Abstract
Besides the hallmark motor symptoms (rest tremor, hypokinesia, rigidity, and postural instability), patients with Parkinson’s disease (PD) have non-motor symptoms, namely neuropsychiatric disorders. They are frequent and may influence the other symptoms of the disease. They have also a negative impact on the quality of life of patients and their caregivers. In this article, we will describe the clinical manifestations of the main PD-related behavioral disorders (depression, anxiety disorders, apathy, psychosis, and impulse control disorders). We will also provide an overview of the clinical and preclinical literature regarding the underlying mechanisms with a focus on the role of the dopaminergic and non-dopaminergic systems.
Highlights
Parkinson’s disease (PD) is a neurodegenerative disease resulting from progressive death of the dopaminergic neurons in the brainstem, the substantia nigra pars compacta (SNc)
Anxiety-like behaviors can be observed in animals using several behavioral paradigms such as the elevated plus maze, the Light/Dark box and the open field. These tests have been used in animal models of PD and most of the literature report an increased anxiety-like behavior in 6-OHDA- or MPTP-lesioned animals (Table 1)
After a MPTP intoxication that causes an almost complete depletion of striatal DA, mice exhibited motor deficits and an increased anxiety-like behavior, concomitant with a reduction of 5-HT levels in the basolateral nucleus of the amygdala (BLA) (Gorton et al, 2010)
Summary
Parkinson’s disease (PD) is a neurodegenerative disease resulting from progressive death of the dopaminergic neurons in the brainstem, the substantia nigra pars compacta (SNc). Besides the hallmark motor symptoms (hypokinesia, rest tremor, rigidity, and postural instability), PD patients have non-motor symptoms including neuropsychiatric disorders (Chaudhuri et al, 2006). These behavioral disorders can be separated into two categories according to their pathogenesis. Depression, anxiety, apathy, and partly psychosis are consequences of the neurodegenerative process while some psychotic symptoms and impulse control disorders (ICDs) occur as adverse effects of some antiparkinsonian drugs. We will describe the clinical manifestations of these behavioral disorders and provide some elements of epidemiology. We will provide an overview of the current literature regarding the underlying mechanisms with a focus on the role of the dopaminergic and non-dopaminergic systems at both the clinical and preclinical levels
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