JNNP: Late Oncology Depression: A Cross-Sectional Study of Dopamine Deficiency and Pre-Parkinson's Disease Symptoms

Late onset depression (LOD) is defined as depression that occurs for the first time after the age of 55 and has no apparent history of depression.
, it is assumed that it is more likely to be caused by underlying physical brain disease than early on.
changes in blood vessels have been taken into account in the pathology of LOD, and white matter lesions in LOD patients have increased, although this is not generally accepted.
study also showed that LOD can cause dementia in up to 40 percent of patients, including Alzheimer's Disease (AD) and Louis Body Dementia (DLB).
At least 10 years before motor characteristics occur, non-motor symptoms such as autonomic neuro dysfunction, sleep disorder (REM sleep behavior disorder )), loss of smell and neuropsychiatric characteristics (including anxiety), depression and indifference can occur in the pre-stage of Parkinson's disease (PD).
Retrospective study of depression and anxiety up to 20 years before the diagnosis of Parkinson's disease, in which the diagnosis of depression was associated with a significant increase in the incidence of Parkinson's disease, suggesting that depression disorders from an early age could represent the first manifestation of Parkinson's disease.
, no studies to date have shown whether clinical or imaging markers of pre-PD or DLB are particularly increased in LOD.
this paper assumes that the clinical evaluation of dopamine transport protein and dopamine transport protein defects is related to dopamine deficiency in patients.
patient health questionnaire 9 (PHQ-9), hospital anxiety and depression scale (HADS), motion disorders society unified Parkinson's disease assessment scale (MDS-UPDRS) (conducted by experienced and MDS-UPDRS-rated researchers), Montreal Cognitive Assessment (MoCA), frontal leaf assessment set of tests (FAB), Lille apathy assessment scale (D) LARS), Rapid Eye Movement Sleep Disorders Single Problem Screening (RBD1Q), Rapid Eye Movement Sleep Disorders Screening Questionnaire (RBDSQ), Parkinson's Sleep Scale (PDSS), Parkinson's Disease Screening Questionnaire (PD Screening), Parkinson's Disease Autonomic Nervous System (SCOPA-AUT) and University of Pennsylvania Odor Recognition Test (UPSIT) Results Scale.
29 LOD patients and 25 HC patients were shown dopamine transporters at two different study sites using 123I ioflupane SPECT.
28 LOD and 20 HC patients also had structural MRI head scans in two areas using Philips 1.5t (n=36) or 3t (n=12) scanners.
OFD patients (n-36) in PD screening questionnaire (average (SD) 1.8 (1.9)vs 0.8 (1.2);p-0.01), sports disorders society unified Parkinson's disease score scale (Average (SD) 19.2 (12.7)vs 6.1 (5.7);p-lt;0.001) scores significantly lower than HC (n-30), REM Sleep Behavioral Disorders Screening Questionnaire (Average (SD) 4.3 (3.2)vs 2.1 (2.1) ;p -0.001; Lille's Apathy Scale (Average (SD) -23.3 (9.6)vs .27.0 (27.0) 4.7) ;p -0.04) and PD Autonomy Prognostic Scale (Average (SD) 14.9 (8.7)vs 7.7 (4.9) ;p-lt;0.001).
24% of LOD patients and 4% of HC patients had SPECT scan abnormalities (p-0.04).
LOD was associated with an increase in the occurrence of motor and non-motor pre-motor symptoms of PD and DLB, and with SPECT abnormal scan results for PD and DLB.
While reported symptoms of anxiety, apathy, and sleep disorders can be explained by depression disorders alone, cognitive impairment and autonantial neurodefunction symptoms, including constipation and urinary tract symptoms, are less likely to occur in depression, making it unlikely that most non-motor characteristics are caused solely by depressive syndrome.
, however, they are characteristic of the PD and DLB forward periods.
PD and DLB of the LOD group showed more specific characteristics, including RBD (RBDSQ and RBD1Q) and the rate of motion function was significantly higher than that of the control group.
the rigid LOD group exercise delay score, MDS-UPDRS self-completion part score was significantly higher than the HC group.
It is worth noting that the difference in pivot characteristics from general body movements (speech retardation, loss of facial expressions, and slow physical movement) is not significant, which is typical in patients with depression, but is particularly pronounced in stiffness and limb movement retardation scores.
, LOD patients scored significantly higher on specific PD screening questionnaires.
study, which further enhanced the likelihood that LOD is a pre-existing condition of PD or DLB, showed that the clinical characteristics of motor and non-motor dysfunction in PD were more common in those with PARKINSON's disease with dopamine transporter scans that were abnormal than those scanned.
all LOD patients with 123I Ioofluorane SPECT abnormalities have clinical characteristics previously described in PD and DLB, indicating that these patients reflect a potential disease process.
found no difference in vascular pathology or risk factors associated with LOD.
these findings are consistent with autopsy studies, and no evidence of cerebrovascular or AD-related lesions was found in patients with advanced depression.
Kazmi H, Walker Z, Booij J, et al Late onset depression: dopaminergic and clinical features of the prodromal Parkinson's disease: a cross-sectionaljournal of Neurology, Neurosurgery and Psimology Published Online First: 02 December 2020. doi: 10.1136/jnnp-2020-324266MedSci Original Source: MedSci Original Copyright Notice: All notes on this website "Source: Met Medical" or "Source: MedSci Original" text, images and audio and video materials, copyrights belong to Mes No media, website or individual may be reproduced without authorization, which must be reproduced with the following "Source: Metz Medicine".
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