Affect in Parkinson's disease: validation of the two-factor approach
Identifieur interne : 000195 ( France/Analysis ); précédent : 000194; suivant : 000196Affect in Parkinson's disease: validation of the two-factor approach
Auteurs : Emmanuelle Pourcher [Canada, France] ; Sophie Remillard [Canada] ; Henri Cohen [Canada, France]Source :
- Journal of the neurological sciences [ 0022-510X ] ; 2010.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
Depression in Idiopathic Parkinson's disease (IPD) is frequent, difficult to recognize, under managed and has a profound impact on quality of life. Current categorization of diagnosis in psychiatry poorly applies to the protean manifestations of mood disorders presented by parkinsonian patients. In this study we have chosen to dissect the state of depressive mood as assessed with the Beck Depression Inventory (BDI) at different points in time of pharmacological interventions using a dimensional approach. The 21 items of the BDI were classified in two new categories or factors: hyperkinetic and hypokinefic. The hyperkinetic factor included all items related to unbalanced intrusions of negative feelings and ideas, as well as to behavioral hyperactivity. The hypokinetic factor included all items related to loss of drive for appetitive behaviors and loss of mental and physical energy. The objectives were to (1) compare different pharmacological treatments on the two-factor approach in PD depression, (2) determine the influence of levodopa therapy on the two-factor approach, and (3) explore the two-factor approach in placebo conditions. Three sets of analyses using the hypo/hyperkinetic dichotomy favour a neurobiological dissociation of these factors in response to pharmacological intervention: symptoms of the hyperkinetic factor are responsive to serotonergic drugs while those of the hypokinetic one are not and may even show deterioration under SSRIs. In contrast, the hypokinetic factor is responsive to dopaminergic drugs and may show deterioration under serotonergic drugs. Furthermore, the two factors seem to transiently dissociate on placebo intervention aiming at correcting either mood or motor status. The dimensional approach to depression symptomatology may thus be of heuristic value in probing aminergic modulation of mood in IPD and establishing new correlations between affective and motor symptoms.
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CNRS (UMR-8189)</s1><s2>Boulogne-Billancourt</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Boulogne-Billancourt</settlement></placeName></affiliation></author></analytic><series><title level="j" type="main">Journal of the neurological sciences</title><title level="j" type="abbreviated">J. neurol. sci.</title><idno type="ISSN">0022-510X</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Journal of the neurological sciences</title><title level="j" type="abbreviated">J. neurol. sci.</title><idno type="ISSN">0022-510X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Depression</term><term>Depression Inventory Beck</term><term>Hyperkinesia</term><term>Idiopathic</term><term>Nervous system diseases</term><term>Parkinson disease</term><term>Placebo</term><term>Surgical approach</term><term>Validation</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Maladie de Parkinson</term><term>Etat dépressif</term><term>Hyperkinésie</term><term>Pathologie du système nerveux</term><term>Validation</term><term>Voie abord</term><term>Idiopathique</term><term>Placebo</term><term>Depression Inventory Beck</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Depression in Idiopathic Parkinson's disease (IPD) is frequent, difficult to recognize, under managed and has a profound impact on quality of life. Current categorization of diagnosis in psychiatry poorly applies to the protean manifestations of mood disorders presented by parkinsonian patients. In this study we have chosen to dissect the state of depressive mood as assessed with the Beck Depression Inventory (BDI) at different points in time of pharmacological interventions using a dimensional approach. The 21 items of the BDI were classified in two new categories or factors: hyperkinetic and hypokinefic. The hyperkinetic factor included all items related to unbalanced intrusions of negative feelings and ideas, as well as to behavioral hyperactivity. The hypokinetic factor included all items related to loss of drive for appetitive behaviors and loss of mental and physical energy. The objectives were to (1) compare different pharmacological treatments on the two-factor approach in PD depression, (2) determine the influence of levodopa therapy on the two-factor approach, and (3) explore the two-factor approach in placebo conditions. Three sets of analyses using the hypo/hyperkinetic dichotomy favour a neurobiological dissociation of these factors in response to pharmacological intervention: symptoms of the hyperkinetic factor are responsive to serotonergic drugs while those of the hypokinetic one are not and may even show deterioration under SSRIs. In contrast, the hypokinetic factor is responsive to dopaminergic drugs and may show deterioration under serotonergic drugs. Furthermore, the two factors seem to transiently dissociate on placebo intervention aiming at correcting either mood or motor status. The dimensional approach to depression symptomatology may thus be of heuristic value in probing aminergic modulation of mood in IPD and establishing new correlations between affective and motor symptoms.</div></front></TEI><affiliations><list><country><li>Canada</li><li>France</li></country><region><li>Île-de-France</li></region><settlement><li>Boulogne-Billancourt</li></settlement></list><tree><country name="Canada"><noRegion><name sortKey="Pourcher, Emmanuelle" sort="Pourcher, Emmanuelle" uniqKey="Pourcher E" first="Emmanuelle" last="Pourcher">Emmanuelle Pourcher</name></noRegion><name sortKey="Cohen, Henri" sort="Cohen, Henri" uniqKey="Cohen H" first="Henri" last="Cohen">Henri Cohen</name><name sortKey="Pourcher, Emmanuelle" sort="Pourcher, Emmanuelle" uniqKey="Pourcher E" first="Emmanuelle" last="Pourcher">Emmanuelle Pourcher</name><name sortKey="Remillard, Sophie" sort="Remillard, Sophie" uniqKey="Remillard S" first="Sophie" last="Remillard">Sophie Remillard</name></country><country name="France"><region name="Île-de-France"><name sortKey="Pourcher, Emmanuelle" sort="Pourcher, Emmanuelle" uniqKey="Pourcher E" first="Emmanuelle" last="Pourcher">Emmanuelle Pourcher</name></region><name sortKey="Cohen, Henri" sort="Cohen, Henri" uniqKey="Cohen H" first="Henri" last="Cohen">Henri Cohen</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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