Neuropsychiatric changes in Parkinson’s disease patients: A prospective observational two years study

Abstract

Parkinson’s disease (PD) is clinically manifested by motor and non-motor symptoms, including neuropsychiatric changes, which can occur both in the early and advanced stages of PD. Objectives. The study evaluated cognitive and behavioral changes in patients with PD. Material and methods. Unified Parkinson’s Disease Rating Scale (UPDRS) and Hoehn and Yahr scale were used to assess the neurological status of 112 patients with PD. Clinical neuropsychological tests were applied to all patients. Outcomes. The longer the duration of the disease is, the more critical impulse-control disorders are, especially shopping, hobbyism, and punding. Hypersexual behavior appears to be age and gender-dependent. Depression and impulse-control disorders seem interconnected: subjects tested with severe depression on the Hamilton Depression Rating Scale have more shopping compulsions. Antiparkinsonian treatment influences the Montreal Cognitive Assessment score. When specific cognitive domains are tested, subjects treated only with levodopa have lower scores at temporal and spatial orientation testing. Dopamine agonists appear to be associated with less cognitive dysfunctions. Conclusions. Neuropsychiatric symptoms impact the quality of life in Parkinson’s disease patients and must be systematically assessed.

Keywords

• parkinson’s disease
• depression
• cognitive dysfunction