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Altered awareness of motor symptoms in Parkinson's disease and Dementia with Lewy Bodies: A systematic review
Author(s) -
Pennington Catherine,
Duncan Gordon,
Ritchie Craig
Publication year - 2020
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.5362
Subject(s) - dementia with lewy bodies , dementia , anosognosia , parkinson's disease , psychology , dyskinesia , lewy body , hypokinesia , disease , cognition , concordance , apathy , psychiatry , frontotemporal dementia , physical medicine and rehabilitation , clinical psychology , medicine , pathology
Objectives Altered awareness of motor symptoms is reported in people with Parkinson's disease and Dementia with Lewy Bodies, and may adversely affect quality of life and medication concordance. How symptom awareness is influenced by motor and cognitive disease severity, age and medication use is not fully understood. We carried out a systematic review of the literature on motor symptom awareness in Parkinson's disease and Dementia with Lewy Bodies. Methods Pubmed and Wed of Science were searched for relevant articles published in or prior to March 2019. Data regarding participant demographics, diagnosis, cognitive status, method of assessing awareness and study findings were extracted from relevant publications. Results Sixteen relevant publications were identified. Motor symptom awareness appears to decline over the course of Parkinson's disease. Imaging studies implicate the prefrontal cortex, with different mechanisms involved in hypokinesia and dyskinesia awareness. The hypothesis that people with right hemisphere based disease would have more severely reduced awareness is only weakly supported. Most studies focused on cognitively intact individuals, and on awareness of dyskinesia rather than hypokinesia. Conclusions Whilst reduced awareness of dyskinesia and to a lesser extent hypokinesia is common, there is a lack of longitudinal data on how awareness changes over time, and how it interacts with global cognitive changes. Motor symptom awareness in Dementia with Lewy Bodies is understudied. Future studies of symptom awareness should include robust assessment of overall cognitive functioning, and use a longitudinal design to elucidate how awareness changes over time. J Am Geriatr Soc 68:‐, 2020.