Short report
Affective symptoms in multiple system atrophy and Parkinson's
disease: response to levodopa therapy
Istituto Nazionale
Neurologico C Besta, Via Celoria 11, I-20133 Milano, Italy
Correspondence to: Dr F Girotti, Istituto Nazionale Neurologico C Besta, Via Celoria 11, I-20133 Milano, Italy
Received 27 March 1998 and in revised form 21 September 1998;
Accepted 15
October 1998
The objective was
to determine the extent to
which psychiatric disturbances (especially mood disorders) generally
considered poor prognostic factors, are present in patients with
striatonigral (SND) type multiple system atrophy (MSA) compared with
patients with idiopathic Parkinson's disease (IPD).
The Hamilton depression scale (HAM-D), brief psychiatric rating
scale (BPRS), and Unified Parkinson's disease rating scale (UPDRS)
were administered to clinically probable non-demented patients with
SND-type MSA and patients with IPD matched for age and motor
disability, at baseline and after receiving levodopa.
At baseline total HAM-D score was greater in patients with IPD.
Overall, BPRS score did not differ between the two groups; however,
patients with IPD scored higher on anxiety items of the BPRS, and
patients with MSA had higher scores on the item indicating blunted
affect. After levodopa, both groups improved significantly in UPDRS and
HAM-D total scores (just significant for patients with MSA). Patients
with IPD improved significantly in total BPRS score but patients with
MSA did not.
At baseline patients with IPD were
more depressed and anxious than patients with MSA who, by contrast,
showed blunted affect. After levodopa, depression and anxiety of
patients with IPD improved significantly whereas the affective
detachment of patients with MSA did not change. Major neuronal loss in
the caudate and ventral striatum, which are part of the lateral
orbitofrontal and limbic circuits, may be responsible for the blunted
affect not responsive to levodopa therapy found in patients with MSA.
© 1999 by Journal of Neurology, Neurosurgery, and Psychiatry
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
-
Kirkpatrick, B., Fischer, B.
(2006). Subdomains Within the Negative Symptoms of Schizophrenia: Commentary. Schizophr Bull
32: 246-249
[Full Text] -
Hemingway, J., Franco, K., Chmelik, E.
(2005). Shy-Drager Syndrome: Multisystem Atrophy With Comorbid Depression. Psychosomatics
46: 73-76
[Full Text] -
Laakso, A., Wallius, E., Kajander, J., Bergman, J., Eskola, O., Solin, O., Ilonen, T., Salokangas, R. K.R., Syvalahti, E., Hietala, J.
(2003). Personality Traits and Striatal Dopamine Synthesis Capacity in Healthy Subjects. Am. J. Psychiatry
160: 904-910
[Abstract] [Full Text] -
Walsh, K, Bennett, G
(2001). Parkinson's disease and anxiety. Postgrad. Med. J.
77: 89-93
[Abstract] [Full Text] -
Narayan, M., Bremner, J. D., Kumar, A.
(1999). Neuroanatomic Substrates of Late-Life Mental Disorders. J Geriatr Psychiatry Neurol
12: 95-106
[Abstract]
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
-
Drugs: CNS (not psychiatric)
-
Movement disorders (other than Parkinsons)
-
Parkinson's disease
- Mood disorders (including depression)
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
