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Mild affective symptoms in de novo P arkinson's disease patients: relationship with dopaminergic dysfunction
Author(s) -
Ceravolo R.,
Frosini D.,
Poletti M.,
Kiferle L.,
Pagni C.,
Mazzucchi S.,
Volterrani D.,
Bonuccelli U.
Publication year - 2013
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2012.03878.x
Subject(s) - dopaminergic , beck depression inventory , dopamine transporter , depression (economics) , medicine , depressive symptoms , rating scale , disease , parkinson's disease , mini–mental state examination , dopamine , gastroenterology , psychiatry , psychology , anxiety , dementia , developmental psychology , economics , macroeconomics
Background and purpose The investigation of the relationship between affective symptoms and dopamine transporter ( DAT ) density provided conflicting data in both P arkinson's disease ( PD ) and non‐ PD patients. However, the potential interference of psychoactive as well as anti‐parkinsonian drugs on DAT density should be taken into account. Objective To investigate the relationship between affective symptoms and pre‐synaptic dopaminergic function in de novo PD patients. Methods Forty‐four de novo PD consecutive outpatients were recruited, and the severity of anxious symptoms was evaluated with the H amilton A nxiety R ating S cale ( HAM ‐ A ), the severity of depressive symptoms with the Hamilton Depression Scale ( HAM ‐ D ) and the Beck Depression Inventory ( BDI ). Six patients had a formal diagnosis of depression. All patients performed 123 I ‐ FP ‐ CIT SPECT , and semi‐quantitative striatal indices were calculated. Results Disease severity, as measured by Unified P arkinson's Disease Rating Scale ( UPDRSIII ), was inversely correlated with bilateral striatal indices. Bilateral striatal uptake was significantly positively correlated with HAM ‐D ( r .329; r .423, respectively, right and left), BDI ( r .377; r .360, respectively, right and left) and HAM ‐A ( r .338; r .340, respectively, right and left). After controlling for age, disease duration and severity, and Mini Mental State Examination ( MMSE ), no significant reduction in r‐ values was observed ( P < 0.05). Conclusion Our data support the existence of a relationship between depressive and anxious symptoms and the striatal 123 I‐ FP ‐ CIT uptake. The finding of an increased DAT density associated with mild affective symptoms could be due to the lack of compensatory mechanisms usually present in early PD , and/or it might have a pathogenic role in affective symptoms by reducing the dopaminergic tone in the synaptic cleft.