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. 2022 Nov;44(9):651-664.
doi: 10.1080/13803395.2022.2157796. Epub 2023 Jan 4.

Differential contributions of depression, apathy, and anxiety to neuropsychological performance in Parkinson's disease versus essential tremor

Adrianna M Ratajska  1 , Bonnie M Scott  2 , Francesca V Lopez  1 , Lauren E Kenney  1 , Kelly D Foote  3 , Michael S Okun  3 , Catherine Price  1 , Dawn Bowers  1   3
Affiliations

Differential contributions of depression, apathy, and anxiety to neuropsychological performance in Parkinson's disease versus essential tremor

Adrianna M Ratajska et al. J Clin Exp Neuropsychol. 2022 Nov.

Abstract

Introduction: Mood symptoms are common features of Parkinson's disease (PD) and essential tremor (ET) and have been linked to worse cognition. The goals of the present study were to compare the severity of anxiety, apathy, and depressive symptoms in PD, ET, and healthy controls (HC) and to examine differential relationships between mood and cognition.

Method: Older adults with idiopathic PD (N = 448), ET (N = 128), or HC (N = 136) completed a multi-domain neuropsychological assessment consisting of memory, executive function, and attention/working memory domains. Participants also completed self-reported mood measures. Between-group differences in mood and cognition were assessed, and hierarchical regression models were conducted to examine relationships between mood and cognition in each group.

Results: Relative to the HC group, the PD and ET groups reported more mood symptoms and scored lower across all cognitive measures. There were no differences between the two movement disorder groups. Mood variables explained 3.9-13.7% of the total variance in cognitive domains, varying by disease group. For PD, apathy was the only unique predictor of executive function (β = -.114, p = .05), and trait anxiety was the only unique predictor of attention/working memory (β = -.188, p < .05). For ET, there were no unique predictors, though the overall models significantly predicted performance in the executive function and attention/working memory domains.

Conclusions: In a large cohort of ET and PD, we observed that the two groups had similar self-reported mood symptoms. Mood symptoms were differentially associated with cognition in PD versus ET. In PD, increased apathy was associated with worse executive function and higher trait anxiety predicted worse attention/working memory. For ET, there were no unique predictors, though the overall mood symptom severity was related to cognition. Our study highlights the importance of considering the relationship between mood and neuropsychological performance in individuals with movement disorders.

Keywords: Depression; Parkinson’s disease; anxiety; apathy; cognition; essential tremor.

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Figures

Figure 1.
Figure 1.
Percentage of clinically significant mood symptoms by group. Asterisks indicate significant between-group differences at p < .05 (Bonferroni-corrected). BDI-II = Beck Depression Inventory-II; AS = Apathy Scale; STAI = State-Trait Anxiety Inventory; PD = Parkinson’s disease; ET = essential tremor; NC = normal control.
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