Development of anxiety in early Parkinson's disease: A clinical and biomarker study.
Eur J Neurol
; 30(9): 2661-2668, 2023 09.
Article
en En
| MEDLINE
| ID: mdl-37227928
ABSTRACT
BACKGROUND:
Anxiety affects approximately 40% of Parkinson's disease (PD) patients. However, little is known about its predictors and development over time.OBJECTIVE:
To identify the clinical factors and biomarkers associated with development of anxiety in patients with newly diagnosed PD, and to test which risk factors predict increases in anxiety over time.METHODS:
Data from the Parkinson's Progression Markers Initiative (PPMI) were utilized. The primary outcome was the State-Trait Anxiety Inventory (STAI). Covariates were demographics, motor and non-motor symptoms, cognitive functions, dopamine transporter imaging data, and cerebrospinal fluid (CSF) biomarkers. We examined the association of risk factors at baseline and over 4 years with changes in anxiety scores over time.RESULTS:
A total of 252 patients met the inclusion criteria (mean age 61.36 years, SD 9.53). At year 4, 42 patients had developed anxiety. Baseline predictors of increase in anxiety scores were greater autonomic dysfunction, dysexecutive function, CSF t-tau levels, excessive daytime sleepiness, and lower olfactory function scores but not motor scores. Over 4 years, change in anxiety scores correlated with deterioration in overall cognitive function, excessive daytime sleepiness, as well as depression and disability, and to a lesser degree worsening of Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor scores and caudate dopaminergic uptake changes.CONCLUSIONS:
These findings suggest that development of anxiety in PD is not primarily based on a dopaminergic deficit in the basal ganglia but related to non-dopaminergic or extrastriatal pathology. Early dysexecutive function predicts development of anxiety but increase in anxiety levels correlates most strongly with more global cognitive decline.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Enfermedad de Parkinson
/
Trastornos de Somnolencia Excesiva
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
/
Middle aged
Idioma:
En
Revista:
Eur J Neurol
Asunto de la revista:
NEUROLOGIA
Año:
2023
Tipo del documento:
Article
País de afiliación:
Reino Unido