Research Topic

Neuropsychiatric impairment in Parkinson's Disease

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Parkinson’s disease (PD) affects multiple neurotransmitter systems, and leads to a dynamic and varied profile of motor and non-motor deficits. The cognitive and neuropsychiatric symptoms seen in these patients is extensive, reflecting the severity and duration of progressive neurodegeneration as well as ...

Parkinson’s disease (PD) affects multiple neurotransmitter systems, and leads to a dynamic and varied profile of motor and non-motor deficits. The cognitive and neuropsychiatric symptoms seen in these patients is extensive, reflecting the severity and duration of progressive neurodegeneration as well as iatrogenic complications stemming from pharmacotherapies that aim to alleviate the movement disorder. A key question is to what extent it is possible to parse the heterogeneity of these symptoms into distinct patterns of cognitive impairment and psychiatric dysfunction, and thus promising treatment targets. We believe this Research Topic is timely and will serve to highlight the need to address these problems in PD, which are currently often underdiagnosed and often go untreated.

The first aim of this Research Topic is to bring into focus and accurately characterise from a phenomenological / sign and symptom perspective, the range of neuropsychiatric symptoms in PD, such as depression, anxiety, psychosis, apathy, REM sleep behaviour disturbance, and impulse control disorders, as well as dementia. Their neurochemical and anatomical basis will be addressed, in relation to disease pathophysiology, complications ensuing from dopatherapies as well as their interactions. The Research Topic will examine relationships of the neuropsychiatric sequelae of PD to aspects of mild cognitive impairment seen in non-demented patients, such as different aspects of executive, visuospatial, attentional and mnemonic deficits. Psychiatric disturbance that precedes the onset of motor symptoms, indicative of early neurodegenerative events, and the utility of better understanding these as well as their utility in early and accurate diagnosis will also be discussed.

The superordinate theme of the collection will be to approach these diverse symptom entities from a neurochemical perspective with a view to optimising pharmacotherapy, by mapping them onto the trajectory of progressive deficits in dopamine, noradrenaline, serotonin and acetylcholine. Delineating the common neurochemical denominators of different impairment clusters with a view to patient stratification is central to effective symptom management. A subset of articles will review evidence from studies using common and repurposed pharmacological agents, and illustrate the utility of this approach to tailoring pharmacotherapy according to the complete clinical picture of the individual.


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