Brain Sciences (Mar 2023)

Neurocognitive Psychiatric and Neuropsychological Alterations in Parkinson’s Disease: A Basic and Clinical Approach

  • Héctor Alberto González-Usigli,
  • Genaro Gabriel Ortiz,
  • Claudia Charles-Niño,
  • Mario Alberto Mireles-Ramírez,
  • Fermín Paul Pacheco-Moisés,
  • Blanca Miriam de Guadalupe Torres-Mendoza,
  • José de Jesús Hernández-Cruz,
  • Daniela Lucero del Carmen Delgado-Lara,
  • Luis Javier Ramírez-Jirano

DOI
https://doi.org/10.3390/brainsci13030508
Journal volume & issue
Vol. 13, no. 3
p. 508

Abstract

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The main histopathological hallmarks of Parkinson’s disease (PD) are the degeneration of the dopaminergic neurons of the substantia nigra pars compacta and the loss of neuromelanin as a consequence of decreased dopamine synthesis. The destruction of the striatal dopaminergic pathway and blocking of striatal dopamine receptors cause motor deficits in humans and experimental animal models induced by some environmental agents. In addition, neuropsychiatric symptoms such as mood and anxiety disorders, hallucinations, psychosis, cognitive impairment, and dementia are common in PD. These alterations may precede the appearance of motor symptoms and are correlated with neurochemical and structural changes in the brain. This paper reviews the most crucial pathophysiology of neuropsychiatric alterations in PD. It is worth noting that PD patients have global task learning deficits, and cognitive functions are compromised in a way is associated with hypoactivation within the striatum, anterior cingulate cortex, and inferior frontal sulcus regions. An appropriate and extensive neuropsychological screening battery in PD must accurately assess at least five cognitive domains with some tests for each cognitive domain. This neuropsychological screening should consider the pathophysiological and clinical heterogeneity of cognitive dysfunction in PD.

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