Article Text

Download PDFPDF
Cortical cholinergic denervation is associated with depressive symptoms in Parkinson’s disease and parkinsonian dementia
  1. N I Bohnen1,2,3,
  2. D I Kaufer1,
  3. R Hendrickson1,
  4. G M Constantine4,
  5. C A Mathis2,
  6. R Y Moore1
  1. 1Department of Neurology, University of Pittsburgh Medical School, Pittsburgh, Pennsylvania, USA
  2. 2Departments of Radiology, University of Pittsburgh Medical School, Pittsburgh, Pennsylvania, USA
  3. 3VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
  4. 4Department of Mathematics and Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  1. Correspondence to:
 Dr N I Bohnen
 Department of Radiology, Division of Nuclear Medicine, The University of Michigan Medical Center, B1 G505 University Hospital, 1500 E Medical Center Drive, Ann Arbor, MI 48109-0028, USA; nbohnen{at}


Aim: To investigate the relationship between ratings of depressive symptoms and in vivo cortical acetylcholinesterase (AChE) activity in subjects with Parkinson’s disease (PD) and parkinsonian dementia (PDem).

Methods: Subjects (with PD, n = 18, including subjects with PDem, n = 6, and normal controls, n = 10) underwent [11C]methyl-4-piperidinyl propionate AChE positron emission tomography imaging and clinical assessment including the Cornell Scale for Depression in Dementia (CSDD).

Results: Subjects with PD and PDem had higher scores on the CSDD compared with normal controls: 7.3 (5.4) and 2.8 (2.6), respectively (F = 6.9, p = 0.01). Pooled analysis demonstrated a significant inverse correlation between cortical AChE activity and CSDD scores: R = −0.5, p = 0.007. This correlation remained significant after controlling for Mini-Mental State Examination scores.

Conclusion: Depressive symptomatology is associated with cortical cholinergic denervation in PD that tends to be more prominent when dementia is present.

  • AChE, acetylcholinesterase
  • CSDD, Cornell Scale for Depression in Dementia
  • MMSE, Mini-Mental State Examination
  • NPI-Q, Neuropsychiatric Inventory Questionnaire
  • PDem, parkinsonian dementia
  • PET, positron emission tomography
  • PMP, methyl-4-piperidinyl propionate
  • UPDRS, Unified Parkinson’s Disease Rating Scale

Statistics from


  • Competing interests: None declared.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.