Motion and emotion: anxiety–axial connections in Parkinson’s disease
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Anxiety is a serious and frequent complication in Parkinson’s disease (PD) that significantly affects the quality of life of patients. Multiple neuroanatomical, experimental, and clinical studies suggest its close association with axial disturbances. However, whether this relation applies for PD patients (commonly suffering from axial difficulties, such as balance and gait disturbance) has not been properly tested yet. The purpose of this study was to determine whether PD patients suffering from axial symptoms have higher levels of anxiety than others and to identify other factors associated with anxiety–axial connections. In this questionnaire study, 212 patients with PD were assessed by standardized scales, such as Hamilton Anxiety Scale, Montgomery–Asberg Depression Rating Scale, Montreal Cognitive Assessment, examining their mood and cognitive status. These data were correlated to dominant motor symptoms of these patients, such as tremor, rigidity, bradykinesia, and axial symptoms. Unlike other motor symptoms, only axial symptoms showed to be significantly related to higher levels of anxiety. The patients suffering from anxiety and axial problems have also shown significantly higher depression levels. Axial disturbances are related to higher anxiety levels in PD patients. It is crucial to pay high attention to symptoms of anxiety in patients having postural instability or gait disorder. Further clinical studies are desirable to investigate new, practical implications of anxiety–axial connection to provide complex management options of these serious symptoms.
KeywordsParkinson’s disease Anxiety Mood Instability Posture
This work was supported by Novartis s.r.o., Czech Republic.
Compliance with ethical standards
Conflict of interest
No compensation was provided to Dr. Šumec for his writing of this manuscript. No compensation was provided to Drs. Rektorová, Jech, Menšíková, Roth, Růžička, Sochorová, Dušek, Kaňovský, Rektor, Pavlík, Filip, and Bareš for their revision of the manuscript. Drs. Bareš, Rektorová, Jech, Menšíková, Roth, and Růžička received compensation from Novartis for their sites’ conduct of the study.
Rastislav Šumec, MD: Employment: University Hospital of St. Anne, Brno, Czech Republic, Masaryk University; ICRC-International Clinical Research Center. Irena Rektorová, MD, PhD: Employment: Faculty of Medicine, Masaryk University, Brno, Czech Republic, Central European Institute of Technology, CEITEC MU, Masaryk University, Brno, Czech Republic, St Anne’s University Hospital, Brno, Czech Republic. Consultancies: none. Advisory boards: none. Honoraria: none. Grants: JPND grants (Joint Programme in Neurodegeneration), Grants of the Czech Ministry of Health, mentor for a postdoc Marie Curie grant/SoMoPro. Clinical trials: none for the last 2 years. Robert Jech, MD, PhD: Employment: Charles University in Prague, General Teaching hospital, Prague, Na Homolce Hospital, Prague. Honoraria: co-organized received consultancy fees and organized teaching courses for Abbvie, Cardion, Ipsen and Medtronic. Kateřina Menšíková, MD: Employment: Palacky University in Olomouc, General University Hospital in Olomouc. Honoraria: Lectures for GSK and Novartis. Jan Roth, MD, CSc.: Employment: Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital in Prague, Katerinska 30, 12000 Prague 2, Czech Republic. Honoraria: from Abbvie, UCB, AOP Orphan. Grants:PRVOUK-P26/LF1/4, NT11190-6/2010, NT11331-6/2010, KONTAKT II LH13256, Česko- Norský výzkumný program 7F14308. Clinical Trials: Teva-Legato. Evžen Růžička, MD, DrSc., FCMA. Employment: Charles University in Prague, General University Hospital in Prague. Grants from: EU Horizon 2020, Grant agency of the Czech Republic, Czech Ministry of Health and Charles University in Prague. In the preceding 12 months, he has received honoraria or consulting fees from Merz. Clinical trials: Kyowa, Solvay, Abbvie. Dana Sochorová: Employment: ICRC-International Clinical Research Center. Grants: ICRC project of specific research MUNI/A/1270/2015. Ladislav Dušek, Employment: Institute of Biostatistics and Analyses, Masaryk University, Brno. Petr Kaňovský, MD, CSc.: Employment: Palacky University in Olomouc, University Hospital Olomouc. Consultancies: Merz, Allergan, Medtronic. Advisory boards: Merz. Honoraria: Merz, Ipsen, Medtronic, Lundbeck, Actavis. Grants: IGA MZ CR NT-14407, NT-13575, NT-12221, AZV NV15-31921A. Clinical trials: Kyowa, Merz, Biogen, Novartis, ONO Pharma, Merck Serono. Ivan Rektor, MD, CSc.: Employment: Masaryk University in Brno, St. Anne’s Hospital Brno. Grants: CEITEC. Tomáš Pavlík, MSc, PhD: Employment: Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic. Honoraria: Sanofi-Aventis. Pavel Filip, MD: Employment: University Hospital of St. Anne, Brno, Czech Republic, Masaryk University; Clinical trials: investigator in INREST 1VIT14037. Martin Bareš, MD, PhD: Employment: Masaryk University Anne’s Hospital Brno. Advisory boards: Boehringer Ingelheim. Honoraria: personal compensations for activities with Ipsen, Neomed, Medtronic, Abbvie. Grants: Czech Ministry of Health, Masaryk University. Clinical Trials: Kyowa, Abbvie.
This study has been approved by ethics committee of St. Anne’s University Hospitál and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All participants gave their informed consent prior to their inclusion in the study.
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