The spectrum of neuropsychiatric symptoms in patients with early, untreated Parkinson's disease.

Dag Aarsland (1) , Kolbjørn Brønnick (1) , Guido Alves (2) , Ole-Bjørn Tysnes (3) , Kenn Freddy Pedersen (2) , Uwe Ehrt (4) , Jan Petter Larsen (1)

1 The Norwegian Centre for Movement Disorders, Stavanger University Hospital
2 The Norwegian Centre for Movement Disorders/Department of Neurology, Stavanger University Hospital
3 Haukeland University Hospital
4 The Norwegian Centre for Movement Disorders/Psychiatric Clinic, Stavanger University Hospital

Background: Neuropsychiatric symptoms are common in Parkinson's disease (PD), and have important clinical consequences for patients, caregivers and society. Few studies of neuropsychiatric symptoms in early, untreated PD exist. Objective: To explore the range, clustering and correlates of neuropsychiatric symptoms in an incidence-cohort of untreated subjects with PD. Methods: All cases with incident PD identified during a 22-months period in four counties of Western and Southern Norway were included. Standardized criteria were employed to diagnose PD. The Neuropsychiatric Inventory (NPI) was administered to 175 PD and 166 healthy control subjects with similar age and sex distribution. Cluster analysis was used to investigate the inter-relationship of NPI items. Results: The proportion with any symptom and severity of NPI symptoms was higher in PD (56%) than in controls (22%) (p<.001). Depression (37%), apathy (17%), sleep disturbance (20%) and anxiety (17%) were the most common symptoms. Clinical significant symptoms occurred in 27% of the PD group, compared to only 3% in the control group (p<.001). Subjects with clinically significant neuropsychiatric symptoms had more severe parkinsonism than those without. Two neuropsychiatric clusters were identified, one characterised by mood symptoms and one by apathy. Conclusions: Although the majority of patients with early, untreated PD do not have clinical significant neuropsychiatric symptoms, these symptoms are more common in patients than in people without PD. Both psychological stress and brain changes associated with PD are likely to contribute to the higher frequencies.

Mots clés: DEPRESSION; PARKINSON'S DISEASE

Dag Aarsland, Kolbjørn Brønnick, Guido Alves, Ole-Bjørn Tysnes, Kenn Freddy Pedersen, et al.. The spectrum of neuropsychiatric symptoms in patients with early, untreated Parkinson's disease.. Journal of Neurology, Neurosurgery and Psychiatry, 2009, 80 (8), pp.928. ⟨10.1136/jnnp.2008.166959⟩. ⟨hal-00552740⟩