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Review
. 2024 Jan 21;16(1):e52663.
doi: 10.7759/cureus.52663. eCollection 2024 Jan.

Behind the Mask: Parkinson's Disease and Depression

Sneha Balasubramanian  1 , Khawar Tariq Mehmood  2 , Shahad Al-Baldawi  3 , Gabriel Zúñiga Salazar  4 , Diego Zúñiga  4
Affiliations
Review

Behind the Mask: Parkinson's Disease and Depression

Sneha Balasubramanian et al. Cureus. .

Abstract

Parkinson's disease (PD) is a common, prevalent neurodegenerative disease. It is mainly characterized by motor symptoms such as rigidity, tremors, and bradykinesia, but it can also manifest with non-motor symptoms, of which depression is the most frequent. The latter can impair the quality of life, yet it gets overlooked and goes untreated because of the significant overlap in their clinical features, hence making the diagnosis difficult. Furthermore, there is limited data on the availability of appropriate criteria for making the diagnosis of depression in PD patients, as it can occur with varying expressions throughout the course of PD or it can also precede it. This review article has included a brief discussion on the diagnosis of depression in PD patients and their overlapped clinical manifestations. Understanding the mechanisms underlying the disease processes of PD and depression and the pathways interconnecting them gives better knowledge on devising treatment options for the patients. Only studies from Pubmed were included and all other databases were excluded. Studies from the last 50 years were included. Suitable references included in these studies were also extracted. Thus, depression in PD and PD in depression, along with their pharmacological and non-pharmacological treatment options, have been discussed.

Keywords: anti-depressants; cognitive behavioural therapy; depression; electro-convulsive therapy; neurodegeneration; neuropathology; non-motor symptoms; parkinson' s disease; pimavanserin; treatment of depression in parkinson's disease.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Summary of the pathogenesis
HPA – Hypothalamus-pituitary-axis, BDNF – Brain-derived neurotrophic factor, IL-6 – Interleukin-6, TNF-alpha – Tumor necrosis factor-alpha, IFN-gamma – Interferon-gamma, IDO – indoleamine 2,3 dioxygenase, PD – Parkinson’s disease, LRRK 2 – Leucine-rich repeat kinase 2, GBA – Glucocerebrosidase, CRY1 – Cryptochrome circadian regulator 1, DA – Dopamine, 5-HT – Serotonin, Ach – Acetylcholine, NA – Nor-adrenaline, DAT – Dopamine transporter, SERT – Serotonin transporter Image credits: Khawar Tariq Mehmood
Figure 2
Figure 2. Overlapping Clinical Features
Image credits: Khawar Tariq Mehmood
See this image and copyright information in PMC

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