Highlights
- •What is the primary question addressed by this study?Do Parkinson's disease neuropsychiatric symptoms (depression, anxiety, and psychosis) correlate with neuronal loss/gliosis and Lewy body pathology in the substantia nigra and locus coeruleus?
- •What is the main finding of this study?Depression and psychosis, but not anxiety, were associated with neuronal loss/gliosis in the substantia nigra after controlling for disease duration and dementia. No neuropsychiatric symptoms were associated with Lewy body score.
- •What is the meaning of the finding?Neuronal loss/gliosis may be a better histopathological marker for neuropsychiatric symptoms in Parkinson's disease than Lewy body pathology.
Abstract
Background
The pathological hallmarks of Parkinson's disease include intraneuronal Lewy bodies,
neuronal loss, and gliosis. We aim to correlate Parkinson's disease neuropsychiatric
symptoms, (e.g., depression, psychosis, and anxiety) with the severity of neuropathology
in the substantia nigra and locus coeruleus.
Methods
The brains of 175 participants with a primary pathologic diagnosis of Parkinson's
disease were analyzed semi-quantitatively to ascertain the burden of neuronal loss
and gliosis and Lewy body pathology within the locus coeruleus and substantia nigra.
Participants’ history of anxiety, depression, and psychosis were determined using
a chart-extracted medical history or record of formal psychiatric evaluation.
Results
Of the sample, 56% (n = 98), 50% (n = 88), and 31.25% (n = 55) of subjects had a diagnosis
of psychosis, depression, and anxiety, respectively. Psychosis (χ2 = 7.1, p = 0.008, df = 1) and depression (χ2 = 7.2, p = 0.007, df = 1) were associated with severe neuronal loss and gliosis in the substantia nigra
but not in the locus coeruleus. No association was observed between anxiety and neuronal
loss and gliosis in either region. No neuropsychiatric symptoms were associated with
Lewy body score. After controlling for disease duration and dementia, psychosis (odds
ratio [OR]: 3.1, 95% confidence interval [CI]: 1.5–6.4, χ2 = 9.4, p = 0.012, df = 1) and depression (OR: 2.6, 95% CI: 1.3–5.0, χ2 = 7.9, p = 0.005, df = 1) remained associated with severe neuronal loss and gliosis in the substantia
nigra.
Conclusion
These results suggest that psychosis and depression in Parkinson's disease are associated
with the underlying neurodegenerative process and demonstrate that cell loss and gliosis
may be a better marker of neuropsychiatric symptoms than Lewy body pathology.
Key Words
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Article info
Publication history
Published online: December 21, 2020
Accepted:
December 12,
2020
Received in revised form:
November 30,
2020
Received:
August 30,
2020
Identification
Copyright
© 2020 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
