholinergic system damage and white matter changes contributing to non-anxious depression in Parkinson's disease, while situational factors related to threat and unpredictability may contribute to the exacerbation and maintenance of anxiety in susceptible individuals. (c) 2011 Movement Disorder Society


Publication metadata

Author(s): Burn DJ, Landau S, Hindle JV, Samuel M, Wilson KC, Hurt CS, Brown RG, PROMS-PD Study Grp

Publication type: Article

Publication status: Published

Journal: Movement Disorders

Year: 2012

Volume: 27

Issue: 3

Pages: 379-386

Print publication date: 11/12/2011

ISSN (print): 0885-3185

ISSN (electronic): 1531-8257

Publisher: John Wiley & Sons, Inc.

URL: http://dx.doi.org/10.1002/mds.24041

DOI: 10.1002/mds.24041


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Funding

Funder referenceFunder name
NIHR Dementias and Neurodegenerative Diseases Research Network (DeNDRoN)
UK Department of Health via the National Institute for Health Research (NIHR) Specialist Biomedical Research Centre for Mental Health
Wales Dementias and Neurodegenerative Diseases Research Network (NEURODEM Cymru)
Institute of Psychiatry at King's College London
Maudsley NHS Foundation Trust (SLaM)
J-0601Parkinson's UK

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