COGNITIVE AND AFFECTIVE DISORDERS AT EARLY STAGES OF PARKINSON’S DISEASE

Cover Page


Cite item

Full Text

Abstract

Background: Non-motor signs, including affective and cognitive ones, are important initial manifestations of Parkinsons disease, along with motor dysfunction. Some of them manifest even before motor disorders and affect patients’ quality of life.

 Aim: To evaluate prevalence and severity of affective and cognitive disorders at early stages of Parkinson’s disease, as well as efficacy of their correction with a dopamine receptor agonist treatment.

Materials and methods: We assessed 33 treatment-naive patients with Parkinsons disease Hoehn & Yahr stage I and II. Degree of motor dysfunction (UPDRS, Unified Parkinson's Disease Rating Scale), depressive (MADRS, Montgomery Asberg Depression Rating Scale), anxiety (HARS, Hamilton Anxiety Rating Scale) and cognitive (Montreal Cognitive Assessment – MoCA, symbols and figures test, Schulte tables, Gorbovs black and red tables) was assessed at baseline and after 1, 3 and 6 months of treatment with pramipexole.

Results: Patients with early signs of Parkinson’s disease had subdepressive disorders, moderate anxiety disorders, mild cognitive disorders of a neurodynamic type and represented mainly be delayed recall of information and attention disorders. Treatment with pramipexole decreased the degree of depressive symptoms by 82% and of anxiety symptoms by 74%. There was an improvement in cognitive functions, indicated by an increase in a delayed recall (+34%), better efficacy (+31%), a decrease in switching time (-38%) and attention distribution (-33%); however, age-related normal values were not achieved.

Conclusion: Already early stages of Parkinsons disease are characterized not only by motor abnormalities, but also by affective and neurodynamic cognitive dysfunction. Medical treatment with pramipexole was effective in correction of motor and neuropsychiatric disorders in patients with Parkinsons disease Hoehn & Yahr stage I–II.

About the authors

R. R. Bogdanov

Moscow Regional Research and Clinical Institute (MONIKI)

Author for correspondence.
Email: rinatbo@rambler.ru

PhD, Associate Professor, Chair of Neurology, Postgraduate Training Faculty

Россия

S. Yu. Borisova

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru

Postgraduate Student, Chair of Neurology, Postgraduate Training Faculty

Россия

S. V. Kotov

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru

MD, PhD, Professor; Head of Department of Neurology; Head of Chair of Neurology, Postgraduate Training Faculty

Россия

References

  1. Левин ОС, Федорова НВ. Болезнь Паркинсона. М.: МЕДпресс-информ; 2014. 352 с. Levin OS, Fedorova NV. Bolezn' Parkinsona [Parkinson’s disease]. Moscow: MEDpress-inform; 2014. 352 p. (in Russian).
  2. Wolters E, Baumann C. Parkinson disease and other movement disorders. Amsterdam: VU University Press; 2014. 832 p.
  3. Brooks DJ. Morphological and functional imaging studies on the diagnosis and progression of Parkinson’s disease. J Neurol. 2000;247 Suppl 2:II11–8.
  4. Braak H, Tredici KD, Rub U, de Vos RA, Jansen Steur EN, Braak E. Staging of brain pathology related to sporadic Parkinson’s disease. Neurobiol Aging. 2003;24(2):197–211.
  5. Rachakonda V, Pan TH, Le WD. Biomarkers of neurodegenerative disorders: how good are they? Cell Res. 2004;14(5):347–58.
  6. Богданов РР, Борисова СЮ, Котов СВ. Нарушения аффективной сферы у пациентов с начальными проявлениями болезни Паркинсона. Нервные болезни. 2014;(2): 12–4. Bogdanov RR, Borisova SYu, Kotov SV. Narusheniya affektivnoy sfery u patsientov s nachal'nymi proyavleniyami bolezni Parkinsona [Affective disorders in patients with initial signs of Parkinson’s disease]. Nervnye bolezni. 2014;(2):12–4 (in Russian).
  7. Федорова НВ, Никитина АВ. Депрессия, апатия и ангедония при болезни Паркинсона: механизмы развития немоторных проявлений и подходы к коррекции. Нервные болезни. 2012;(3):31–6. Fedorova NV, Nikitina AV. Depressiya, apatiya i angedoniya pri bolezni Parkinsona: mekhanizmy razvitiya nemotornykh proyavleniy i podkhody k korrektsii [Depression, apathy and anhedonia in Parkinson’s disease: mechanisms of non-motor symptoms and approaches to their correction]. Nervnye bolezni. 2012;(3):31–6 (in Russian).
  8. Martinez-Martin P, Damiаn J. Parkinson disease: Depression and anxiety in Parkinson disease. Nat Rev Neurol. 2010;6(5):243–5.
  9. Leentjens AF. The role of dopamine agonists in the treatment of depression in patients with Parkinson's disease: a systematic review. Drugs. 2011;71(3):273–86.
  10. Lemke MR, Brecht HM, Koester J, Kraus PH, Reichmann H. Anhedonia, depression, and motor functioning in Parkinson’s disease during treatment with pramipexole. J Neuropsychiatry Clin Neurosci. 2005;17(2):214–20.
  11. Barone P, Scarzella L, Marconi R, Antonini A, Morgante L, Bracco F, Zappia M, Musch B; Depression/Parkinson Italian Study Group. Pramipexole versus sertraline in the treatment of depression in Parkinson's disease: a national multicenter parallel-group randomized study. J Neurol. 2006;253(5):601–7. Barone P, Scarzella L, Marconi R, Antonini A, Morgante L, Bracco F, Zappia M, Musch B; Depression/ Parkinson Italian Study Group. Pramipexole versus sertraline in the treatment of depression in Parkinson's disease: a national multicenter parallel-group randomized study. J Neurol. 2006;253(5):601–7.
  12. Захаров ВВ, Ярославцева НВ, Яхно НН. Когнитивные нарушения при болезни Паркинсона. Неврологический журнал. 2003;8(2):11–6. Zakharov VV, Yaroslavtseva NV, Yakhno NN. Kognitivnye narusheniya pri bolezni Parkinsona [Cognitive disorders in Parkinson’s disease]. Nevrologicheskiy zhurnal [Journal of Neurology]. 2003;8(2):11–6 (in Russian).
  13. Шток ВН, Иванова-Смоленская ИА, Левин ОС. Экстрапирамидные расстройства. М.: МЕДпресс-информ; 2002. 235 с. Shtok VN, Ivanova-Smolenskaya IA, Levin OS. Ekstrapiramidnye rasstroystva [Extrapyramidal disorders]. Moscow: MEDpress-inform; 2002. 235 p. (in Russian).
  14. Kim JS, Oh YS, Lee KS, Kim YI, Yang DW, Goldstein DS. Association of cognitive dysfunction with neurocirculatory abnormalities in early Parkinson disease. Neurology. 2012;79(13):1323–31.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2015 Bogdanov R.R., Borisova S.Y., Kotov S.V.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies