Late life psychotic features in prodromal Parkinson's disease.

Ioanna Pachi, Maria I Maraki, Nikolaos Giagkou, Mary H Kosmidis, Mary Yannakoulia, Efthimios Dardiotis, Georgios Hadjigeorgiou, Paraskevi Sakka, Eva Ntanasi, Georgia Xiromerisiou, Maria Stamelou, Nikolaos Scarmeas, Leonidas Stefanis

Journal: Parkinsonism & related disorders 2022;86():67-73

PMID: 33866230

Full Text on Elsevier Science View on PubMed

Abstract

INTRODUCTION

Some case series have suggested that psychotic features could occur even before the onset of motor symptoms of Parkinson's Disease (PD). Our aim was to investigate a possible association between psychotic symptoms and prodromal Parkinson's disease in a population-based cohort, the Hellenic Longitudinal Investigation of Aging and Diet study.

METHODS

This cross-sectional study included participants aged ≥65 years without dementia or PD. We defined psychotic symptoms as the presence of at least one new hallucinatory or delusional feature, assessed with the Neuropsychiatric Inventory scale and the Columbia University Scale for Psychopathology in Alzheimer's Disease, exhibited only at follow-up and not present at baseline visit. We calculated the probability of prodromal PD (pPD) for every participant, according to the 2019 International Parkinson and Movement Disorders Society research criteria for prodromal PD.

RESULTS

Participants who developed psychotic manifestations over a three-year follow up (20 of 914) had 1.3 times higher probability of pPD score (β [95%CI]: 1.3 [0.9-1.5], p=0.006) compared to non-psychotic subjects. This association was driven mostly by depressive symptoms, constipation and subthreshold parkinsonism (p<0.05).

CONCLUSION

Our data indicate that emerging psychotic features evolve in parallel with the probability of pPD. This is the first study that provides evidence for the presence of psychotic experiences in pPD. The association detected needs to be confirmed in longitudinal studies.

Address: 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.; Department of Nutrition and Dietetics, Harokopio University, Athens, Greece; Section of Sport Medicine and Biology of Exercise, School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece.; 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece; Parkinson's Disease and Movement Disorders Department, Hygeia Hospital, Athens, Greece.; Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece.; Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.; School of Medicine, University of Thessaly, Larissa, Greece.; Medical School, University of Cyprus, Nicosia, Cyprus.; Athens Association of Alzheimer's Disease and Related Disorders, Marousi, Greece.; 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece; Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.; 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece; Parkinson's Disease and Movement Disorders Department, Hygeia Hospital, Athens, Greece; Medical School, University of Cyprus, Nicosia, Cyprus.; 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece; Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY, USA.; 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece; Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece. Electronic address: [email protected].

DOI: 10.1016/j.parkreldis.2021.04.001

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MeSH Terms: Aged, Cross-Sectional Studies, Female, Humans, Male, Parkinson Disease, Prodromal Symptoms, Psychotic Disorders