Please use this identifier to cite or link to this item: https://doi.org/10.1111/ene.13002
Title: Depression, anxiety, and apathy in Parkinson's disease: Insights from neuroimaging studies
Authors: Wen M.-C. 
Chan L.L. 
Tan L.C.S. 
Tan E.K. 
Keywords: Anxiety
Apathy
Depression
Frontostriatal pathway
Neuroimaging
Parkinson's disease
Issue Date: 2016
Publisher: Blackwell Publishing Ltd
Citation: Wen M.-C., Chan L.L., Tan L.C.S., Tan E.K. (2016). Depression, anxiety, and apathy in Parkinson's disease: Insights from neuroimaging studies. European Journal of Neurology 23 (6) : 1001-1019. ScholarBank@NUS Repository. https://doi.org/10.1111/ene.13002
Abstract: Depression, anxiety and apathy are common mood disturbances in Parkinson's disease (PD) but their pathophysiology is unclear. Advanced neuroimaging has been increasingly used to unravel neural substrates linked to these disturbances. A systematic review is provided of neuroimaging findings in depression, anxiety and apathy in PD. A PubMed, MEDLINE and EMBASE search of peer-reviewed original research articles on these mood disturbances in PD identified 38 studies on depression, eight on anxiety and 14 on apathy in PD. Most of the imaging studies used either position emission tomography or single-photon emission computed tomography techniques. These studies generally suggest increased neural activity in the prefrontal regions and decreased functional connectivity between the prefrontal-limbic networks in depressed patients. Functional imaging studies revealed an inverse correlation between dopaminergic density in the caudate and putamen with the severity of anxiety in PD. There was no consistent correlation between dopaminergic density of thalamus and anxiety. Studies demonstrated both positive and inverse correlations between apathy and metabolism or activity in the striatum, amygdalar, prefrontal, temporal and parietal regions. The clinical variability of study subjects and differences in image pre-processing and analytical strategies may contribute to discrepant findings in these studies. Both nigrostriatal and extra-nigrostriatal pathways (in particular the frontal region and its connecting areas) are affected in mood disorders in PD. Identifying the relative contributions of these neural pathways in PD patients with overlapping motor and mood symptoms could provide new pathophysiological clues for the development of better therapeutic targets for affected patients. � 2016 European Academy of Neurology.
Source Title: European Journal of Neurology
URI: http://scholarbank.nus.edu.sg/handle/10635/149007
ISSN: 13515101
DOI: 10.1111/ene.13002
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