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The neuropsychiatry of Parkinson's disease: advances and challenges

Research output: Contribution to journal › Review article › peer-review

Daniel Weintraub, Dag Aarsland, Kallol Ray Chaudhuri, Roseanne D. Dobkin, Albert FG Leentjens, Mayela Rodriguez-Violante, Anette Schrag

Original languageEnglish
Pages (from-to)89-102
Number of pages14
JournalThe Lancet Neurology
Volume21
Issue number1
DOIs
PublishedJan 2022
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Bibliographical note

Funding Information: DW is employed by the Crescenz Veterans Affairs Medical Center. For DA, this Review represents work partly supported by the UK National Institute for Health Research Biomedical Research Centre, Maudsley NHS Foundation Trust, and King's College London. AS is supported by University College London and the UK National Institute for Health Research, University College London Hospitals Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the UK National Health Service, the UK National Institute for Health Research, the UK National Institute for Health Research Department of Health and Social Care, the US Government, or the US Department of Veterans Affairs. Funding Information: Acknowledgements, DW is employed by the Crescenz Veterans Affairs Medical Center. For DA, this Review represents work partly supported by the UK National Institute for Health Research Biomedical Research Centre, Maudsley NHS Foundation Trust, and King's College London. AS is supported by University College London and the UK National Institute for Health Research, University College London Hospitals Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the UK National Health Service, the UK National Institute for Health Research, the UK National Institute for Health Research Department of Health and Social Care, the US Government, or the US Department of Veterans Affairs. Publisher Copyright: © 2022 Elsevier Ltd

King's Authors

Abstract

In people with Parkinson's disease, neuropsychiatric signs and symptoms are common throughout the disease course. These symptoms can be disabling and as clinically relevant as motor symptoms, and their presentation can be similar to, or distinct from, their counterparts in the general population. Correlates and risk factors for developing neuropsychiatric signs and symptoms include demographic, clinical, and psychosocial characteristics. The underlying neurobiology of these presentations is complex and not well understood, with the strongest evidence for neuropathological changes associated with Parkinson's disease, mechanisms linked to dopaminergic therapy, and effects not specific to Parkinson's disease. Assessment instruments and formal diagnostic criteria exist, but there is little routine screening of these signs and symptoms in clinical practice. Mounting evidence supports a range of pharmacological and non-pharmacological interventions, but relatively few efficacious treatment options exist. Optimising the management of neuropsychiatric presentations in people with Parkinson's disease will require additional research, raised awareness, specialised training, and development of innovative models of care.

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