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Neuropsychiatric disturbances in atypical parkinsonian disorders

Authors Belvisi D, Berardelli I, Suppa A, Fabbrini A, Pasquini M, Pompili M, Fabbrini G

Received 26 June 2018

Accepted for publication 31 July 2018

Published 9 October 2018 Volume 2018:14 Pages 2643—2656

DOI https://doi.org/10.2147/NDT.S178263

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Justinn Cochran

Peer reviewer comments 3

Editor who approved publication: Dr Roger Pinder


Daniele Belvisi,1 Isabella Berardelli,2 Antonio Suppa,1,3 Andrea Fabbrini,3 Massimo Pasquini,3 Maurizio Pompili,2 Giovanni Fabbrini1,3

1IRCCS Neuromed, Pozzilli, Italy; 2Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy; 3Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy

Abstract: Multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD) are the most common atypical parkinsonisms. These disorders are characterized by varying combinations of autonomic, cerebellar and pyramidal system, and cognitive dysfunctions. In this paper, we reviewed the evidence available on the presence and type of neuropsychiatric disturbances in MSA, PSP, and CBD. A MedLine, Excerpta Medica, PsycLit, PsycInfo, and Index Medicus search was performed to identify all articles published on this topic between 1965 and 2018. Neuropsychiatric disturbances including depression, anxiety, agitation, and behavioral abnormalities have been frequently described in these disorders, with depression as the most frequent disturbance. MSA patients show a higher frequency of depressive disorders when compared to healthy controls. An increased frequency of anxiety disorders has also been reported in some patients, and no studies have investigated apathy. PSP patients may have depression, apathy, disinhibition, and to a lesser extent, anxiety and agitation. In CBD, neuropsychiatric disorders are similar to those present in PSP. Hallucinations and delusions are rarely reported in these disorders. Neuropsychiatric symptoms in MSA, PSP, and CBD do not appear to be related to the severity of motor dysfunction and are one of the main factors that determine a low quality of life. The results suggest that neuropsychiatric disturbances should always be assessed in patients with atypical parkinsonisms.

Keywords:
atypical parkinsonisms, multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration, neuropsychiatric disturbances, depression

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