Clinical correlates of depressive symptoms in familial Parkinson's disease.
Depression is one of the most common nonmotor complications of Parkinson's disease (PD) and has a major impact on quality of life. Although several clinical factors have been associated with depression in PD, the relationship between depression and stage of illness as well as between depression and degree of disability remains controversial. We have collected clinical data on 1,378 PD cases from 632 families, using the Unified Parkinson's Disease Rating Scale (UPDRS) Parts II (activities of daily living) & III (motor), the Mini-Mental State Exam, the Geriatric Depression Scale (GDS), and the Blessed Functional Activity Scale (Blessed). Analyses were performed using the 840 individuals with verified PD and without evidence of cognitive decline. Logistic regression was used to identify study variables that individually and collectively best predicted the presence of depressive symptoms (GDS >or= 10). After correcting for multiple tests, depressive symptoms were significantly associated with Hoehn and Yahr stage and other clinical measures but not with any genetic variant (parkin, LRRK2, APOE). The Blessed score, education, presence of a first degree relative with signs of depression, and UPDRS Part II were found to best predict depressive symptomatology (R(2) = 0.33; P = 4 x 10(-48)). Contrary to several reports, the results from this large study indicate that stage of illness, motor impairment, and functional disability are strongly correlated with depressive symptoms.
Pankratz
Nathan
N
Department of Medical and Molecular Genetics, Indiana University, Indianapolis, Indiana 46202, USA. npankrat@iupui.edu
Marder
Karen S
KS
Halter
Cheryl A
CA
Rudolph
Alice
A
Shults
Cliff W
CW
Nichols
William C
WC
Foroud
Tatiana
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001057:Apolipoproteins E / Q000235:genetics; D004252:DNA Mutational Analysis / Q000379:methods; D003863:Depression / Q000150:complications* / Q000235:genetics*; D005192:Family Health; D005260:Female; D006801:Humans; D000071158:Leucine-Rich Repeat Serine-Threonine Protein Kinase-2; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D010300:Parkinson Disease / Q000150:complications* / Q000235:genetics*; D017346:Protein Serine-Threonine Kinases / Q000235:genetics; D016601:RNA-Binding Proteins / Q000235:genetics; D012720:Severity of Illness Index
D001057:Apolipoproteins E; C104647:PRKRA protein, human; D016601:RNA-Binding Proteins; C495280:LRRK2 protein, human; D000071158:Leucine-Rich Repeat Serine-Threonine Protein Kinase-2; D017346:Protein Serine-Threonine Kinases
Parkinsonism Relat Disord. 2003 Oct;10(1):23-8
14499203
Neurology. 2005 Jun 28;64(12):2134-5
15985588
Brain. 1989 Oct;112 ( Pt 5):1141-53
2804609
J Med Genet. 2002 Jul;39(7):489-92
12114481
Clin Neuropharmacol. 2000 Nov-Dec;23(6):331-4
11575867
J Neurol Neurosurg Psychiatry. 1992 May;55(5):377-82
1602311
Neurology. 2006 Mar 28;66(6):956; author reply 956
16567734
Neurology. 2003 Mar 11;60(5):796-801
12629236
Behav Neurol. 2006;17(2):109-15
16873922
J Psychiatr Res. 1982-1983;17(1):37-49
7183759
J Neurol. 1997 Aug;244(8):493-8
9309555
Br J Psychiatry. 1968 Jul;114(512):797-811
5662937
Mov Disord. 2006 Jan;21(1):45-9
16116614
Arch Neurol. 1995 Jul;52(7):695-701
7619026
J Neurol Sci. 2006 Oct 25;248(1-2):138-42
16814323
J Psychiatr Res. 1975 Nov;12(3):189-98
1202204
Lancet. 2005 Jan 29-Feb 4;365(9457):410-2
15680455
J Neurol Neurosurg Psychiatry. 2007 Feb;78(2):123-6
16980336
J Neuropsychiatry Clin Neurosci. 1996 Winter;8(1):20-5
8845697
J Neurol Neurosurg Psychiatry. 1988 Jun;51(6):855-8
3404193
J Am Geriatr Soc. 1991 Sep;39(9):876-80
1885862
Mov Disord. 2006 Oct;21(10):1618-22
16817205
J Neuropsychiatry Clin Neurosci. 2002 Spring;14(2):223-36; discussion 222
11983801
Arch Neurol. 1996 Feb;53(2):175-9
8639068
J Neurol Neurosurg Psychiatry. 2005 Oct;76(10):1445-7
16170093
Neurology. 1990 Oct;40(10):1529-34
2215943
J Neurol. 1987 Feb;234(2):94-6
2435855
J Neurol Neurosurg Psychiatry. 1997 Jan;62(1):10-5
9010393
J Geriatr Psychiatry Neurol. 2004 Sep;17(3):120-6
15312275
Arch Neurol. 1997 May;54(5):625-30
9152120
Arch Neurol. 1992 Mar;49(3):305-7
1536634
J Neural Transm (Vienna). 1996;103(3):349-54
8739846
Arch Neurol. 2001 Oct;58(10):1611-5
11594919
J Neural Transm (Vienna). 2000;107(1):59-71
10809404
Neurology. 1996 Jul;47(1):256-9
8710089
Am J Hum Genet. 2002 Jul;71(1):124-35
12058349
Mov Disord. 2006 Dec;21(12):2257-60
17078063
Neurology. 2007 Oct 30;69(18):1737-44
17804834
Arch Neurol. 1999 Mar;56(3):334-7
10190824