ORCID Profile
0000-0002-0164-3337
Current Organisation
University Of Queensland Centre for Clinical Research
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Publisher: Public Library of Science (PLoS)
Date: 05-05-2017
Publisher: Springer Science and Business Media LLC
Date: 04-08-2021
DOI: 10.1007/S00415-021-10736-X
Abstract: Preliminary evidence has demonstrated a link between anxiety and memory impairment in Parkinson's disease (PD). This study further investigated this association using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for anxiety disorders and a standardized cognitive test battery. A convenience s le of 89 PD patients without dementia was recruited from neurology outpatient clinics. A cross-sectional design was applied. Participants completed two semi-structured interviews. The first interview diagnosed DSM-5 anxiety disorders, unspecified anxiety disorder, and no anxiety. The second interview applied a neurocognitive test battery comprising two tests for each domain. Logistic regression models compared cognitive characteristics associated with anxiety disorders to no anxiety. Clinically significant anxiety was associated with immediate verbal memory impairment compared to the no anxiety group (OR, 95% CI 0.52, 0.30-0.89 p = 0.018), controlling for sex and age. The anxiety disorders group demonstrated immediate (OR, 95% CI 0.46, 0.26-0.83 p = 0.010) and delayed (OR, 95% CI 0.63, 0.40-0.99 p = 0.047) verbal memory impairments compared to those without anxiety, controlling for sex and age. This association remained for immediate (OR, 95% CI 0.43, 0.22-0.84 p = 0.013), but not delayed verbal memory impairment (OR, 95% CI 0.65, 0.39-1.06 p = 0.081) when additionally controlling for disease severity, education and levodopa dose. These findings present first evidence that anxiety disorders are associated with verbal memory impairment in PD and have implications for the management and treatment of anxiety in PD.
Publisher: Wiley
Date: 29-12-2012
DOI: 10.1111/J.1741-6612.2010.00487.X
Abstract: To examine the psychometric properties of a novel anxiety rating scale, the Geriatric Anxiety Inventory (GAI) in Parkinson's disease (PD). The predictive validity of the GAI was tested against the presence of any DSM-IV anxiety disorders in 58 PD patients using receiver operating curve analysis. The concurrent validity of this scale was also studied against the state half of the Spielberger State Trait Anxiety Inventory (STAI). The internal consistency and test-retest reliability of the GAI were also examined. The GAI displayed good concurrent validity against the STAI and the DSM-IV. It also showed good internal consistency and test-retest reliability. This study suggested that the GAI is an appropriate scale to use in non-demented PD patients.
Publisher: Elsevier BV
Date: 11-2020
Publisher: Informa UK Limited
Date: 30-05-2022
DOI: 10.1080/07317115.2022.2074814
Abstract: Anxiety is common in Parkinson's disease (PD), negatively impacting daily functioning and quality of life in PD patients and their families. This systematic review evaluates the effectiveness of different psychotherapeutic approaches for reducing anxiety in PD and provides recommendations for clinical practise. Following PRISMA guidelines, 36 studies were included and risk of bias was evaluated. We identified cognitive behavioral therapy (CBT), mindfulness-based therapies, acceptance and commitment therapy, and psychodrama psychotherapies. There is good evidence-base for anxiety reduction using CBT approaches, but with mixed results for mindfulness-based therapies. Other therapeutic approaches were under researched. Most randomized control trials examined anxiety as a secondary measure. There was a paucity of interventions for anxiety subtypes. Secondarily, studies revealed the consistent exclusion of PD patients with cognitive concerns, an importance of care partner involvement, and a growing interest in remote delivery of psychotherapy interventions. Person-centered anxiety interventions tailored for PD patients, including those with cognitive concerns, and trials exploring modalities other than CBT, warrant future investigations. Practitioners should consider PD-specific anxiety symptoms and cognitive concerns when treating anxiety. Key distinctions between therapeutic modalities, therapy settings and delivery methods should guide treatment planning.
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.JAD.2019.05.012
Abstract: Neural mechanisms contributing to an underlying cognitive impairment in Parkinson's disease (PD) are poorly understood. An effective method to probe cognitive processing deficits in PD is the examination of brain activity during emotional processes, particularly in explicit language emotion recognition contexts. The present study utilised cortical source imaging of event related potentials (ERP) from electroencephalography (EEG) to evaluate valence judgements on negative and neutral target words in an automatic affective priming paradigm. Fifty non-demented PD patients, unmedicated for depression or anxiety, completed affective priming tasks during EEG monitoring. Cognitive impairment was measured using the validated Parkinson's Disease-Cognitive Rating Scale (PD-CRS). Results reveal that compared to healthy age-matched controls, PD patients demonstrate a reduced N400 activation during affective priming tasks in bilateral regions of the middle frontal gyrus (MFG), inferior parietal lobule (IPL) and, notably, have a late wave ERP component (LPP) in left MFG, present between 600 and 800 ms, following family-wise error correction (p Although affective priming paradigms are an effective means for various domains of cognition, it is not a focused cognitive behavioural test for cognitive dysfunction. Our study is thus limited to a surrogate measure of cognitive dysfunction via examination of emotional word processing cues. These findings suggest that source imaging methods with ERP paradigms in PD are effective in identifying delayed cognitive processes in PD.
Publisher: Wiley
Date: 29-04-2016
DOI: 10.1002/MDS.26643
Abstract: Prevalence rates of anxiety disorders in Parkinson's disease (PD) vary widely, ranging from 6% up to 55%. The aim of this systematic review was to calculate the average point prevalence of anxiety disorders and clinically relevant anxiety symptoms in PD. Using PubMed, we carried out a systematic literature search for studies reporting Diagnostic and Statistical Manual-defined anxiety disorders or clinically relevant anxiety symptoms assessed by an anxiety rating scale. A total of 49 articles were included and assessed for quality, and 45 articles fulfilled the quality criteria. The average point prevalence of anxiety disorders in PD was 31%, with nonepisodic anxiety being more prevalent than episodic anxiety. Generalized anxiety disorder was the most frequent in 14%, followed by social phobia (13.8%), anxiety not otherwise specified (13.3%), and specific phobia (13.0%). Panic disorder with or without phobia was present in 6.8% of PD patients. Of the patients, 31% fulfilled the criteria for current multiple anxiety disorders. Based on anxiety rating scale cutoff scores, clinically significant anxiety symptoms were present in a weighted average of 25.7%. This systematic review confirms that anxiety, although often unrecognized, is very common and highlights the need for efficient identification of anxiety in PD. © 2016 International Parkinson and Movement Disorder Society.
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.EURONEURO.2018.03.012
Abstract: Dopaminergic medication can induce severe addictive behaviours (e.g., pathological gambling) in susceptible Parkinson's disease (PD) patients. It is still unknown which particular neurocognitive processes become exacerbated or dysfunctional in PD patients with addictive behaviours. We sought to systematically review the relevant literature to identity potential neurocognitive correlates of medication-induced addictive behaviours in PD. We framed our review around neurocognitive processes central to four dominant accounts of substance addiction: 'aberrant learning', 'incentive sensitization', 'impulsivity to compulsivity' and 'impaired response inhibition and salience attribution'. Searches of the PubMed and Scopus databases were completed on June 23, 2017. To be included, studies were required to involve: (a) medicated PD patients, without a history of deep brain stimulation, with and without addictive behaviours (b) a reward-related or decision-making task and (c) statistical comparison of addictive and non-addictive groups' 'on' medication performance on the task(s). Studies were summarised qualitatively with statistically significant (p<.05) group differences and effect sizes (Cohen's d) highlighted. 35 studies were included. Findings showed that the extant literature is highly heterogeneous. The domains of reward and punishment learning, reflection impulsivity and disadvantageous decision-making exemplify this. More homogeneity exists in domains in which (a) neurocognitive dysfunction is not apparent (motor control, cognitive/attentional flexibility and cognitive control) or (b) typical neurocognitive processes appear exacerbated by medication (reward motivation and choice impulsivity). Future large-scale neurocognitive studies are still required to develop our scientific understanding of addictive behaviours in PD and aid their clinical treatment and prediction.
Publisher: Elsevier BV
Date: 03-2017
Publisher: SAGE Publications
Date: 26-07-2017
Abstract: Burden is a negative psychological state induced in caregivers by the demands of providing care to a person with an illness or a disability. Managing caregiver burden in Parkinson disease (PD) is significant because informal caregivers make a substantial contribution to the well-being of persons with PD, incurring financial, social, and personal losses. Failure to recognize and manage caregiver burden may lead to burnout and premature institutionalization of the person with PD. We conducted a comprehensive literature review to identify and summarize factors that may lify burden, including motor and nonmotor symptoms of PD, caregiver psychiatric symptoms, and caregiver coping style. We review instruments designed to s le the construct of burden among caregivers and evaluate interventions that may reduce burden, either by directly targeting caregivers or by treating PD symptoms associated with burden. We aim to provide a concise synopsis of these issues for the clinician or researcher working with this population in order to facilitate recognition of caregiver burden, provide accurate assessment, administer appropriate interventions, and stimulate further research in this area.
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.IJLP.2018.04.003
Abstract: Dopamine replacement therapy can induce impulse control disorders (ICDs) (e.g., hypersexuality) in susceptible Parkinson's disease patients. ICDs can sometimes result in criminal offending. In a number of past Commonwealth cases, it appears offending ICD patients have been considered to be suffering from 'irresistible impulses' such that their decision-making capacity, behavioural control and responsibility were totally compromised. This contrasts with courts' general scepticism of drug-induced 'compulsion' in cases of addiction-related offending. In one case of explicit ICD-related offending, testimony was limited to three experts and not contested by the prosecution. We explored whether the testimony offered in this particular case, and another similar case, reflects the views of the neurological and psychiatric communities at large. Thematic analysis revealed that neurologists, geriatricians and psychiatrists (n = 11): (a) attributed ICDs to a variety of causes (b) considered ICD patients' decision-making capacities and behavioural control to be partially, but not totally, compromised (c) were ided or ambivalent about ICD patients' responsibility and (d) astutely noted the difficulties inherent in assessing complex constructs such as 'control' and 'responsibility'. We suggest that there is sufficient ergence between our findings and expert testimony from past cases for prosecution teams to engage their own experts in future cases of ICD-related offending.
Publisher: Hindawi Limited
Date: 2016
DOI: 10.1155/2016/7109052
Abstract: Background . Motor and nonmotor symptoms negatively influence Parkinson’s disease (PD) patients’ quality of life. Mindfulness interventions have been a recent focus in PD. The present study explores effectiveness of a manualized group mindfulness intervention tailored for PD in improving both motor and neuropsychiatric deficits in PD. Methods . Fourteen PD patients completed an 8-week mindfulness intervention that included 6 sessions. The Five Facet Mindfulness Questionnaire (FFMQ), Geriatric Anxiety Inventory, Hamilton Depression Rating Scale, PD Cognitive Rating Scale, Unified PD Rating Scale, PD Quality of Life Questionnaire, and Outcome Questionnaire (OQ-45) were administered before and after the intervention. Participants also completed the FFMQ-15 at each session. Gains at postassessment and at 6-month follow-up were compared to baseline using paired t -tests and Wilcoxon nonparametric tests. Results . A significant increase in FFMQ-Observe subscale, a reduction in anxiety, depression, and OQ-45 symptom distress, an increase in PDCRS-Subcortical scores, and an improvement in postural instability, gait, and rigidity motor symptoms were observed at postassessment. Gains for the PDCRS were sustained at follow-up. Conclusion . The mindfulness intervention tailored for PD is associated with reduced anxiety and depression and improved cognitive and motor functioning. A randomised controlled trial using a large s le of PD patients is warranted.
Publisher: Elsevier BV
Date: 11-2011
DOI: 10.1016/J.JNS.2011.06.031
Abstract: Depression is a common problem experienced by patients with Parkinson's disease (PD). Identifying depression in PD is difficult and the determinants of depression in PD are complex and debatable. Here we review our recent studies which have (i) examined the validity of current depression rating scales in PD, (ii) introduced a self-reported and validated strategy to identify a lifetime history of depression in PD, and (iii) investigated genetic and non-genetic factors associated with depression in the context of PD. Our research showed PD-specific cut-off values suitable to use for the Hamilton Depression Scales (HAMD and HDI) and the Geriatric Depression Scale (GDS-15) when dichotomising patients with and without a current depression. Using the GDS-15 specific cut-off scores and a number of self-reported questions that screen for a lifetime history of depression, we developed a novel method to dichotomise PD patients according to current depression or a past history of depression. This method was applied in a large-scale study examining the factors associated with depression in PD. We clarified that the severity of PD is positively related to depression. We also showed that a number of other clinical factors including a longer duration of PD, a younger PD onset age, frequent falls, a history of anxiety disorder and memory problems were associated with depression in PD. In addition to these clinical factors, we observed associations between depression, and lower education levels, a history of smoking and a regular use of non-aspirin bases NSAIDs or analgesics. No associations were found between depression in PD and common genetic variations examined across the serotonin and dopamine transporter genes. Our studies provide a focus for future intervention strategies.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-09-2015
Publisher: Wiley
Date: 18-07-2022
DOI: 10.1111/ENE.15481
Abstract: Recent application of the mild cognitive impairment concept to Parkinson disease (PD) has proven valuable in identifying patients at risk of dementia. However, it has sparked controversy regarding the existence of cognitive subtypes. The present review evaluates the current literature pertaining to data‐driven subtypes of cognition in PD. Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) guidelines, systematic literature searches for peer‐reviewed articles on the topic of cognitive subtyping in PD were performed. Twenty‐two relevant articles were identified in the systematic search. Subtype structures showed either a spectrum of severity or specific domains of impairment. Domain‐specific subtypes included amnestic/nonamnestic, memory/executive, and frontal osterior dichotomies, as well as more complex structures with less definitive groupings. Preliminary longitudinal evidence showed some differences in cognitive progression among subtypes. Neuroimaging evidence provided insight into distinct patterns of brain alterations among subtypes. Recurring phenotypes in the literature suggest strong clinical relevance of certain cognitive subtypes in PD. Although the current literature is limited, it raises critical questions about the utility of data‐driven methods in cognitive research. The results encourage further integration of neuroimaging research to define the latent neural mechanisms behind ergent subtypes. Although there is no consensus, there appears to be growing consistency and inherent value in identifying cognitive subtypes in PD.
Publisher: SAGE Publications
Date: 23-05-2022
DOI: 10.1177/08919887221103579
Abstract: Introduction: Parkinson’s disease (PD) is characterized by high-rates of depression with limited evidence-based treatment options to improve mood. Objective: To expand therapeutic options, we evaluated the feasibility and effect of a telehealth mindfulness-based cognitive therapy intervention adapted for PD (MBCT-PD) in a s le of participants with DSM-5 depressive disorders. Methods: Fifteen participants with PD and clinically-significant depression completed 9 sessions of MBCT-PD. Depression, anxiety, and quality of life were evaluated at baseline, endpoint, and 1-month follow-up. Results: Telehealth MBCT-PD was feasible and beneficial. Completion rates exceeded 85% and treatment satisfaction rates were high. Notable improvements were observed for depression, anxiety, and quality of life over the course of the trial. Conclusion: Telehealth MBCT-PD shows promise and warrants further evaluation via randomized clinical trial with more erse participants. Such research holds the potential to expand the range of therapeutic options for depression in PD, thereby setting the stage for personalized care.
Publisher: Elsevier BV
Date: 12-2020
Publisher: American Psychiatric Association Publishing
Date: 10-2021
DOI: 10.1176/APPI.NEUROPSYCH.20110272
Abstract: The mechanisms and neuronal networks associated with anxiety in Parkinson's disease (PD) are incompletely understood. One of the best tools for investigating both component function and neuronal networks associated with psychiatric symptoms is functional MRI (fMRI). Unlike structural scans, functional scans, whether task-based or resting-state, are more likely to be clinically relevant and sensitive to changes related to treatment. The investigators provide a comprehensive review of and present results for imaging studies of anxiety in PD. A systematic review of the literature on fMRI and anxiety in PD was conducted, and the quality of all included studies was simultaneously assessed. Eighteen studies were included: 15 studies assessed anxiety directly, and three evaluated emotional processing. Imaging methodology and behavioral assessments varied across studies, preventing direct comparison of results in most cases. There was a convergence in findings across methods, implicating involvement of the amygdala, caudate, and putamen in association with anxiety in PD. For both task-based activation and resting-state connectivity, dopamine medication status was associated with differences in activation and behavioral function. Although there is little consensus in the current fMRI literature studying anxiety in PD, these results suggest an overlap between structures classically involved in the brain's fear circuit (particularly the amygdala) and the alterations in the nigro-striatal system (e.g., the caudate and putamen and on-off dopamine findings) related to PD and its dopaminergic treatments.
Publisher: Elsevier BV
Date: 09-2015
DOI: 10.1016/J.JAD.2015.05.059
Abstract: Depression is a prominent non-motor symptom in Parkinson's disease (PD). Assessing depression in PD remains a challenge due to the overlap of somatic symptoms between depression and PD. Other neuropsychiatric manifestations associated with PD, such as cognitive decline, also complicate assessment of depression. Therefore it is critical to investigate the validity of depression rating scales for use in PD. This will allow evaluation of observer- and self-report instruments to be administered in neurologically ill geriatric populations such as PD, and identification of appropriate scales to use in cognitively challenged PD patients. The present review includes all studies examining the validity of depression rating scales in PD. It discusses the usefulness of 13 depression rating scales in PD. The clinician-rated and widely used HAMD-17 and the self-report GDS scales are recommended for screening and measuring severity of depression in PD. The GDS-15 may be a preferred choice due to its brevity and ease of use design for older adults. Other valid and reliable instruments to use in PD include self-rated scales, such as the HADS-D, HDI, and the BDI, and the observer-report, MADRS. The CSDD displayed satisfactory validity and reliability for identification of PD patients with and without dementia. The PHQ-2, PHQ-10, SDS, CES-D, UPDRS-Depression item, IDS-SR, and IDS-C each showed some evidence of validity or reliability, however further research on the psychometric properties of these scales when used in a PD population are required.
Publisher: Informa UK Limited
Date: 13-11-2020
DOI: 10.1080/07317115.2018.1539424
Abstract: Sleep disturbances are a debilitating non-motor symptom in Parkinson's disease (PD) and negatively impact patients, their carers and the patient-carer dyadic relationship. This review outlines the phenomenology, as well as factors associated with and treatment of sleep disturbances, in PD patients and their informal carers. The following terms were used in four databases: Parkinson*, sleep* disturbance*, carer*, dyad*, intervention* and treatment*. Across the articles reviewed, the frequency of reported sleep disturbances in PD ranged between 60% and 98%. Common sleep problems in PD included insomnia, excessive day time sleepiness, REM sleep behavior disorder (RBD), sleep apnoea, periodic limb movements and sleep attacks. Within dyads, significant correlations were found with depression, anxiety and carer burden relating to night time care in particular. Despite the negative impact of sleep disturbance in PD, the evidence-base for treatment remains limited. While addressing in idual factors associated with sleep disturbances, it is also important to emphasize the needs arising from the patient-carer dyadic relationship. While a number of non-pharmacological interventions were suggested in the literature, further well-controlled trials are still required. Multiple approaches are required to reduce sleep disturbances and associated burden in PD.
Publisher: SAGE Publications
Date: 13-05-2021
Abstract: Subthalamic deep brain stimulation for Parkinson's disease may not ameliorate burden among caregivers. An 8-session, manualized program of cognitive-behavioral therapy (CBT) was delivered to a pilot s le of 10 caregivers (6 females, mean age: 60, age range: 34-79). Primary outcome measures were caregiver burden (Zarit Burden Interview) and caregiver quality of life (Parkinson’s Disease Questionnaire–Carer). Secondary outcome measures comprised ratings of depression and anxiety in the caregiver, in addition to relationship quality. Caregiver burden ( t = 2.91 P = .017) and caregiver anxiety ( t = 2.82 P = .020) symptoms were significantly reduced at completion of the program, and these benefits were maintained 3 months later. Caregiver quality of life had significantly improved by the end of the intervention ( t = 3.02 P = .015), but this effect was not sustained after 3 months. The longitudinal influence of participation in the program on caregiver burden was confirmed in a linear, mixed-effects model, χ 2 (3) = 15.1, P = .0017). The intervention was well received by participants, and qualitative feedback was obtained. These results indicate that caregiver burden is modifiable in this cohort with a short course of CBT, that benefits are maintained after termination of the program, and that psychological treatment is acceptable to participants. Larger, controlled trials are justified.
Publisher: SAGE Publications
Date: 13-08-2021
Abstract: This study examines factors related to sleep disturbances, and the dyadic sleep relationship, in a convenience s le of 29 persons with Parkinson disease (PD) and spouse carer dyads living in regional Queensland. Carers completed questionnaires on sleep, depression, anxiety, carer burden, and well-being. Regarding carers, 66% reported sleep disturbances related to nocturnally care demands. Less than half of informal carers with a disturbed sleep had informed a health professional of this problem. Medication was the most commonly advised sleep intervention (44%). Sleep disturbances in informal carers correlated with increasing carer burden, depression scores, anxiety scores, poor quality of life, negative cognitions related to their sleep disturbance, and poor sleep hygiene. Regarding patient-carer dyads, 59% reported both the in iduals having problematic sleep disturbances. Patient sleep disturbance correlated with informal carer increase in depression and anxiety scores, and poor carer burden. Informal carer’s sleep disturbance correlated with patient anxiety scores and severity of complications from PD therapy. Evidence-based sleep interventions addressing such dyads in rural areas warrant future study.
Publisher: ARC Publishing
Date: 13-02-2018
Publisher: Cambridge University Press (CUP)
Date: 11-05-2018
DOI: 10.1017/S1041610218000340
Abstract: Over two-thirds of Parkinson's disease (PD) patients experience comorbid neuropsychiatric symptoms, which adversely impact their quality of life and often require intervention. There is a preference for non-pharmacological, psychological approaches in addressing these symptoms. Given mobility limitations, travel burden, and cost, accessibility to psychological treatment can be problematic in this population. There has been a recent shift toward delivering care via telehealth in PD. Accordingly, this review aimed to examine remotely delivered psychological interventions for PD patients. Most of the telehealth studies for PD involved Cognitive Behavioral Therapy (CBT) based anxiety and depression telephone interventions with relatively short (one month) follow-up periods. Although a preliminary work indicates efficacy, future studies should demonstrate the non-inferiority of these telehealth programs compared to face-to-face delivery, and examine the long-term outcomes of remotely delivered therapy. Video-conferencing (VC) appears to be a promising modality to overcome noted limitations of telephone delivery, and has demonstrated efficacy for PD speech programs. Further research should be conducted evaluating telehealth VC modalities for delivery of psychotherapy including CBT, as well as mindfulness-based therapy and acceptance and commitment therapy for remote treatment of depression and anxiety in PD.
Publisher: Wiley
Date: 13-04-2010
DOI: 10.1002/MDS.22833
Abstract: Anxiety disorders are common in Parkinson's disease (PD) patients, yet are poorly studied. We examined the prevalence of anxiety disorders in PD, investigated the association between anxiety, and presentation and progression of PD, and studied for the first time the contribution of putative risk factors for anxiety in PD. A case-series of 79 PD patients recruited from neurology out-patient clinics was examined for anxiety disorders using the DSM-IV criteria. The Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr Staging of PD were employed to understand the relationship between anxiety disorders, and the clinical presentation and severity of PD. A validated survey assessed putative risk factors for anxiety in PD. Twenty-five percent of PD patients were diagnosed with anxiety. Panic disorder, generalised anxiety disorder and social phobia were prevalent anxiety disorders. Comorbid depression with anxiety was observed (14%). The severity but not the duration of PD was positively related to anxiety. PD patients with postural instability and gait dysfunction symptom clustering were more likely to experience anxiety than tremor-dominant patients. While levodopa dosage had no relationship to anxiety, experience of dyskinesias or on/off fluctuations increased the risk. Lateralisation of PD had no association with anxiety. Anxiety disorders decreased with age and young onset PD patients were more likely to experience anxiety than the late onset subjects. Anxiety adds to the complexity of PD, lowering patients' quality of life. Future research can be directed to identify reactive and organic nature of anxiety in PD.
Publisher: American Psychological Association (APA)
Date: 09-2017
DOI: 10.1037/NEU0000333
Abstract: Emotional and cognitive disturbances are common complications in Parkinson's disease (PD). N400 is an event related potential (ERP) strongly linked to lexical-semantic processing and has demonstrated alterations in litude and latency when PD patients performed semantic priming tasks. The present study investigated the role of N400 in an automatic affective priming paradigm in PD. Other ERP components relevant to emotion processing were also examined. Twenty-two PD patients and 17 healthy adults performed an automatic affective priming task while ERPs were recorded using 128 channels. Prime-target word pairs of negative or neutral valence were presented at a stimulus onset asynchrony of 250 ms. Participants were asked to evaluate the valence of the target word by button press. A larger N400 litude for incongruent compared with congruent neutral targets was observed at right central and parietal regions and did not differ between PD and controls. PD and controls also displayed larger P300 and late positive potential (LPP) litudes for negative compared with neutral targets at central parietal and right frontal regions. In contrast, whereas controls showed a larger slow negative wave (SNW) for negative targets compared with neutral targets at left frontal and left central regions, PD group demonstrated a significant reduction in SNW litude difference at the left central region. N400 is intact in PD when processing evaluative judgments of emotional words. P300 and LPP were also intact in PD. The altered left central SNW in PD suggests an ERP marker for emotional dysfunction in PD. (PsycINFO Database Record
Publisher: Hindawi Limited
Date: 24-07-2019
DOI: 10.1155/2019/2478980
Abstract: Background . The optimal prescription of cueing for the treatment of freezing of gait (FoG) in Parkinson’s disease (PD) is currently a difficult problem for clinicians due to the heterogeneity of cueing modalities, devices, and the limited comparative trial evidence. There has been a rise in the development of motion-sensitive, wearable cueing devices for the treatment of FoG in PD. These devices generally produce cues after signature gait or electroencephalographic antecedents of FoG episodes are detected (phasic cues). It is not known whether these devices offer benefit over simple (tonic) cueing devices. Methods . We assembled 20 participants with PD and FoG and familiarized them with a belt-worn, laser-light cueing device (Agilitas™). The device was designed with 2 cueing modalities—gait-dependent or “phasic” cueing and gait-independent or “tonic” cueing. Participants used the device sequentially in the off, phasic, or tonic modes, across 2 tasks—a 2-minute walk and an obstacle course. Results . A significant improvement in mean distance walked during the 2-minute walk test was observed for the tonic mode (127.3 m) compared with the off (111.4 m) and phasic (116.1 m) conditions. In contrast, there was a nonsignificant trend toward improvement in FoG frequency, duration, and course time when the device was switched from off to tonic and to phasic modes for the obstacle course. Conclusions . Parkinson’s disease patients with FoG demonstrated an improvement in distance walked during the two-minute walk test when a cueing device was switched from off to phasic and to tonic modes of operation. However, this benefit was lost when patients negotiated an obstacle course.
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.JAD.2018.11.094
Abstract: Depression is a predominant non-motor symptom of Parkinson's disease (PD), which is often under recognised and undertreated. To improve identification of depression in PD it is imperative to examine objective brain-related markers. The present study addresses this gap by using electroencephalography (EEG) to evaluate the processing of emotionally valanced words in PD. Fifty non-demented PD patients, unmedicated for depression or anxiety, completed an affective priming task while EEG was simultaneously recorded. Prime and target word pairs of negative or neutral valence were presented at a short 250 ms stimulus onset asynchrony. Participants were asked to evaluate the valence of the target word by button press. Depression was measured using an established rating scale. Repeated measures analysis of covariance and correlational analyses were performed to examine whether event-related potentials (ERP) varied as a function of depression scores. Key ERP findings reveal reduced responses in parietal midline P300, N400 and Late Positive Potential (LPP) difference waves between congruent and incongruent neutral targets in patients with higher depression scores. Comparisons of ERPs were limited by insufficient classification of participants with and without clinical depression. A majority of PD patients who had high depression scores were excluded from the analysis as they were receiving antidepressant and/or anxiolytic medications which could interfere with ERP sensitivity. The present study suggests that the Pz-P300, N400 and LPP are ERP markers relates to emotional dysfunction in PD. These findings thus advance current knowledge regarding the neurophysiological markers of a common neuropsychiatric deficit in PD.
Publisher: Wiley
Date: 2019
Publisher: Wiley
Date: 2007
DOI: 10.1002/MDS.21309
Abstract: Studies investigating the assessment of depression in Parkinson's disease (PD) are limited. We examined the concurrent validity and the internal consistency of the Hamilton Depression Inventory (HDI) and compared it to the Hamilton and Geriatric Depression Scales. PD patients (n = 79) were recruited from neurology clinics. Diagnosis of depressive disorder was made according to DSM-IV criteria. Receiver operating characteristic curves were used to calculate sensitivity, specificity, and positive and negative predictive values. The HDI exhibited an optimal cutoff for discriminating between depressed and nondepressed PD patients of 13.5/14.0 and is a valid instrument to use in the setting of PD.
Publisher: Wiley
Date: 02-06-2021
DOI: 10.1002/JNR.24863
Abstract: The present review asks whether magnetic resonance imaging (MRI) studies are able to define neural correlates of episodic memory within the hippoc us in Parkinson's disease (PD). Systematic searches were performed in PubMed, Web of Science, Medline, CINAHL, and EMBASE using search terms related to structural and functional MRI (fMRI), the hippoc us, episodic memory, and PD. Risk of bias was assessed for each study using the Newtown–Ottawa Scale. Thirty‐nine studies met inclusion criteria eight fMRI, seven diffusion MRI (dMRI), and 24 structural MRI (14 exploring whole hippoc us and 10 exploring hippoc al subfields). Critical analysis of the literature revealed mixed evidence from functional and dMRI, but stronger evidence from sMRI of the hippoc us as a biomarker for episodic memory impairment in PD. Hippoc al subfield studies most often implicated CA1, CA3/4, and subiculum volume in episodic memory and cognitive decline in PD. Despite differences in imaging methodology, study design, and s le characteristics, MRI studies have helped elucidate an important neural correlate of episodic memory impairment in PD with both clinical and theoretical implications. Natural progression of this work encourages future research on hippoc al subfield function as a potential biomarker of, or therapeutic target for, episodic memory dysfunction in PD.
Publisher: Springer Science and Business Media LLC
Date: 11-12-2019
DOI: 10.1038/S41531-019-0102-8
Abstract: Anxiety is a severe problem for at least one-third of people living with Parkinson’s disease (PD). Anxiety appears to have a greater adverse impact on quality of life than motor impairment. Despite its high prevalence and impact on daily life, anxiety is often undiagnosed and untreated. To better address anxiety in PD, future research must improve knowledge about the mechanism of anxiety in PD and address the lack of empirical evidence from clinical trials. In response to these challenges, the Parkinson’s Foundation sponsored an expert meeting on anxiety on June 13th and 14th 2018. This paper summarizes the findings from that meeting informed by a review of the existing literature and discussions among patients, caregivers, and an international, clinician-scientist, expert panel working group. The goal is to provide recommendations to improve our understanding and treatment of anxiety in PD.
Publisher: Elsevier BV
Date: 07-2011
DOI: 10.1016/J.JAD.2011.01.021
Abstract: Depression is common in Parkinson's disease (PD) and contributes significantly to a reduced quality of life in PD patients. The determinants of depression in PD are complex and poorly understood. We investigated the factors associated with depression in PD. PD patients were recruited from Neurology clinics. A validated method was used to screen for a lifetime history of depression. 'Depressed' patients were identified by a score of >6 in the Geriatric Depression Scale (GDS-15) or by having had prescribed treatment for depression. 'Never depressed' patients were recognised by a score of <5 in the GDS-15 with no signs of a history of depression. A newly developed and validated questionnaire was used to collect other information. Depression was identified in 66% of the 639 PD patients who met the inclusion criteria. Depression was associated with an increased severity of illness as evidenced by higher Unified PD Rating Scale scores and a higher Hoehn and Yahr stage. Other clinical factors associated with disease severity were also more frequently observed in depressed patients. Similar to findings in non-PD s les, depressed PD patients were more likely to have a lower education level, a history of smoking and to regularly use non-aspirin based NSAIDs or analgesics. Comorbidities such as anxiety, memory problems, hallucinations, sleep disturbances and postural hypotension were more common in depressed PD patients. To avoid patient exhaustion of over-surveying, some factors within the psychological domain were not examined. Our results provide a focus for future intervention strategies.
Publisher: Cambridge University Press (CUP)
Date: 07-04-2016
DOI: 10.1017/S1041610216000569
Abstract: Emotional distress associated with Parkinson's disease (PD) increases disease burden and decreases functioning. The literature supports the benefits of psychological interventions for amelioration of emotional distress in persons with PD. The objective of this study is to apply the Contextual Adult Lifespan Theory for Adapting Psychotherapy (CALTAP) to enhancing psychological treatment for persons with PD. This paper uses case ex les to demonstrate the usefulness of the CALTAP model in helping patients and clinicians separate disease symptoms from the aging process. The ex les also illustrate how working in this way can be beneficial in reducing emotional distress in persons with PD. CALTAP contributes to helping persons with PD and persons treating them understand the effects of the disease, separate disease effects from aging processes, and think through the influences of social context, cohort effects, and cultural differences. The CALTAP model can guide adaptations to psychological interventions for emotional distress in PD and potentially improve their effects.
Publisher: Wiley
Date: 09-03-2011
DOI: 10.1002/ANA.22321
Publisher: Cambridge University Press (CUP)
Date: 20-11-2018
DOI: 10.1017/S1041610218001229
Abstract: It is well established that there is a high prescribing rate of psychotropic agents in residential aged care (RAC). The appropriateness of these medications has become controversial, given the limited data on efficacy and growing evidence of associated adverse outcomes. To assess psychotropic prescribing in RAC including identification of potentially inappropriate prescriptions (PIPs) and common psychological and behavioral symptoms indicated for prescribing. These were viewed in context of dementia and different RAC facilities. Electronic care plans of 779 RAC residents across 12 facilities were examined to elucidate psychotropic prescribing rates, PIPs, and indications for use. One in two residents (48.1%) were prescribed a psychotropic drug. The primary reasons for prescribing were depression (61.5%), anxiety (26.7%), sleep problems (25.4%), agitation (13.7%), psychosis (11.0%), and other behaviors (7.2%). Residents with dementia (56.6%) were more likely to be prescribed a drug for agitation and psychosis, and had a significantly increased prescription rate for antidepressants (OR = 1.50, 95% CI = 1.08–2.08, p = 0.01) and antipsychotics (OR = 1.88, 95% CI = 1.23–2.88, p & 0.01). Conversely, residents with dementia were less likely to receive medication to combat sleeping difficulties, with significantly lower benzodiazepine prescribing (OR = 0.63, 95% CI = 0.44–0.91, p = 0.01). Over half of all psychotropic prescriptions (54.0%) were potentially inappropriate based on the Beers Criteria. There was high variability of prescribing rates between homes. There is a high prescribing rate of potentially inappropriate medications. Residents with dementia are more likely to receive medication for agitation and psychosis, and are less likely to receive medication to combat sleeping difficulties.
Publisher: Wiley
Date: 07-12-2011
DOI: 10.1111/J.1360-0443.2010.03218.X
Abstract: To describe the prevalence, phenomenology and correlates of 'impulse control disorders' (ICDs) in patients with Parkinson's disease (PD) treated with dopamine replacement therapy (DRT) to assess the strength of the evidence that DRT plays a contributory causal role in these disorders and to highlight the implications of these disorders for research in the addiction field. PubMed and Web of Science databases were searched and the reference lists of papers examined. The prevalence of ICDs in Parkinson's patients using DRT varied between 3.5% and 13.6%, depending on the severity and range of disorders assessed. PD patients with ICDs were: generally younger had an earlier onset of PD had a personal or family history of substance abuse or an ICD and were more likely to be treated with dopamine receptor agonists (DA agonists) than levodopa (l-dopa). There is reasonable evidence that dopaminergic medications play a causal role in ICDs in that they occur at a higher rate in an otherwise low-risk population of adults, begin after initiation of DA agonist therapy and cease upon its discontinuation. A causal relationship is biologically plausible, but the role of other factors (such as concurrent mood disorders) remain to be clarified by better-controlled studies. Impulse control disorders among patients with Parkinson's disease receiving dopamine replacement therapy may provide a unique opportunity for addiction researchers to study the neurobiology of impulsive forms of behaviour (such as problem gambling) that appear to be caused, in part, by the therapeutic use of dopamine receptor agonists.
Publisher: Cambridge University Press (CUP)
Date: 07-02-2022
DOI: 10.1017/S1041610221002866
Abstract: Informal carers play an essential role in the care of in iduals with Parkinson’s disease (PD). This role, however, is often fraught with difficulties, including emotional, physical, and financial. Coping styles and relationship quality have been hypothesized to influence the impact of stressors. The aim of this study is to examine the relationship between carers’ coping style, relationship quality, and carer burden. Cross-sectional. Thirty-nine PD patient carer dyads were included in the study. Participants completed self-rated questionnaires including the Dyadic Adjustment Scale, Zarit Burden Interview, and Brief Coping Orientation to Problems Experienced Inventory. Correlational analyses found significant and positive correlation between carer burden and all three coping styles (problem-focused, emotion-focused, and dysfunctional). There was also a moderate association between carers’ perceived relationship quality and satisfaction and carer burden. Regression analyses found that carer’s gender, severity of PD, relationship quality, emotion-focused, and dysfunctional coping styles did not predict carer burden. Conversely, problem-focused coping style predicted carer burden. The results highlight that there is no perfect way to react and care for a loved one and serves as important information for practitioners who design and implement interventions.
Publisher: Cambridge University Press (CUP)
Date: 05-12-2017
DOI: 10.1017/S1355617716000953
Abstract: Objectives: Cognitive-linguistic impairments in Parkinson’s disease (PD) have been well documented however, few studies have explored the neurophysiological underpinnings of semantic deficits in PD. This study investigated semantic function in PD using event-related potentials. Methods: Eighteen people with PD and 18 healthy controls performed a semantic judgement task on written word pairs that were either congruent or incongruent. Results: The mean litude of the N400 for new incongruent word pairs was similar for both groups, however the onset latency was delayed in the PD group. Further analysis of the data revealed that both groups demonstrated attenuation of the N400 for repeated incongruent trials, as well as attenuation of the P600 component for repeated congruent trials. Conclusions: The presence of N400 congruity and N400 repetition effects in the PD group suggests that semantic processing is generally intact, but with a slower time course as evidenced by the delayed N400. Additional research will be required to determine whether N400 and P600 repetition effects are sensitive to further cognitive decline in PD. ( JINS , 2017, 23 , 78–89)
Publisher: Elsevier BV
Date: 2020
DOI: 10.1016/J.NEUBIOREV.2019.10.021
Abstract: Growing evidence suggests that patients with essential tremor (ET) show impairment in psychosocial functions and subsequently increasing vulnerability to anxiety. Here we review evidence supporting a positive relationship between self-reported motor disability and psychological symptoms in ET and critically analyze evidence suggesting how psychosocial factors enhance tremor disability in ET. Theories related to motor competency, behavioral conditioning, and social anxiety have been proposed to relate self-concepts to self-reported tremor disability. We review these theories and then propose a new model in an effort to focus on the self-concepts among ET patients as a factor in tremor disability. Patients with ET exhibited cognitive abnormalities, depression, anxiety, and a higher prevalence of avoidant personality types. Although anxiety, depression and personality types may influence tremor disability in ET, self-concepts may better explain perceived tremor disability in social situations. We conclude by discussing a proposed biopsychosocial model and suggesting future research on ET specific assessment tools and intervention methods.
Publisher: Mary Ann Liebert Inc
Date: 08-2019
Publisher: Wiley
Date: 06-04-2015
DOI: 10.1002/MDC3.12157
Abstract: Background: Anxiety disorders are common in Parkinson's disease ( PD ) and are undertreated. The current study investigates demographic and PD‐ specific factors associated with Diagnostic and Statistical Manual ( DSM ‐ IV ) anxiety disorders and subsyndromal anxiety in PD . It also examines the use of pharmacological and nonpharmacological treatments for anxiety in PD . Methods: Ninety nondemented PD patients completed a semistructured interview. Logistic regression models were constructed examining associations between several demographic, disease‐specific, and treatment factors, as well as both current syndromal, DSM ‐ IV anxiety disorders, and subsyndromal anxiety. Results: Associations were found between current DSM ‐ IV anxiety disorder, as well as female gender, younger age, more severe stages of PD , and poor activities of daily living. Subsyndromal anxiety was related to a younger onset age of PD . Relationships were also found between both anxiety groups and more complications of PD therapy, as well as higher depression scores. There were no associations between anxiety and levodopa equivalent daily dosage, motor disability, and cognition. In our s le, 57% of patients with current DSM ‐ IV anxiety disorders or subsyndromal anxiety were not currently treated with pharmacotherapy. Of those who currently received such treatment, 83% still experienced current anxiety disorders. Results suggest that anxiety is poorly recognized and treated in PD . Conclusions: Clinical trials investigating the efficacy of pharmacotherapy, tailored psychotherapy, and combination therapy primarily focusing on anxiety are much needed, with the aim of establishing novel targeted treatment protocols for the management of subtypes of anxiety disorders in PD .
Publisher: Informa UK Limited
Date: 09-2023
Publisher: Oxford University Press (OUP)
Date: 10-12-2021
Abstract: recognition of the multifactorial causes of delirium represents a clinical challenge. to develop and show proof of principle of a diagnostic support tool (DST) for identification of causes of delirium. stage 1—development of the aetiology in delirium-diagnostic support tool (AiD-DST) stage 2—validation of the AiD-DST against reference standard diagnosis, based on clinical assessment from two independent consultant geriatricians. a series of eight steps AiD-DST were formulated by an expert group to identify possible causes of delirium. Forty inpatients admitted to a general medical unit with a consultant physician/geriatrician diagnosis of delirium were recruited, consented and reviewed against the AiD-DST. Mean age was 85.1 (standard deviation 7.9) years and 26 (65%) of participants were female. Participants had multiple chronic co-morbidities [median Charlson Comorbidity Index 7 interquartile range (IQR 6–9)] and median number of medications was 8 (IQR 6–11.75). Median number of causes of delirium detected on AiD-DST was 3 (IQR 3–4) versus 5 (IQR 3–6) using the reference standard diagnosis, with sensitivity of 88.8% (95% confidence interval, 81.6–93.9%) and specificity of 71.8% (63–79.5%). the aetiology in delirium DST shows promise in the identification of cause(s) in delirium.
Publisher: Informa UK Limited
Date: 06-07-2023
Publisher: Springer Science and Business Media LLC
Date: 16-07-2022
DOI: 10.1007/S11682-022-00698-7
Abstract: People living with Parkinson’s disease (PD) with poor verbal fluency have an increased risk of developing dementia. This study examines the neural mechanisms underpinning semantic fluency deficits in patients with PD with mild cognitive impairment (PD-MCI) compared to those without MCI (PD-NC) and control participants without PD (non-PD). Thirty-seven (37) participants with PD completed a cognitive assessment battery to identify MCI (13 PD-MCI). Twenty sex- and age-matched non-PD patients also participated. Participants were scanned (3T Siemens PRISMA) while performing semantic fluency, semantic switching, and automatic speech tasks. The number of responses and fMRI data for semantic generation and semantic switching were analyzed. Participants also completed a series of verbal fluency tests outside the scanner, including letter fluency. Participants with PD-MCI performed significantly worse than PD-NC and non-PD participants during semantic fluency and semantic switching tasks. PD-MCI patients showed greater activity in the right angular gyrus than PD-NC and non-PD patients during semantic switching. Increased right angular activity correlated with worse verbal fluency performance outside the scanner. Our study showed that the PD-MCI group performed worse on semantic fluency than either the PD-NC or non-PD groups. Increased right angular gyrus activity in participants with PD-MCI during semantic switching suggests early compensatory mechanisms, predicting the risk of future dementia in PD.
Publisher: Cambridge University Press (CUP)
Date: 23-09-2019
DOI: 10.1017/S1041610219001212
Abstract: Sleep disturbances negatively impact the quality of life of patients with Parkinson’s disease (PD). While persons living in regional areas are at higher risk of PD, PD is poorly managed in regional communities. This study examined factors associated with sleep problems in PD in a regional context. A mixed-methods cross-sectional design was used. Patients with PD were recruited from the Queensland Parkinson’s Project database. Those who agreed to participate were sent a questionnaire assessing aspects of sleep, depression, anxiety, quality of life, and PD severity. Qualitative information was also gathered. Correlations between variables were examined thematic analyses were performed for qualitative data. All participants (n = 49) reported sleep disturbances, with 73% (n = 36) reporting sleep disturbance to be problematic. Global sleep dysfunction positively correlated with daytime napping (r = .34, p = .01), watching the clock when unable to sleep (r = .38, p = .01), staying in bed when unable to sleep (r = .43, p = .01), and going to bed hungry (r = .31, p = .03) and negatively correlated with daytime exercise (r = -.32, p = .02). Positive correlations were observed between global sleep dysfunction and depression (r = .55, p = .01), anxiety (r = .31, p = .04), and dysfunctional sleep beliefs (r = .39, p = .01). There is a clear need for identifying factors related to sleep disturbances in PD for effective management.
Publisher: Wiley
Date: 06-2023
DOI: 10.1002/GPS.5955
Publisher: Informa UK Limited
Date: 06-01-2020
Publisher: SAGE Publications
Date: 16-12-2012
Abstract: This article explores the use of probabilistic classification, namely finite mixture modelling, for identification of complex disease phenotypes, given cross-sectional data. In particular, if focuses on posterior probabilities of subgroup membership, a standard output of finite mixture modelling, and how the quantification of uncertainty in these probabilities can lead to more detailed analyses. Using a Bayesian approach, we describe two practical uses of this uncertainty: (i) as a means of describing a person's membership to a single or multiple latent subgroups and (ii) as a means of describing identified subgroups by patient-centred covariates not included in model estimation. These proposed uses are demonstrated on a case study in Parkinson's disease (PD), where latent subgroups are identified using multiple symptoms from the Unified Parkinson's Disease Rating Scale (UPDRS).
Publisher: Oxford University Press
Date: 25-02-2019
DOI: 10.1093/ACREFORE/9780190236557.013.413
Abstract: Progressive neurological disorders are incurable disorders with gradual deterioration and impacting patients for life. Two common progressive neurological disorders found in late life are Parkinson’s disease (PD) and motor neuron disease (MND). Psychological complications such as depression and anxiety are prevalent in people living with PD and MND, yet they are underdiagnosed and poorly treated. PD is classified a Movement Disorder and predominantly characterized by motor symptoms such as tremor, bradykinesia, gait problems and postural instability however, neuropsychiatric complications such as anxiety and depression are common and contribute poorly to quality of life, even more so than motor disability. The average prevalence of depression in PD suggest 35% and anxiety in PD reports 31%. Depression and anxiety often coexist. Symptoms of depression and anxiety overlap with symptoms of PD, making it difficult to recognize. In PD, daily fluctuations in anxiety and mood disturbances are observed with clear synchronized relationships to wearing off of PD medication in some in iduals. Such unique characteristics must be addressed when treating PD depression and anxiety. There is an increase in the evidence base for psychotherapeutic approaches such as cognitive behavior therapy to treat depression and anxiety in PD. Motor neuron disease (MND) is classified a neuromuscular disease and is characterized by progressive degeneration of upper and lower motor neurons is the primary characteristic of MND. The most common form of MND is Amyotrophic lateral sclerosis (ALS) and the terms ALS and MND are simultaneously used in the literature. Given the short life expectancy (average 4 years), rapid deterioration, paralysis, nonmotor dysfunctions, and resulting incapacity, psychological factors clearly play a major role in MND. Depression and suicide are common psychological concerns in persons with MND. While there is an ALS-specific instrument to assess depression, evaluation of anxiety is poorly studied although emerging studies suggesting that anxiety is highly prevalent in MND. Unfortunately, there is no substantial evidence-base for the treatment of anxiety and depression in MND. Caregivers play a major role in the management of progressive neurological diseases. Therefore, evaluating caregiver burden and caregiver psychological health are essential to improve quality of care provided to the patient, as well as to improve quality of life for carers. In progressive neurological diseases, caregiving is often provided by family members and spouses, with professional care at advanced disease. Psychological interventions for PD carers addressing unique characteristics of PD and care needs is required. Heterogeneous clinical features, rapid functional decline, and short trajectory of MND suggest a multidisciplinary framework of carer services including psychological interventions to mitigate MND. A Supportive Care Needs Framework has been recently proposed encompassing practical, informational, social, psychological, physical, emotional, and spiritual needs of both MND patients and carers.
Publisher: Springer Science and Business Media LLC
Date: 02-2019
DOI: 10.1007/S11682-019-00041-7
Abstract: Changes in reward circuitry have been studied extensively in substance and behavioural addictions. However, comparatively little is known about the neurobiology underlying impulse control disorders (ICDs) in Parkinson's disease, which show roughly similar risk factors and behavioural presentations to both stimulant and behavioural addictions. ICDs occur in a subset of susceptible patients with Parkinson's disease (PD) following intake of dopamine replacement therapy (DRT). These behavioural disorders often have debilitating effects on a patient's quality of life and increase caregiver burden. This comprehensive review examined findings of 40 neuroimaging studies of ICDs in PD to determine (a) whether there are putative neurobiological commonalities between traditional substance and behavioural addictions and DRT-induced ICD in PD and (b) opportunities for future studies to advance current neurobiological understanding of the phenomenon. Results revealed that strikingly similar (a) deficits in dopaminergic receptor expression, (b) connectivity changes in corticostriatal circuitry and (c) neural responses to cue exposure are observed in both ICDs in PD and addictive disorders. These findings point to the value of adopting a transdiagnostic approach when studying addicted populations and pave the way for demystifying this peculiar, often-devastating phenomenon in PD that has so far proven extremely difficult to treat and predict with any precision.
Publisher: SAGE Publications
Date: 02-08-2018
Abstract: Depression and anxiety are prevalent in Parkinson disease (PD) yet underrecognized in clinical practice. Caregiver reports are frequently utilized to aid in the assessment of neuropsychiatric symptoms but little is known about caregivers’ ability to recognize them in patients with PD. This study sought to examine the accuracy of caregiver reports. Eighty patient–caregiver dyads were involved. Accuracy of caregiver recognition was assessed by examining the level of agreement between caregiver ratings on the Neuropsychiatric Inventory and patients’ diagnosis of depression and anxiety on the Mini-International Neuropsychiatric Interview (MINI)-Plus. The agreement between caregiver report and MINI-Plus diagnosis was low for both depression (6.3%) and anxiety (17.5%). The presence of depression was overreported, while anxiety was largely underestimated by caregivers. Caregiver distress significantly predicted inaccurate caregiver identification of depression ( R 2 = .51, P .001) and anxiety ( R 2 = .08, P .05). Results indicate that caregivers may be poor at recognizing depression and anxiety in patients with PD. Utilization of caregiver report should take into account potential biases that affect caregiver judgment.
Publisher: Wiley
Date: 05-09-2019
DOI: 10.1111/OPN.12268
Abstract: The ageing population is increasing, and negative attitudes towards older people are all too common and largely overlooked. However, little research has examined how ageist, prejudice, and discrimination, that often occur in healthcare settings, impact the community's perceptions of entering Residential Aged Care (RAC) in the future. In particular, studies have not investigated how contact with RAC influences in iduals' attitudes towards RAC facilities, residents and staff. This study is the first to examine in iduals' resistance towards living in RAC using the contact hypothesis, a theory of prejudice reduction. To explore how positive or negative contact with RAC residents and staff impacts in iduals' behavioural intentions towards entering RAC in the future. To examine whether perceptions of trust, independence and RAC staff mediate the relationship between contact and behavioural intentions towards entering RAC in the future. A cross-sectional survey design. Data were collected via online surveys using contact (positive or negative), trust, independence, perceptions of RAC staff and resistance levels (mild refusal or extreme refusal) measures. Participants (n = 373) from Australia and USA were recruited using social media, word of mouth and Amazons Mechanical Turk. In iduals who experienced negative contact with RAC residents and staff were more likely to report intense resistance to RAC, "I would rather die than enter RAC". Whereas, positive contact with RAC residents and staff was associated with reductions in the adverse appraisal of RAC staff a diminished perception that in iduals lost their independence, and an increased trust in RAC residents, facilities and staff. Participants from USA reported greater levels of resistance towards RAC in comparison with participants from Australia. This study demonstrates how interactions with RAC residents, facilities and staff are critical in shaping attitudes towards RAC. It is recommended that the public are exposed to opportunities where they can experience positive contact with RAC. RAC facilities can promote interaction between the public and RAC residents through encouraging participation in community partnership programs/intergenerational programs.
Publisher: Wiley
Date: 07-2014
DOI: 10.1002/MDS.25937
Abstract: Anxiety is common in Parkinson's disease (PD), and contributes to increased disability and poorer quality of life. In spite of its significant impact, the symptomatology, chronology, and neurobiology of anxiety in PD are all poorly understood, and this hinders accurate diagnosis and development of effective treatment strategies. This review investigates and updates literature related to the clinical spectrum of anxiety in PD. The reported prevalence of anxiety in PD varies considerably, with emerging interest in the frequency of the DSM-IV residual category of "Anxiety disorder, not otherwise specified" (Anxiety disorder NOS), which is observed in up to 25% of PD patients. By design, there are no standardized diagnostic criteria for Anxiety disorder NOS, because this is the category applied to in iduals who do not meet diagnostic criteria for any other current anxiety disorder. Anxiety rating scales incompletely capture anxiety symptoms that relate specifically to PD symptoms and the complications arising from PD therapy. Consequently, these scales have been deemed inappropriate for use in PD, and there remains a need for the development of a new PD-specific anxiety scale. Research establishing accurate symptom profiles of anxiety in PD is sparse, although characterizing such symptomatology would likely improve clinical diagnosis and facilitate targeted treatment strategies. Research into the neurobiological and psychological underpinnings of anxiety in PD remains inconclusive. Anxiety can precede the onset of PD motor symptoms or can develop after a diagnosis of PD. Further investigations focused on the chronology of anxiety and its relationship to PD diagnosis are required.
Publisher: Elsevier BV
Date: 04-2021
DOI: 10.1016/J.PARKRELDIS.2021.02.009
Abstract: Deficits in attentional processing observed in Parkinson's disease (PD) patients with mild cognitive impairment (MCI) increase risk of PD dementia. However, the neural basis of these attentional deficits are presently unknown. The present study aimed to explore the neural correlates of attention dysfunction in PD-MCI using the Attention Network Test (ANT) and functional Magnetic Resonance Imaging (fMRI). Fifteen (15) PD-MCI patients, 26 PD patients without MCI (PD-NC) and 22 healthy controls (HC) were scanned (3T Siemens PRISMA) whilst performing the ANT. Reaction time, accuracy and fMRI BOLD activation were compared between groups for the three attentional task components of 1) alerting, 2) orienting, and 3) executive control. PD-MCI patients showed an overall slower reaction time compared to PD-NC and HC, and showed less interference of reaction time in the orienting effect than HC. fMRI data demonstrated greater activation in the bilateral cerebellum crus 1 during the alerting attention condition in both PD-MCI and PD-NC compared to HC. However, activation was supressed in the left postcentral gyrus in PD-MCI compared to PD-NC and HC. Alterations in the alerting attention functional network despite intact task performance in PD-MCI suggests that functional brain changes may precede cognitive changes in the attention domain. Furthermore, increased activation in the cerebellum may reflect an attentional compensatory mechanism unique to the PD pathology. Taken together, the findings suggest that PD has a complex effect on attentional ability that can, at least in part, be elucidated using functional neuroimaging.
Publisher: Springer Science and Business Media LLC
Date: 02-06-2020
DOI: 10.1038/S41531-020-0114-4
Abstract: An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Publisher: Wiley
Date: 17-01-2012
Publisher: Springer Science and Business Media LLC
Date: 13-06-2020
Publisher: Informa UK Limited
Date: 04-10-2017
DOI: 10.1080/07317115.2016.1240131
Abstract: Anxiety negatively impacts the quality of life of Parkinson's disease (PD) patients and caregivers. Despite high prevalence, there is a paucity of trials investigating effective treatments for anxiety in PD. This uncontrolled study investigated the use of a manualized and tailored Cognitive Behavior Therapy (CBT) for anxiety in PD. Participants completed 6 weekly CBT sessions. Pre-, post- and follow-up (3 and 6 months) assessments were made. Change in outcomes were analysed using t-tests and Reliability Change Index. Of 17 PD patients who agreed to CBT, 12 completed the intervention. This study showed a significant reduction in Hamilton Anxiety Rating Scale scores in PD immediately post CBT (t(11) = 3.59, p < .01), maintained at 3-month (t(8) = 2.83, p = .02) and 6-month (t(7) = 2.07, p = .04) follow-up. A reduction in caregiver burden (t(11) = 2.68, p = .03) was observed post intervention. Improvements in motor disability (t(11) = 2.41, p = .04) and cognitive scores (t(11) = -2.92, p = .01) were also observed post intervention and at follow-up. Tailored CBT can be used to treat anxiety in PD. This study provides preliminary evidence suggesting that tailored CBT reduces anxiety in PD with persisting benefits, and lowers caregiver burden.
Publisher: Cambridge University Press (CUP)
Date: 23-06-2015
DOI: 10.1017/S1041610215000885
Abstract: Assessing anxiety in Parkinson's disease (PD) has been a recent focus, and a number of studies have extensively investigated the validity of anxiety rating scales in PD. The present review aims to provide an overview of anxiety scales widely used and/or validated in PD, and to highlight recommendations for future research required in this area. A literature search was performed using terms such as Parkinson* disease, psychiatric, depress*, anxiety, assessment, scales, and valid* in PsycInfo, PubMed, and Web of Science databases. Validation studies and reviews focussed on assessment of anxiety in PD were included. The literature search identified nine anxiety rating scales. The new Parkinson's Anxiety Scale (PAS) showed good psychometric properties. Having a simple design appropriate for older adults and items focussed on cognitive anxiety, the Geriatric Anxiety Inventory (GAI) also appeared promising for use in PD. The Beck Anxiety Inventory (BAI), Hospital Anxiety and Depression Scale, and Hamilton Anxiety Rating Scale (HAM-A) did not demonstrate satisfactory psychometric characteristics when used in PD, while other scales had limited or no evidence of validity or reliability to infer judgments. PAS and GAI are can be recommended for use in PD without dementia. Usefulness of these scales to assess anxiety in dementia should be examined in the future. Moreover, the complex symptomatology of anxiety relating to “off” PD medication states were not addressed in these scales. Further research is required to develop an anxiety scale tailored for PD.
Publisher: Elsevier BV
Date: 09-2022
DOI: 10.1016/J.JAGP.2022.02.004
Abstract: Anxiety is a prominent concern in Parkinson's disease (PD) that negatively impacts quality of life, increases functional disability, and complicates clinical management. Atypical presentations of anxiety are under-recognized and inadequately treated in patients with PD, compromising global PD care. This systematic review focuses on the prevalence, symptomology and clinical correlates of atypical presentations of PD-related anxiety following PRISMA guidelines. Of the 60 studies meeting inclusion criteria, 14 focused on 'Anxiety Not Otherwise Specified (NOS)' or equivalent, 31 reported on fluctuating anxiety symptoms, and 22 reported on 'Fear of Falling (FOF)'. Anxiety NOS accounted for a weighted mean prevalence of 14.9%, fluctuating anxiety for 34.19%, and FOF for 51.5%. These latter two exceeded the average reported overall prevalence rate of 31% for anxiety disorders in PD. We identified a erse array of anxiety symptoms related to motor and non-motor symptoms of PD, to complications of PD medication (such as "on" and "off" fluctuations, or both), and, to a lesser extent, to cognitive symptoms. Atypical anxiety is common, clinically relevant, and heterogeneous in nature. A better understanding of the phenomenology, clinical course, and pathophysiology of varied forms of atypical anxiety in PD is needed to improve recognition, advance therapeutic development and ultimately optimize quality of life in PD.
Publisher: Wiley
Date: 09-10-2013
DOI: 10.1002/MDS.25689
Abstract: A significant proportion of persons affected by Parkinson's disease (PD) are over age 65 years. Mental health issues are often less a focus of treatment in this population than physical manifestations of the illness. Anxiety or depression alone, as well as comorbid depression and anxiety, are underrecognized in patients with PD and are associated with deleterious effects on physical and interpersonal functioning, negatively impacting quality of life and well-being. We offer a brief overview of salient clinical points with respect to assessment and treatment approaches to enhance efficacy of the treatment of mental health symptoms in older adults with PD. Cognitive behavior therapy involves the patient learning to overcome behavioral avoidance associated with anxiety and challenge unhelpful negative cognitions. It is suggested that cognitive behavior therapy is an effective approach to treatment of anxiety and depression in PD and should be offered as a treatment to patients.
Publisher: Wiley
Date: 15-01-2009
DOI: 10.1002/MDS.22134
Abstract: Altered levels of the neurotransmitters dopamine and serotonin are observed in both Parkinson's disease (PD) and depression. Therefore, the neurotransmitter transporter genes, SLC6A3 (dopamine) and SLC6A4 (serotonin) are candidates for depression in PD. We genotyped 24 tagging SNPs together with VNTRs and the SLC6A4 LPR polymorphism in 190 PD patients categorised according to lifetime history of depression. Log-additive, dominant and recessive statistical models were constructed. No significant genotype or haplotype associations were observed suggesting that common genetic variables around the dopamine and serotonin transporter genes do not play a significant role in the etiology of depression in PD.
Publisher: Wiley
Date: 15-12-2009
DOI: 10.1002/MDS.22819
Publisher: Wiley
Date: 04-04-2021
DOI: 10.1002/MDC3.13193
Abstract: Anxiety is a major complication in Parkinson's disease (PD). Many PD patients experience clinically significant anxiety not meeting Diagnostic and Statistical Manual of Mental Disorders (DSM‐IV) anxiety disorder criteria. This atypical anxiety (anxiety disorder not otherwise specified [NOS]) is often under‐recognized and its diagnosis is underdeveloped. This study aimed to identify the demographic, psychiatric, and clinical characteristics of anxiety disorder NOS in PD. A cross‐sectional design studied a convenience s le of 184 PD patients without dementia recruited from neurology outpatient clinics. A semi‐structured interview using DSM‐IV criteria categorized PD patients into current anxiety disorder NOS (n = 28), DSM‐IV anxiety disorders (n = 42) or no anxiety (n = 86) groups. Logistic regression modeling identified characteristics associated with the anxiety disorder NOS group compared to DSM‐IV anxiety and no anxiety groups. The anxiety disorder NOS group was associated with motor complications of PD therapy, episodic, persistent and social anxiety symptoms, depression, non‐motor experiences of daily living, poor quality of life, and female sex compared to the no anxiety group. Compared to DSM‐IV anxiety, those with anxiety disorder NOS demonstrated greater global cognitive impairment, more severe motor complications of PD therapy, a greater severity and functional impact of dyskinesias, and greater complexity of motor fluctuations. Persistent, episodic, and social anxiety symptoms did not significantly differ between anxiety disorder NOS and DSM‐IV anxiety groups. These findings suggest that PD‐specific symptoms characterize anxiety in a subgroup of PD patients who do not fulfill DSM‐IV criteria for anxiety disorders.
Publisher: Cambridge University Press
Date: 08-03-2021
Abstract: Historically, clinicians and researchers have focused on depression and dementia in older people, paying little attention to anxiety except as a complication of these disorders. However, increased research into late-life anxiety has seen a growth in scientific literature and clinical interest. This important book brings together international experts to provide a comprehensive overview of current knowledge in relation to anxiety in older people, highlighting gaps in both theory and practice, and pointing towards the future. Early chapters cover the broader aspects of anxiety disorders, including epidemiology, risk factors, diagnostic issues, association with insomnia, impaired daily functioning, suicidality, and increased use of healthcare services. The book then explores cross-cultural issues, clinical assessment, and pharmacological and psychological interventions across a variety of settings. An invaluable resource for mental health professionals caring for older people including researchers, psychiatrists, psychologists, specialist geriatric nurses and social workers.
Publisher: Cambridge University Press (CUP)
Date: 04-07-2016
DOI: 10.1017/S104161021600096X
Abstract: Impulse control disorders (ICDs) have become a widely recognized non-motor complication of Parkinson's disease (PD) in patients taking dopamine replacement therapy (DRT). There are no current evidence-based recommendations for their treatment, other than reducing their dopaminergic medication. This study reviews the current literature of the treatment of ICDs including pharmacological treatments, deep brain stimulation, and psychotherapeutic interventions. Dopamine agonist withdrawal is the most common and effective treatment, but may lead to an aversive withdrawal syndrome or motor symptom degeneration in some in iduals. There is insufficient evidence for all other pharmacological treatments in treating ICDs in PD, including amantadine, serotonin selective reuptake inhibitors, antipsychotics, anticonvulsants, and opioid antagonists (e.g. naltrexone). Large randomized control trials need to be performed before these drugs can be routinely used for the treatment of ICDs in PD. Deep brain stimulation remains equivocal because ICD symptoms resolve in some patients after surgery but may appear de novo in others. Cognitive behavioral therapy has been shown to improve ICD symptoms in the only published study, although further research is urgently needed. Further research will allow for the development of evidence-based guidelines for the management of ICDs in PD.
Publisher: Wiley
Date: 27-07-2012
DOI: 10.1111/J.1360-0443.2011.03511.X
Abstract: The compulsive use of dopamine replacement therapy (DRT) or dopamine dysregulation syndrome (DDS) is one of the behavioural disturbances reported in some patients with Parkinson's disease (PD) and other disorders who are receiving DRT. We draw this phenomenon to the attention of the addiction field as a topic deserving of more systematic study. We outline: the clinical features, epidemiology and clinical correlates of the disorder the unresolved issues in its definition and diagnosis and its potential relevance to neurobiological models of psychostimulant addiction. We argue that compulsive DRT use may provide a useful model for drug addiction, while advancing our understanding of the neurobiology of addiction and improving the management of PD patients with the disorder.
Publisher: Cambridge University Press (CUP)
Date: 05-2020
Publisher: Informa UK Limited
Date: 07-06-2022
DOI: 10.1080/07317115.2022.2085643
Abstract: Decline in language and cognitive functioning often deprives people living with moderate-to-severe dementia of self-reporting their quality of life (QoL) on the written and verbal formats of questionnaires. This systematic review aimed to evaluate the effectiveness of pictorial tools as an alternative method for enabling people living with dementia to self-report their QoL. PubMed, PsycINFO, CINAHL, and EMBASE were searched. Primary research studies reporting on information elicitation from people living with dementia through pictures were deemed eligible. Six studies satisfied the inclusion criteria. Methodological quality of the studies was evaluated through Downs and Black checklist. Data was extracted according to population, intervention, comparator, and outcomes (PICO) and results were summarized and supplemented by narrative synthesis. Compared to usual communication methods, pictorial tools were found to have a superior effect on comprehension of conversations and decision-making abilities, minimal effect on preference consistency, and an undeterminable effect on discourse features. There is consistent evidence that pictures enhance comprehension and might facilitate decision-making abilities. QoL information can be elicited more effectively through pictorial tools. Future studies warrant development of pictorial versions of standardized QoL tools which will assist the inclusion of people living with severe dementia.
Publisher: Cambridge University Press (CUP)
Date: 10-02-2016
DOI: 10.1017/S1041610215002410
Abstract: Symptoms of anxiety relating to Parkinson's disease (PD) occur commonly and include symptomatology associated with motor disability and complications arising from PD medication. However, there have been relatively few attempts to profile such disease-specific anxiety symptoms in PD. Consequently, anxiety in PD is underdiagnosed and undertreated. The present study characterizes PD-related anxiety symptoms to assist with the more accurate assessment and treatment of anxiety in PD. Ninety non-demented PD patients underwent a semi-structured diagnostic assessment targeting anxiety symptoms using relevant sections of the Mini International Neuropsychiatric Interview (MINI-plus). In addition, they were assessed for the presence of 30 PD-related anxiety symptoms derived from the literature, the clinical experience of an expert panel and the PD Anxiety-Motor Complications Questionnaire (PDAMCQ). The onset of anxiety in relation to the diagnosis of PD was determined. Frequent ( %) PD-specific anxiety symptoms included distress, worry, fear, agitation, embarrassment, and social withdrawal due to motor symptoms and PD medication complications, and were experienced more commonly in patients meeting DSM-IV criteria for an anxiety disorder. The onset of common anxiety disorders was observed equally before and after a diagnosis of PD. Patients in a residual group of Anxiety Not Otherwise Specified had an onset of anxiety after a diagnosis of PD. Careful characterization of PD-specific anxiety symptomatology provides a basis for conceptualizing anxiety and assists with the development of a new PD-specific measure to accurately assess anxiety in PD.
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.JAGP.2019.03.005
Abstract: Parkinson disease (PD) is a progressive neurodegenerative disease with a higher prevalence of neuropsychiatric symptoms compared with the general population. Symptoms such as anxiety, depression, psychosis, impulse control disorders, and cognitive impairment cause a greater worsening of quality of life than even the motor symptoms that define PD. Despite the ubiquity and impact of neuropsychiatric symptoms, specialty mental healthcare is not routinely available, accessible, or integrated in most neurology practices. Currently, training in PD-specific mental healthcare is not standard in most programs, and the need for subspecialty-trained, mental healthcare providers will only increase over time, as the prevalence of PD will more than double by 2060. Many barriers limit extension of mental healthcare into existing models of integrated or multidisciplinary care and the community at large. Foundations and professional societies have played an important role in raising awareness of mental healthcare needs in PD however, their initiatives to promote integrated or multidisciplinary care have traditionally focused on disciplines outside of mental health such as physical, occupational, and speech therapy. This article examines these issues and suggests strategies to better address mental healthcare needs for PD patients in the future.
Publisher: Elsevier BV
Date: 09-2019
Publisher: Cold Spring Harbor Laboratory
Date: 25-07-2020
DOI: 10.1101/2020.07.22.20158469
Abstract: The progression of Parkinson’s disease (PD) can often exacerbate symptoms of depression, anxiety, and/or cognitive impairment. In this study, we explore the possibility that multiple brain network responses are associated with symptoms of depression, anxiety and cognitive impairment in PD. This association is likely to provide insights into a single multivariate relationship, where common affective symptoms occurring in PD cohorts are related with alterations to electrophysiological response. 70 PD patients and 21 healthy age-matched controls (HC) participated in a high-density electroencephalography (EEG) study. Functional connectivity differences between PD and HC groups of oscillatory activity at rest and during completion of an emotion-cognition task were examined to identify key brain oscillatory activities. A canonical correlation analysis (CCA) was applied to identify a putative multivariate relationship between connectivity patterns and affective symptoms in PD groups. A CCA analysis identified a single mode of co-variation linking theta and gamma connectivity with affective symptoms in PD groups. Increases in frontotemporal gamma, frontal and parietal theta connectivity were related with increased anxiety and cognitive impairment. Decreases in temporal region theta and frontoparietal gamma connectivity were associated with higher depression ratings and PD patient age. This study only reports on optimal dosage of dopaminergic treatment (‘on’ state) in PD and didn’t investigate at “off” medication. Theta and gamma connectivity during rest and task-states are linked to affective and cognitive symptoms within fronto-temporo-parietal networks, suggesting a potential assessment avenue for understanding brain-behavior associations in PD with electrophysiological task paradigms.
Publisher: Mary Ann Liebert Inc
Date: 03-2020
Abstract: This study determines the feasibility of using virtual reality (VR) for residents with and without dementia in the residential aged care (RAC) environment (also referred to as nursing homes or long-term care). A mixed-methods study was conducted with 13 residents of varying cognitive capacity in a residential aged care facility (RACF) operated by a not-for-profit organization in Brisbane, Australia. Residents participated in one facilitated VR session, either as a group or in idual session. Residents' mood and apathy were measured by the Observed Emotion Rating Scale (OERS) and the Person-Environment Apathy Rating Scale. Residents also completed a structured interview to provide their feedback after the VR session. In addition, four RACF staff members were interviewed about their experience of using the VR in residents and the ongoing feasibility. The experience of VR administered by a researcher and leisure and lifestyle coordinator as a leisure activity, significantly reduced apathy in residents (
Publisher: Elsevier BV
Date: 05-2021
DOI: 10.1016/J.JAMDA.2021.07.026
Abstract: To assess the feasibility of using group-based fully immersive virtual reality (VR) across multiple sessions to reduce behavioral and psychological symptoms (BPSs), including depression, anxiety, and agitated behaviors, in cognitively erse aged care residents. A 6-session feasibility trial was conducted within a residential aged care facility using convenience s ling to recruit N = 25 residents of varying cognitive capacity. Groups of 5 residents viewed 360-degree videos on a wireless head-mounted display to provide fully immersive VR experiences. Half of the participants recruited from the 160-bed facility had a diagnosis of dementia (48%), whereas assessment with the Psychogeriatric Assessment Scale for cognitive impairment revealed that 64% experienced cognitive impairment (mild 20%, moderate 16%, and severe 28%). Additionally, 32% of participants had an existing anxiety or depression diagnosis. The Cornell Scale for Depression in Dementia, Generalized Anxiety Disorder 7-item, and Cohen Mansfield Agitation Inventory-Short were used to assess changes in persisting BPS pre- to postintervention period. The Person-Environment Apathy Rating apathy subscale, Observed Emotions Rating Scale, and a visual analog scale (Smileometer) were used to assess immediate mood responses from residents at every VR session. VR tolerability and resident feedback was also recorded. Pleasure (z = -5.892, P < .001) and general alertness (z = -2.455, P = .014) of participants improved at VR sessions, whereas apathy diminished (z = -5.275, P < .001). Compared to baseline, post-intervention depression was significantly lowered (z = -2.60, P = .009), whereas agitation increased (z = -2.98, P = .003). No significant changes in anxiety were observed. The quality of 360-degree videos and the device used did not induce any major VR-related negative side effects. Overall group-based VR reduced depressive symptoms and apathy, and induced a positive emotional response in most residents, with few observed side effects. Results indicate feasibility of group-based VR technological innovation within RAC.
Location: Australia
Location: Australia
Start Date: 2018
End Date: 2020
Funder: Brain & Behavior Research Foundation
View Funded ActivityStart Date: 2018
End Date: 2024
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2021
End Date: 2025
Funder: Royal Brisbane and Women's Hospital Foundation
View Funded ActivityStart Date: 2016
End Date: 2016
Funder: University of Queensland
View Funded ActivityStart Date: 2021
End Date: 2025
Funder: Australian Government
View Funded ActivityStart Date: 2021
End Date: 2025
Funder: Dementia Collaborative Research Centres, Australia
View Funded Activity