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Cortical cholinergic denervation is associated with depressive symptoms in Parkinson’s disease and parkinsonian dementia


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

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