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Depression, Apathy, Anhedonia, and Fatigue in Parkinson’s Disease

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Neuropsychiatric Symptoms of Movement Disorders

Part of the book series: Neuropsychiatric Symptoms of Neurological Disease ((NSND))

Abstract

Depression, apathy, anhedonia, and fatigue are common neuropsychiatric symptoms in Parkinson’s disease (PD) and impact deeply on health-related quality of life. The present chapter focuses on their definition, pathophysiology, epidemiology, assessment tools, relationship with other PD nonmotor-associated features, and management. Despite the importance of recognizing these disorders in PD, their diagnosis is greatly complicated since motor or cognitive features of the neurological disorder overlap with them. Furthermore, many features of depression, apathy, anhedonia, and fatigue are imbricated one with each other, further tangling up their assessment.

The pathophysiology of these symptoms is quite complex and reflects the widespread dysfunction of the brainstem and subcortical and cortical structures with the involvement of several neurotransmitter systems in addition to dopamine.

Treatment options should be based on the specific characteristics of the patient. Overall, the first step should include a review of all drugs taken by the patient in order to identify and possibly eliminate those medications that could contribute to these symptoms; then, the identification of potentially coexisting factors (e.g., cognitive dysfunction, sleep disorders, etc.) should be taken into account and possibly treated; finally, the optimization of dopaminergic treatment should be considered, since this strategy is often effective.

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Authors and Affiliations

  1. Neuroscience Section, Department of Medicine and Surgery, Center for Neurodegenerative Diseases, University of Salerno, Via S. Allende, 1, Baronissi, Salerno, 84081, Italy

    Marianna Amboni MD, PhD & Paolo Barone MD, PhD

  2. Division of Neurology, IDC Hermitage-Capodimonte, Via Cupa Delle Tozzole, 2, Naples, 80131, Italy

    Marianna Amboni MD, PhD

  3. Department of Psychology, Second University of Naples, Viale Ellittico 31, Caserta, 81100, Italy

    Gabriella Santangelo PhD

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  2. Gabriella Santangelo PhD
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  3. Paolo Barone MD, PhD
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Correspondence to Paolo Barone MD, PhD .

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  1. Department of Neurology, Technische Universität Dresden, Dresden, Sachsen, Germany

    Heinz Reichmann

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Amboni, M., Santangelo, G., Barone, P. (2015). Depression, Apathy, Anhedonia, and Fatigue in Parkinson’s Disease. In: Reichmann, H. (eds) Neuropsychiatric Symptoms of Movement Disorders. Neuropsychiatric Symptoms of Neurological Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-09537-0_1

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