Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030567 (Parkinson's disease)
 63,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Anxiety disorders, particularly generalized anxiety, panic, and social phobia, occur in up to 40% of patients with Parkinson's disease (PD). This rate is higher than in normal or other disease comparison populations. Current evidence suggests that anxiety may not be a psychological reaction to the illness but rather may be linked to specific neurobiologic processes accompanying PD. Anxiety in PD often coexists with depression. The optimal pharmacologic treatment for anxiety in patients with PD has not been established, but available information about the use of anxiolytics in PD is reviewed. Further study of the relationship between anxiety and PD may provide an excellent opportunity to clarify the neurobiologic substrate of anxiety itself.
 ...
PMID:Anxiety and Parkinson's disease. 911 73

Social anxiety disorder has only recently garnered recognition as a unique anxiety disorder. Although social anxiety disorder is distinguishable from other psychiatric disorders, there are several areas in which this distinction is not straightforward. Furthermore, social anxiety disorder is associated with considerable comorbidity with other disorders, which may render differential diagnosis a challenging endeavor. This article will review those disorders that must be differentiated from social anxiety disorder, including major depression, panic disorder with agoraphobia, generalized anxiety disorder, obsessive-compulsive disorder, and body dysmorphic disorder. In addition, the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) provides specific examples of disorders, e.g., verbal dysfluency (stuttering) and Parkinson's disease, in the context of which social anxiety disorder is not to be diagnosed. Social anxiety disorder is also frequently comorbid with the Axis II avoidant personality disorder. Interestingly, this may present a prime example of "comorbidity by committee," because it is growing increasingly clear that much avoidant personality disorder as defined by DSM-IV merely denotes a subgroup of patients with generalized social anxiety disorder. Because social anxiety disorder has a chronic course and is associated with significant morbidity, it is critical that patients receive an accurate diagnosis and appropriate treatment.
 ...
PMID:The history, epidemiology, and differential diagnosis of social anxiety disorder. 1033 73

In addition to more widely and longer known indications of ETS, various neurological disorders and psychologically stressful situations in their worst expressions might be alleviated by the reversible ESB procedure. The patients with social phobia, especially those who have also blushing and/or stage fright type of heart racing, benefit from the ESB. The disturbances of the sympathetic nervous system, e. g. in Parkinson's disease and multiple system atrophy might be alleviated with sympathetic block, especially the extrapyramidal symptoms in these diseases. In migraine, sympathetic surgery has been noted to give some help. The unilateral left-sided block has been effective in long QT-syndrome type arrhythmias. In schizophrenia, the phobic, paranoic or confusional reactions have been tentatively treated by the sympathetic block.
 ...
PMID:Psychoneurological applications of endoscopic sympathetic blocks (ESB). 1467 67

The authors investigated the prevalence of DIS-ascertained DSM-III psychiatric disorders occurring in 28 patients with dystonia and 28 patients with Parkinson's Disease (PD). In patients with dystonia, lifetime prevalences of major depression (25.0%), bipolar disorder (7.1%), atypical bipolar disorder (7.1%), social phobia (17.9%), and generalized anxiety disorder (25.0%) were significantly more common than in epidemiologic catchment area (ECA) study population controls (p < 0.005). Social phobia and generalized anxiety disorder preceded dystonia (primary), while bipolar disorder developed after dystonia onset (secondary). In PD patients, the lifetime prevalence of simple phobia (35.7%, p < 0.0001) and atypical depression (21.4%) were significantly more common. Parkinson's Disease was associated with primary simple phobia and secondary atypical depression. These findings are considered in light of previous results and in terms of the differences in pallidothalamic physiologies in dystonia and PD. These data suggest distinctive profiles of psychiatric disorders in dystonia and PD.
 ...
PMID:Differential DSM-III psychiatric disorder prevalence profiles in dystonia and Parkinson's disease. 1499 Jul 56

Individuals with Parkinson's disease often exhibit symptoms of social anxiety. However, they rarely meet criteria for social phobia due to the medical exclusion criteria of DSM-IV. The present study reports the case of a 60-year-old male with Parkinson's disease who also met criteria for social phobia. After receiving 12 weekly cognitive-behavioral group sessions for social phobia, clinician ratings and self-report measures at post-treatment and 6-month follow-up showed a significant short-term and long-term reduction of his social anxiety. These findings suggest that cognitive-behavior therapy may be an effective treatment for social anxiety, even if these symptoms are related to Parkinson's disease.
 ...
PMID:Cognitive-behavioral treatment for social phobia in Parkinson's disease: A single-case study. 1677 Apr 38

This article reviews neuroimaging studies of conscious and voluntary regulation of various emotional states (sexual arousal, sadness, negative emotion). The results of these studies show that metacognition and cognitive recontextualization selectively alters the way the brain processes and reacts to emotional stimuli. Neuroimaging studies of the effect of psychotherapy in patients suffering from diverse forms of psychopathology (obsessive-compulsive disorder, panic disorder, unipolar major depressive disorder, social phobia, spider phobia, borderline personality) are also examined. The results of these studies indicate that the mental functions and processes involved in diverse forms of psychotherapy exert a significant influence on brain activity. Neuroimaging investigations of the placebo effect in healthy individuals (placebo analgesia, psychostimulant expectation) and patients with Parkinson's disease or unipolar major depressive disorder are also reviewed. The results of these investigations demonstrate that beliefs and expectations can markedly modulate neurophysiological and neurochemical activity in brain regions involved in perception, movement, pain, and various aspects of emotion processing. Collectively, the findings of the neuroimaging studies reviewed here strongly support the view that the subjective nature and the intentional content (what they are "about" from a first-person perspective) of mental processes (e.g., thoughts, feelings, beliefs, volition) significantly influence the various levels of brain functioning (e.g., molecular, cellular, neural circuit) and brain plasticity. Furthermore, these findings indicate that mentalistic variables have to be seriously taken into account to reach a correct understanding of the neural bases of behavior in humans. An attempt is made to interpret the results of these neuroimaging studies with a new theoretical framework called the Psychoneural Translation Hypothesis.
 ...
PMID:Mind does really matter: evidence from neuroimaging studies of emotional self-regulation, psychotherapy, and placebo effect. 1734 30

There are few studies about social anxiety disorder in Parkinson's disease (PD). The objective of this study was to assess its frequency and to explore the psychometric properties of the Liebowitz social anxiety scale (LSAS) in PD. Ninety patients with PD underwent neurologic and psychiatric examination. Psychiatric examination was composed by a structured clinical interview (MINI-Plus) followed by the application of the LSAS, the Hamilton depression rating scale (Ham-D), and the Hamilton anxiety rating scale (Ham-A). Neurologic examination included the MMSE, the UPDRS, the Hoehn-Yahr Scale, and the Schwab-England scale of activities of daily living. Social phobia was diagnosed in 50% of PD patients. The disorder was not associated with any sociodemographic or neurological feature, but was associated to major depression (P = 0.023), generalized anxiety disorder (P = 0.023), and obsessive-compulsive disorder (P = 0.013). The score of LSAS correlated positively with the scores of Ham-D and Ham-A (P < 0.001 for both). A ROC curve analysis of the LSAS suggested that a cutoff score in 41/42 provided the best balance between sensitivity and specificity. This disorder seems to be more common and not just restricted to performance as previously thought.
 ...
PMID:Frequency of social phobia and psychometric properties of the Liebowitz social anxiety scale in Parkinson's disease. 1866 50

Social anxiety disorder (SAD) is characterised by fear of scrutiny by other people, avoidance of social situations and vegetative/motor symptomatology. The correlation between reduced striatal dopaminergic (DA) function, SAD motor symptoms and the high occurrence of SAD in patients with Parkinson's disease (PD), suggests a link between SAD and movement diseases caused by dopamine dysfunction. However, little is known about the electrophysiological aspects of SAD. We applied single- and paired-pulse transcranial magnetic stimulation (TMS) to investigate excitatory and inhibitory mechanisms of the primary motor cortex (M1) in 15 SAD patients and the relationship between these neurophysiological measures and clinical symptoms or temperamental traits. Data were compared with those obtained in 15 age- and sex-matched healthy volunteers. SAD patients showed significantly higher harm avoidance scores and lower novelty seeking scores when compared to controls. TMS measures did not significantly differ between groups. However, in SAD patients the cortical silent period (CSP) duration and the amount of long-interstimulus interval intracortical inhibition were significantly correlated with the NS score. Accordingly with NS reduction and CSP shortening reported in PD, the relationship between NS levels and the excitability of inhibitory circuits of the M1 may support the hypothesis that DA dysfunction could underlie NS deficits in SAD. Furthermore, these data suggest that "trait variables" (i.e., NS) are more closely related to neurophysiological measures than SAD symptoms, which represent "state variables" linked to social performance.
 ...
PMID:Motor cortex excitability correlates with novelty seeking in social anxiety: a transcranial magnetic stimulation investigation. 2035 52

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.
 ...
PMID:Anxiety disorders in Parkinson's disease: prevalence and risk factors. 2046

Buspirone is an anxiolytic drug and is a partial agonist for the serotonin 5-HT(1A) receptors as well as possessing low affinity and is an antagonist for the dopamine D(2) autoreceptors, with some evidence of a weak affinity to 5-HT(2) receptors. The underlying mechanism of action of buspirone is not clear; however it is thought that its main pharmacology is mediated via the 5-HT(1A) receptors. Initially developed for use in the treatment of generalised anxiety disorder, it appears that buspirone may be useful in various other neurological and psychiatric disorders, such as attenuating side effects of Parkinson's disease therapy, ataxia, depression, social phobia, and behaviour disturbances following brain injury, and those accompanying Alzheimer's disease, dementia and attention deficit disorder. Considering the potential of this drug to be included in the management of many conditions, thorough and controlled studies are required to elucidate the exact mechanism of action. This review will consider the evidence so far for both the potential underlying mechanisms and its use in various conditions.
 ...
PMID:Buspirone: what is it all about? 2260 68


1 2 Next >>