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Neuropsychiatry
Research paper
Effects of dopaminergic depletion and brain atrophy on neuropsychiatric symptoms in de novo Parkinson’s disease
  1. Byoung Seok Ye1,
  2. Seun Jeon2,
  3. Sohoon Yoon1,
  4. Seong Woo Kang1,
  5. KyoungWon Baik1,
  6. Yoonju Lee1,
  7. Su Jin Chung1,
  8. Jungsu S Oh3,
  9. Hyojeong Moon3,
  10. Jae Seung Kim3,
  11. Phil Hyu Lee1,
  12. Young Ho Sohn1
  1. 1 Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
  2. 2 McGill Center for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada
  3. 3 Department of Nuclear Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
  1. Correspondence to Professor Young Ho Sohn, Department of Neurology, Yonsei University College of Medicine, 5001 Yonsei ro Seodaemun gu, Seoul, 120-752, South Korea; yhsohn62{at}yuhs.ac

Abstract

Background Neuropsychiatric symptoms impact the patients’ quality of life and caregivers’ burdens in Parkinson’s disease (PD). We aimed to investigate the effects of striatal dopaminergic depletion and brain atrophy on the neuropsychiatric symptoms of patients with PD.

Methods Two hundred and seven patients with de novo drug-naïve PD underwent dopamine transporter (DAT) positron emission tomography and brain MRI scanning. In addition, the patients were assessed with caregiver-administered neuropsychiatric inventory (NPI) questionnaires. To evaluate the effects of DAT uptake, subcortical volume and cortical thinning on the patients’ neuropsychiatric symptoms, we performed logistic regression and negative binomial regression analyses on the NPI data after controlling for possible confounders.

Results Frontal cortical thinning was associated with the presence of nighttime behaviour and irritability, and the thinning correlated with the severity of the nighttime behaviour. Temporal cortical thinning was associated with the presence of aggression/agitation, and it correlated with the severity of the aggression/agitation. Subcortical atrophy in the accumbens was associated with the presence of disinhibition and correlated with the severity of the disinhibition. Putamen atrophy and insular thinning were independently associated with the presence of apathy, but only insular thinning correlated with the severity of the apathy. Of the predictors, only frontal cortical thinning correlated with the total NPI score.

Conclusions The results of this study suggested that accumbens atrophy and frontotemporal cortical thinning, especially frontal cortical thinning, independently contributed to neuropsychiatric symptoms in patients with PD, while DAT uptake did not affect the neuropsychiatric symptoms.

  • cortical thickness
  • dopamine transporter imaging
  • neuropsychiatric symptom
  • subcortical atrophy
  • parkinson’s disease

https://doi.org/10.1136/jnnp-2017-316075

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    Footnotes

    • Contributors BSY and YHS: conceived and planned the study. BSY, SY, SWK, KB, YL, SJC, PHL and YHS: collected the data. BSY, SJ, JO, HM and JSK: analysed the data. BSY and YHS: were involved in the drafting of manuscript. YHS: was involved in the final approval of the version to be published, and takes responsibility for the integrity and accuracy of the data analyses.

    • Funding This study was supported by a Faculty research grant from Yonsei University College of Medicine (6-2016-0080).

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval The study was approved by Yonsei University Severance Hospital ethical standards committee.

    • Provenance and peer review Not commissioned; externally peer reviewed.