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

The relationship between depression and disability in idiopathic Parkinson's disease (PD) was examined in 31 outpatients. Thirteen percent had current major depression (MD), 10% dysthymia, and 32% a lifetime history of MD. Depression was significantly related to both illness severity and functional impairment. Male patients with early-onset PD (before age 55) had more mood and anxiety disorders than late-onset male patients. Patients with right-sided PD had significantly more depressive symptoms than those with left-sided PD. On multiple regression analyses, depression predicted impaired social, role, and physical functioning for men (but not for women), independent of the impact of illness severity. The results suggest that treatment of depression may improve function; however, findings of gender differences will require replication.
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PMID:Depression and disability in Parkinson's disease. 884 97

Dysfunction of the central serotonergic system has been associated with depression in Parkinson's disease. To evaluate central serotonergic function in Parkinson's disease in relation to depression, we examined prolactin and cortisol responses to a single-dose challenge with fenfluramine (60 mg orally), a serotonin releasing/uptake-inhibiting agent, in the course of 5 hours in 11 patients with Parkinson's disease associated with major depression (SADS-RDC), 22 nondepressed parkinsonians, and 20 age- and gender-matched healthy controls. No difference in cortisol responses were observed between the groups; however, prolactin responses to fenfluramine were significantly impaired in patients with Parkinson's disease compared to controls, and the response was significantly more blunted in parkinsonian patients with major depression in comparison with the nondepressed ones. These findings indicate that there is a diminished serotonergic responsivity in depression associated with Parkinson's disease.
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PMID:Prolactin and cortisol responses to fenfluramine in Parkinson's disease. 889 70

The phosphoinositide signal transduction system constitutes one of the primary means for intercellular communication in the central nervous system, but only recently has this system been studied in human brain. Although some investigations have studied phosphoinositide signaling in slices from biopsied human brain, due to the limited access to such material a greater number of studies have utilized membranes prepared from postmortem human brain. With membranes exposed to exogenous labeled phosphoinositides, activation of phospholipase C with calcium, with G-proteins stimulated by GTP gamma S or NaF, or with several receptor agonists, have demonstrated that all of the components of the phosphoinositide system are retained in human brain membranes and are responsive to appropriate stimuli. Investigators have begun to examine the effects of neurological (Alzheimer's disease, epilepsy, Parkinson's disease) and psychiatric (schizophrenia, major depression, bipolar affective disorder) diseases on the activity of the phosphoinositide system. Alzheimer's disease has been studied to the greatest extent and a severe deficit in phosphoinositide signaling has been identified in most studies. In addition, brain regionally selective deficits in G-protein function associated with phosphoinositide signaling have been reported in subjects with major depression or with bipolar affective disorder, and in the latter an ameliorative effect of the therapeutic drug lithium was identified. Although significant progress has been achieved in studying the phosphoinositide system in human brain, many issues remaining to be addressed are discussed in this review. With carefully controlled studies, it appears that much will be learned in the near future about the phosphoinositide signal transduction system in human brain and the effects of a variety of disorders on its function.
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PMID:Phosphoinositide signaling in human brain. 897 82

Depression is a common condition that often responds to a variety of treatment modalities. Concerns about antidepressant medications' safety and efficacy and individuals' lack of response or their problems complying with medication regimens have prompted a resurgence in electroconvulsive therapy (ECT) for specific mental health conditions. Outpatient maintenance ECT, performed under general anesthesia, is a safe, effective follow-up treatment for individuals with major depression who have undergone inpatient ECT. Individuals with bipolar disorders, catatonia, mania, and schizophrenia and those with Parkinson's disease also can benefit from outpatient ECT. Perioperative nursing care for individuals who undergo outpatient ECT is similar to the care provided to patients scheduled for ambulatory surgery. Successful performance of outpatient ECT requires collaboration by skilled perioperative nurses, psychiatrists, anesthesia care providers, affected individuals, and family members.
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PMID:Treatment of depression with outpatient electroconvulsive therapy. 906 Nov 52

The aim of the study was to estimate the prevalence of major depression and to evaluate associated features in random age cohorts of 75, 80, and 85 years (N = 651). A clinical examination was made by experienced health center physicians, and major depression was diagnosed according to DSM-III criteria. The prevalence increased with age and was 1% to 4% in the age groups of 75 and 80 years, but 13% at the age of 85 years. No sex difference was found. The frequency of major depression was fourfold among institutionalized patients (16%) as compared to those living at home (4%). Major depression was strongly associated with objective health, intellectual functioning, and functional capacity. Depression was most common in subjects suffering from poor vision, urinary incontinence, or Parkinson's disease (odd ratios 4.2 to 4.9). Depression was also correlated with musculoskeletal disorders, coronary heart disease, and cerebrovascular diseases (odd ratios 2.5 to 3.4). The survey suggests that major depression is quite rare in healthy elderly people but common in disabled institutionalized patients.
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PMID:Major depression in the elderly: a population study in Helsinki. 911 79

Functional imaging of the brain using SPECT provides information correlative to the alterations of regional blood flow. In this paper we review the literature pertaining to SPECT in Parkinson's disease with and without dementia and depression. Parkinson's disease itself is not associated with a consistent pattern of cerebral blood flow alterations in the basal ganglia, but reduced parietal blood flow is more often reported. The heterogeneity of blood flow changes possibly reflects the multifactorial pathophysiology of the disease. In demented Parkinson's disease patients frontal hypoperfusion is often found or bilateral temporoparietal deficits, probably indicative of concomitant Alzheimer's disease. The SPECT studies undertaken in depressed patients with and without Parkinson's disease show highly conflicting and inconsistent results, probably due to methodological and diagnostic flaws (especially the inclusion of demented Parkinson patients). Several lines of reasoning point to a prefrontal dysfunction and future SPECT studies are planned to study this region in non-demented Parkinson's disease patients with and without major depression.
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PMID:rCBF SPECT in Parkinson's disease patients with mental dysfunction. 912 Apr 20

We evaluated 109 Chinese patients with Parkinson's disease (PD) in three ways: using a standardized psychiatric interview for depression and anxiety, using standardized neurological evaluation for motor disability, and using cognitive assessment for cognitive impairment. Six of the 109 patients who had dementia and another two afflicted with organic delusional disorder were excluded from further analysis. The remaining 101 PD patients were divided into the following three groups according to the DSM-III-R criteria: major depressive disorder (n = 18), other depressive disorders (n = 25) including dysthymic disorder and depressive disorder not otherwise specified, and no depression (n = 58). The frequency of major depressive disorder of the 109 PD patients was 16.5%, and the frequency of major and other depressive disorders, taken together, was 42.2%. Using the percentage points measured on the Schwab & England Activities of Daily Living Scale as the dependent variable to fit a multivariate regression model, we found the lower score significantly correlated with the diagnosis of depressive disorder and higher score of the Hamilton Depression Rating Scale, in addition to motor disability and disease severity of PD. Given the high frequency of depression and the significant correlation between depression and performance in daily functional activites, we believe that an evaluation of PD patients for coexisting depression is necessary for a better therapeutic outcome.
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PMID:The correlation of depression with functional activity in Parkinson's disease. 930 55

A 65-year-old woman with chronic pain was admitted to the hospital for severe recurrent major depression complicating Parkinson's disease (PD). Pain complaints were closely related to the fluctuating motor syndrome of PD. Specifically, pain was experienced in conjunction with hypomobility, and, as a result, she self-medicated with extra carbidopa/levodopa. A regimen of tramadol and cyclobenzaprine, along with sustained-release carbidopa/levodopa for PD and buproprion for her depression resulted in sustained symptomatic and functional improvement. Craving for, and self-medication with, supplemental carbidopa/levodopa ceased. Theoretical support for synergism among dopamine and opioid neurotransmitter systems can be found in recent literature.
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PMID:Chronic pain in the setting of Parkinson's disease and depression. 937 71

Electroconvulsive therapy (ECT) has demonstrated to be useful in psychiatric patients with parkinsonism as well as patients with Parkinson's disease (PD) without associated psychopathology. We prospectively evaluated three patients with PD and major depression in whom ECT proved to be efficacious. These patients experimented a marked improvement measured by the Unified Parkinson's Rating Scale (UPDRS). In two cases the ECT allowed for a reduction in their drug treatment, and in one case complex fluctuations disappeared. In the two patients who continued with ECT fortnightly, the improvement observed inicially has remained. Since ECT has shown a good tolerance, we conclude that this therapy should be considered as an alternative approach for PD patients with a poor answer to conventional treatment.
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PMID:[Electroconvulsive therapy in Parkinson disease. Description of three cases]. 943 2

We examined the prevalence of major depression and dysthymia in 78 patients with the classic variant of Parkinson's disease (PD) (that is, tremor plus rigidity and/or bradykinesia), and in 34 patients with the akinetic-rigid variant. Although the prevalence of dysthymia was similar in both groups (classic PD, 31%; and akinetic-rigid PD, 32%), patients with akinetic-rigid PD had a significantly higher prevalence of major depression (38% versus 15%, respectively; p < 0.01). A stepwise regression analysis demonstrated that bradykinesia was the extrapyramidal sign with the highest correlation with Hamilton depression scale scores. Our findings demonstrate a significant association between major depression and the akinetic-rigid type of PD.
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PMID:Depression in classic versus akinetic-rigid Parkinson's disease. 945 22


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