Major and minor depression in Parkinson's disease: A neuropsychological investigation

ArticleinEuropean Journal of Neurology 13(9):972-80 · October 2006with7 Reads
DOI: 10.1111/j.1468-1331.2006.01406.x · Source: PubMed
Abstract
Previous studies have failed to distinguish the differential contribution of major and minor depression to cognitive impairment in patients with idiopathic Parkinson's disease (PD). This study was aimed at investigating the relationships among major depression (MD), minor depression (MiD) and neuropsychological deficits in PD. Eighty-three patients suffering from PD participated in the study. MD and MiD were diagnosed by means of a structured interview (SCID-I) based on the DSM-IV criteria, and severity of depression was evaluated by the Beck Depression Inventory. For the neuropsychological assessment, we used standardized scales that measure verbal and visual episodic memory, working memory, executive functions, abstract reasoning and visual-spatial and language abilities. MD patients performed worse than PD patients without depression on two long-term verbal episodic memory tasks, on an abstract reasoning task and on three measures of executive functioning. The MiD patients' performances on the same tests fell between those of the other two groups of PD patients but did not show significant differences. Our results indicate that MD in PD is associated with a qualitatively specific neuropsychological profile that may be related to an alteration of prefrontal and limbic cortical areas. Moreover, the same data suggest that in these patients MiD and MD may represent a gradual continuum associated with increasing cognitive deficits.
    • "Starkstein et al. [16] found that patients with major depression performed significantly worse than non-depressed patients on all aspects of neuropsychological function tests, including language tasks. However, another study suggested no difference in language function among patients with minor depression or major depression and the control group [17]. Thus far, there is no consensus on how major depression affects language function. "
    [Show abstract] [Hide abstract] ABSTRACT: Language impairment is relatively common in Parkinson's disease (PD), but not all PD patients are susceptible to language problems. In this study, we identified among a sample of PD patients those pre-disposed to language impairment, describe their clinical profiles, and consider factors that may precipitate language disability in these patients. A cross-sectional cohort of 31 PD patients and 20 controls were administered the Chinese version of the Western Aphasia Battery (WAB) to assess language abilities, and the Montreal Cognitive Assessment (MoCA) to determine cognitive status. PD patients were then apportioned to a language-impaired PD (LI-PD) group or a PD group with no language impairment (NLI-PD). Performance on the WAB and MoCA was investigated for correlation with the aphasia quotient deterioration rate (AQDR). The PD patients scored significantly lower on most of the WAB subtests than did the controls. The aphasia quotient, cortical quotient, and spontaneous speech and naming subtests of the WAB were significantly different between LI-PD and NLI-PD groups. The AQDR scores significantly and positively correlated with age at onset and motor function deterioration. A subset group was susceptible to language dysfunction, a major deficit in spontaneous speech. Once established, dysphasia progression is closely associated with age at onset and motor disability progression.
    Full-text · Article · Jan 2015
    • "patients have shown an association between on/off states, fluctuations of mood and anxiety symptoms [47], and a potential negative influence of affective disorders on cognitive performance [48, 49]. Therefore, the State and Trait Anxiety Inventory-State Anxiety (STAY-S) [50] and the Beck Depression Inventory (BDI) [51, 52] were administered to both PD and healthy participants in the two experimental sessions. "
    [Show abstract] [Hide abstract] ABSTRACT: previous data suggest that i) dopamine modulates the ability to implement non-routine schemata and updating operations (flexibility processes) and that ii) dopamine-related improvement may be related to baseline dopamine levels in target pathways (inverted U-shaped hypothesis). to investigate above hypotheses in individuals with Parkinson's disease (PD). twenty PD patients were administered tasks varying as to flexibility load in two treatment conditions: i) "off" condition, about 18~hours after dopamine dose; ii) "on" condition, after dopamine administration. PD patients were separated into two groups: low performers (i.e., performance on Digit Span Backward below the sample mean) and high performers (i.e. performance above the mean). Twenty healthy individuals performed the tasks in two sessions without taking drugs. passing from the "off" to the "on" state, only low performer PD patients significantly improved their performance on high-flexibility measures (interference condition of the Stroop test; p< 0.05); no significant effect was found on low-flexibility tasks. these findings document that high-flexibility processes are sensitive to dopamine neuromodulation in the early phases of PD. This is in line with the hypothesis that striatal dopamine pathways, affected early by PD, are precociously implicated in the expression of cognitive disorders in these individuals.
    Full-text · Article · Sep 2013
    • "Interestingly , these multivariate models confirmed that specific cognitive dimensions predict hedonic tone differently in MDD and NODEP patients. Indeed, reduced episodic verbal memory performance, a previously described [29] cognitive marker of MDD in PD patients, was correlated with anhedonia only in our MDD patients, whereas reduced attention performance was correlated with anhedonia only in our NODEP patients. The finding of a relationship between anhedonia and frontal attention performance in pure PD patients with no depressive disorders supports the hypothesis of the involvement of frontal and prefrontal dopamine dysfunction, [30] "
    [Show abstract] [Hide abstract] ABSTRACT: Anhedonia has been mainly reported as a symptom of depression and cognitive impairment in Parkinson's disease (PD) patients. Here, we investigated whether hedonic tone depends on depression and clarified its relationship with the cognitive performance of PD patients with different mood disorders. In 254 patients, we assessed hedonic tone using the Snaith-Hamilton Pleasure Scale, depression severity using the Beck Depression Inventory, and cognitive performances using the Mental Deterioration Battery. A structural psychiatric interview was used to diagnose major depressive disorder (MDD) and minor depressive disorder (MIND), according to the DSM-IV-TR criteria. PD patients with diagnosis of MDD were more anhedonic than those with MIND and those without depressive disorders. Reduced hedonic tone correlated with depression severity in patients with MDD and no depressive disorders. In multivariate models that consider depression severity and cognitive performances together, anhedonia was related to increased depression severity and episodic memory (auditory-verbal learning) impairment, in patients with MDD and with increased depression severity and attention impairment in patients with no depressive disorders. In patients with MIND, anhedonia did not correlate with depression severity or any cognitive performance score. Our findings suggest that anhedonia is related to depression severity and specific cognitive performances in patients with MDD and with no depressive disorder. By contrast, the reduced hedonic tone in patients with MIND is independent from depression severity and cognition. Thus, anhedonia in PD is a heterogeneous and multidimensional phenomenon and require investigation at different levels.
    Full-text · Article · Jan 2013
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