Objective: To compare the frequency of neuropsychiatric symptoms (NPS) (depression, anxiety, psychotic, irritability, aggression, euphoria, apathy, behavioral disinhibition, repetitive motor behavior (RMB) and eating disorder) between early (EOPD) and late-onset PD (LOPD).

Background: NPS are common in PD and have a great impact on other variables, including QoL, motor and cognitive function and even eligibility for medical and surgical treatments. Although EOPD and LOPD share key motor features, not only can they differ in neurobiological variables, but also in psychosocial and pharmacological treatment variables that could all result in differential frequency of NPS in both phenotype groups.

Method: We used the Beck Depression and Cummings Neuropsychiatric Inventories; 136 EOPD and 57 LOPD non-demented patients were studied.

Results: Groups were similar in education level, activities of daily living, UPDRS III scores, and premorbid IQ. Groups differed in age (<.001), age at onset (<.001) and disease duration (.03). Frequency of NPS in EOPD and LOPD was as follows, respectively: depression (44% vs. 39%), specifically moderate-severe depression (17.6% vs 9.8%), although depression was reported by family members only in 25% of LOPD patients. Most frequently reported by family in EOPD were aggression (27 vs. 9%), depression (52 vs. 25%), anxiety (56 vs. 31%), euphoria (17 vs. 4%) and repetitive motor behavior (20 vs. 9%), whereas most frequently reported in LOPD were delusions (18 vs. 8%), hallucinations (22 vs. 10%) and apathy (34 vs 29%). Disinhibition, irritability and eating disorders had similar frequency in both groups (18%,33%, and 38%, respectively). In EOPD patients, compulsive or overeating were more commonly reported, whereas in LOPD loss of appetite was more common.

Conclusion: Frequency of specific NPS differs between EOPD and LOPD patients. Symptoms commonly associated to greater progression of PD pathology were more common in LOPD (apathy and psychotic symptoms), despite shorter disease duration, which suggests that age related factors could be relevant contributors. Aggression, euphoria and repetitive motor behavior in the EOPD sample could be symptoms related to ICD´s and dopamine dysregulation, given that this group was more commonly treated with dopamine agonists (pramipexole) and had greater daily doses of levodopa.

« Back to 2019 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/frequency-of-neuropsychiatric-symptoms-in-non-demented-early-and-late-onset-parkinsons-disease-patients/