Mirjana Petrovic1, Elka Stefanova2, Ljubomir Ziropadja3, Tanja Stojkovic2, Vladimir S Kostic4. 1. Clinic of Neurology, Clinical Center Kragujevac, Serbia. 2. Faculty of Medicine, University of Belgrade, Serbia; Clinic of Neurology, CCS, Serbia. 3. Faculty of Philology, University of Belgrade, Serbia. 4. Faculty of Medicine, University of Belgrade, Serbia; Clinic of Neurology, CCS, Serbia. Electronic address: vladimir.s.kostic@gmail.com.
Abstract
BACKGROUND: Parkinson's disease [PD] is associated with wide variety of neuropsychiatric symptoms, although it is primarily considered as a movement disorder. OBJECTIVE: To examine whether PD patients can be meaningfully classified into subgroups according to their neuropsychiatric symptoms, reported by their caregivers. METHODS: Three hundred and sixty PD patients [mean age=63.5, SD=10.3] from the academic clinical setting were assessed with the 12-subscale Neuropsychiatric Inventory Questionnaire [NPI]. A two-stage cluster analysis was used to identify the subgroups groups of patients with specific neuropsychiatric profile. RESULTS: Three hundred and twenty-one PD patients [89%] showed at least one psychiatric symptom. The most common symptoms were anxiety [73.1%], depression [64.7%], and apathy [51.7%], and nighttime disturbance [51.3%], whereas the least common were euphoria [0.3%], and delusions [1.7%]. The mean [SD] total NPI composite score was 16.9 [17.4]. Two hundred eight PD subjects [58%] of the total sample had at least one symptom with a score ≥4. Three clusters were identified: a] Cluster 1, with no or few NPI symptoms [n=200; 55.6%]; b] Cluster 2, with mild to moderate symptoms on depression, anxiety and apathy scales [n=140; 38.9%]; and c] Cluster 3 with high agitation, disinhibition and irritability scores [n=20 patients; 5.6%]. PD subjects with clinically significant neuropsychiatric symptoms were older with more severe motor and cognitive impairment. CONCLUSIONS: This study emphasizes the high prevalence and importance of neuropsychiatric symptoms in PD patients; therefore clinicians should also focus on treating in parallel with motor symptoms.
BACKGROUND:Parkinson's disease [PD] is associated with wide variety of neuropsychiatric symptoms, although it is primarily considered as a movement disorder. OBJECTIVE: To examine whether PDpatients can be meaningfully classified into subgroups according to their neuropsychiatric symptoms, reported by their caregivers. METHODS: Three hundred and sixty PDpatients [mean age=63.5, SD=10.3] from the academic clinical setting were assessed with the 12-subscale Neuropsychiatric Inventory Questionnaire [NPI]. A two-stage cluster analysis was used to identify the subgroups groups of patients with specific neuropsychiatric profile. RESULTS: Three hundred and twenty-one PDpatients [89%] showed at least one psychiatric symptom. The most common symptoms were anxiety [73.1%], depression [64.7%], and apathy [51.7%], and nighttime disturbance [51.3%], whereas the least common were euphoria [0.3%], and delusions [1.7%]. The mean [SD] total NPI composite score was 16.9 [17.4]. Two hundred eight PD subjects [58%] of the total sample had at least one symptom with a score ≥4. Three clusters were identified: a] Cluster 1, with no or few NPI symptoms [n=200; 55.6%]; b] Cluster 2, with mild to moderate symptoms on depression, anxiety and apathy scales [n=140; 38.9%]; and c] Cluster 3 with high agitation, disinhibition and irritability scores [n=20 patients; 5.6%]. PD subjects with clinically significant neuropsychiatric symptoms were older with more severe motor and cognitive impairment. CONCLUSIONS: This study emphasizes the high prevalence and importance of neuropsychiatric symptoms in PDpatients; therefore clinicians should also focus on treating in parallel with motor symptoms.
Authors: Adrianus L A J Hommel; Marjan J Meinders; Stefan Lorenzl; Richard Dodel; Miguel Coelho; Joaquim J Ferreira; Brice Laurens; Umberto Spampinato; Wassilios Meissner; Kristina Rosqvist; Jonathan Timpka; Per Odin; Michael Wittenberg; Bas R Bloem PhD; Raymond T Koopmans; Anette Schrag Journal: Mov Disord Clin Pract Date: 2020-05-21