Jessie S Gibson1,2, Joseph L Flanigan3, James T Patrie4, W Alex Dalrymple3, Madaline B Harrison3. 1. School of Nursing, University of Virginia, Charlottesville, VA, USA. js6zn@virginia.edu. 2. Department of Neurology, University of Virginia, Charlottesville, VA, USA. js6zn@virginia.edu. 3. Department of Neurology, University of Virginia, Charlottesville, VA, USA. 4. Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.
Abstract
INTRODUCTION: Anxiety symptoms are the most common neuropsychiatric manifestation of Parkinson's disease (PD), contributing to decreased quality of life. Few longitudinal studies in PD samples have examined correlates of anxiety symptoms over time. Understanding predictor variables may help to identify novel targets for reducing anxiety in PD. The aim of this study was to identify predictors of anxiety symptoms over 3 years in a clinic-based PD cohort. METHODS: Our cohort included patients with PD at an academic medical center in the Southeastern United States (n = 105). Visits included assessment of motor, psychiatric, and cognitive features, including neuropsychological testing. For our multivariate model, we selected 11 predictor variables with the most existing evidence or theoretical support for an association with anxiety symptoms in PD. Multivariate linear mixed model regression was performed to determine which variables were significantly associated with anxiety symptoms over time. RESULTS: Over half of participants (57%) met the screening threshold for an anxiety disorder at some point during the study. Independent predictors of anxiety symptoms over time included symptoms of REM sleep behavior disorder (RBD) and dysautonomia. DISCUSSION: In this PD sample, RBD and dysautonomia symptoms were significantly associated with anxiety symptoms over time. Each of these relationships has been reported in one of two prior longitudinal studies. Unlike prior studies, cognitive impairment was not a significant predictor of anxiety symptoms in our sample. Future research should confirm the direction and mechanisms underlying these relationships, including the potential for anxiety symptom reduction through treatment for RBD and dysautonomia.
INTRODUCTION: Anxiety symptoms are the most common neuropsychiatric manifestation of Parkinson's disease (PD), contributing to decreased quality of life. Few longitudinal studies in PD samples have examined correlates of anxiety symptoms over time. Understanding predictor variables may help to identify novel targets for reducing anxiety in PD. The aim of this study was to identify predictors of anxiety symptoms over 3 years in a clinic-based PD cohort. METHODS: Our cohort included patients with PD at an academic medical center in the Southeastern United States (n = 105). Visits included assessment of motor, psychiatric, and cognitive features, including neuropsychological testing. For our multivariate model, we selected 11 predictor variables with the most existing evidence or theoretical support for an association with anxiety symptoms in PD. Multivariate linear mixed model regression was performed to determine which variables were significantly associated with anxiety symptoms over time. RESULTS: Over half of participants (57%) met the screening threshold for an anxiety disorder at some point during the study. Independent predictors of anxiety symptoms over time included symptoms of REM sleep behavior disorder (RBD) and dysautonomia. DISCUSSION: In this PD sample, RBD and dysautonomia symptoms were significantly associated with anxiety symptoms over time. Each of these relationships has been reported in one of two prior longitudinal studies. Unlike prior studies, cognitive impairment was not a significant predictor of anxiety symptoms in our sample. Future research should confirm the direction and mechanisms underlying these relationships, including the potential for anxiety symptom reduction through treatment for RBD and dysautonomia.
Authors: Gregory M Pontone; James R Williams; Karen E Anderson; Gary Chase; Susanne A Goldstein; Stephen Grill; Elaina S Hirsch; Susan Lehmann; John T Little; Russell L Margolis; Peter V Rabins; Howard D Weiss; Laura Marsh Journal: Mov Disord Date: 2009-07-15 Impact factor: 10.338
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Authors: Gregory M Pontone; Nadeeka Dissanayka; Liana Apostolova; Richard G Brown; Roseanne Dobkin; Kathy Dujardin; Joseph H Friedman; Albert F G Leentjens; Eric J Lenze; Laura Marsh; Lynda Mari; Oury Monchi; Irene H Richard; Anette Schrag; Antonio P Strafella; Beth Vernaleo; Daniel Weintraub; Zoltan Mari Journal: NPJ Parkinsons Dis Date: 2019-12-11