The Spectrum of Neuropsychiatric Symptoms in Parkinson’s disease according to Cognitive Function

초록

Background & Objective: Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor symptoms and nonmotor symptoms such as cognitive impairment and neuropsychiatric symptoms. PD with normal cognition (PDNC) may progress to PD with mild cognitive impairment (PDMCI) prior to PD with Dementia (PDD). The aim of this study was to investigate the spectrum of neuropsychiatric symptoms in PD according to cognitive function. Methods: Eighty five patients with PD were consecutively recruited. After they had undergone an intensive interview with a neurologist and the Seoul Neuropsychological Screening Battery-dementia version, they were divided into three groups: 21 patients in PDNC, 39 in PDMCI, and 25 in PDD. Forty five healthy control subjects without memory complaints were also recruited. The caregivers of all participants administered the Caregiver-Administered Neuropsychiatric Inventory (CGA-NPI). Results: There were significant differences of total scores of the CGA-NPI (23.0 &#61617; 20.2 vs. 8.0 &#61617; 13.2 vs. 1.5 &#61617; 3.0 vs. 1.0 &#61617; 1.6, p<0.001), and the prevalence of neuropsychiatric symptoms (96% vs. 64% vs. 38% vs. 44%, p<0.001) among PDD, PDMCI, PDNC and control groups. Depression was the symptom which was observed most often (62%), followed by delusion (50%), hallucination (50%), anxiety (46%), night-time behaviour (46%), and aberrant motor behaviour (35%) in PDD. Depression (34%), anxiety (32%), apathy (27%), and eating change (24%) were also commonly observed in PDMCI, but delusion, hallucination, euphoria and aberrant motor behaviour were seldom presented in PDMCI (less than 3%). The prevalence of neuropsychiatric symptoms in PDNC was similar to that in normal controls than PDMCI group. Conclusion: Depression was most common neuropsychiatric symptom in PD. The presence of delusion, hallucination, or aberrant motor behavior may differentiate PDD from PDMCI. The neuropsychiatric symptoms were not prevalent