RT Journal Article
SR Electronic
T1 A smaller amygdala is associated with anxiety in Parkinson’s disease: a combined FreeSurfer—VBM study
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 493
OP 500
DO 10.1136/jnnp-2015-310383
VO 87
IS 5
A1 Chris Vriend
A1 Premika SW Boedhoe
A1 Sonja Rutten
A1 Henk W Berendse
A1 Ysbrand D van der Werf
A1 Odile A van den Heuvel
YR 2016
UL http://jnnp.bmj.com/content/87/5/493.abstract
AB Background Up to 50% of all patients with Parkinson's disease (PD) suffer from anxiety symptoms, a much higher percentage than in the general population. This suggests that PD associated pathological alterations partly underlie these symptoms, although empirical evidence is limited.Methods Here we investigated the association between anxiety symptoms measured with the Beck Anxiety Inventory (BAI) and hippocampal and amygdalar volume in 110 early-stage patients with PD. Measures of anxiety in PD are often obscured by overlap with the somatic symptoms. We therefore also used a subscale of the BAI, established by our recent factor analysis, that reflects ‘psychological’ anxiety symptoms and is independent of the severity of PD-related motor and autonomic symptoms. We used FreeSurfer and voxel-based morphometry for the volumetric analyses.Results Both software packages showed a negative correlation between the ‘psychological’ subscale of the BAI, but not total BAI and volume of the left amygdala, independent of the severity of motor symptoms, autonomic dysfunction and dopaminergic or anxiolytic medication status.Conclusions These results confirm studies in non-PD samples showing lower left amygdalar volume in anxious patients. The results also indicate that the ‘psychological’ BAI subscale is a better reflection of neural correlates of anxiety in PD. Whether the left amygdalar volume decrease constitutes a premorbid trait, a PD-associated neurobiological susceptibility to anxiety or arises as a consequence of chronic anxiety symptoms remains to be determined by future prospective longitudinal studies. Nonetheless, we speculate that the Parkinson pathology is responsible for the reduction in amygdalar volume and the concomitant development of anxiety symptoms.