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Review
. 2018 Oct 9:14:2643-2656.
doi: 10.2147/NDT.S178263. eCollection 2018.

Neuropsychiatric disturbances in atypical parkinsonian disorders

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

Neuropsychiatric disturbances in atypical parkinsonian disorders

Daniele Belvisi et al. Neuropsychiatr Dis Treat. .

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; corticobasal degeneration; depression; multiple system atrophy; neuropsychiatric disturbances; progressive supranuclear palsy.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flowchart of the search and selection process.
See this image and copyright information in PMC

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