Abstract

Parkinson's disease is a progressive neurodegenerative disease with motor symptoms and non-motor impairments, including depression, observed in 2.7-90% of cases. Depression is frequently underestimated and diagnosed late due to its similarity with symptoms of Parkinson's disease, such as fatigue, sleep disturbances, hypomimia, etc. In approximately 25% of patients, depression precedes motor symptoms, which may indicate its connection with the pathogenesis of Parkinson's disease. The purpose of the study was to analyze current data on the pathophysiology, diagnosis, and treatment of depression in patients with Parkinson's disease. The study results have demonstrated that the pathophysiological mechanisms of depression in Parkinson's disease include neurodegeneration of dopaminergic, noradrenergic, and serotonergic neurons, neuroinflammation, and impaired neuroplasticity. For timely treatment, patients, especially those with changes in motor or non-motor symptoms, should be regularly examined. Treatment is based on a multimodal approach and includes the use of supportive psychotherapy and pharmacotherapy. Alternative methods such as exercise, cognitive behavioral therapy, transcranial magnetic stimulation, and electroconvulsive therapy are also being explored. Thus, treatment of patients with depression and Parkinson's disease requires an individualized approach. Further research into this problem is crucial to develop and improve patient management algorithms.

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