Current Medical Science

, Volume 39, Issue 1, pp 122–126 | Cite as

Neuropsychiatric Symptoms and Cognitive Impairment in Chinese Patients with Parkinson’s Disease in Han and Hui Ethnicity

  • Mei-ling Yao
  • Hong ZhangEmail author
  • Yan Xu
  • Sheng-ming Zhang
  • Yong-zhe Gao
  • Min Shu
  • Jun-Jian Zhang


Neuropsychiatric symptoms are common in patients with Parkinson’s disease (PD) and they are likely to outweigh the motor symptoms and become a major factor affecting the quality of life of PD patients. However, the studies focusing on the non-motor symptoms in Chinese PD patients from different ethnicity are scarce. The aim of this retrospective study was to investigate neuropsychiatric symptoms and cognitive impairment in Chinese PD patients from Han and Hui populations from central China. Seventy-two Han Chinese PD patients (Han PD group) and 71 age-and sex-matched Hui Chinese PD patients (Hui PD group) were enrolled from Zhongnan Hospital of Wuhan University between Sept. 2011 and Aug. 2014 in the study. The neuropsychiatric symptoms and cognitive impairment were assessed using Neuropsychiatric Inventory (NPI) and Mini Mental State Examination (MMSE). We found that the proportion of depression, anxiety, apathy, irritability, euphoria and night time behavior disturbances were higher in the Han PD group than in the Hui PD group (P<0.05 or P<0.01). But the proportion of delusion, hallucination, agitation, disinhibition, aberrant motor behavior and change in appetite were not significantly different between the Han PD group and the Hui PD group (P>0.05). The total mean scores of the MMSE from patients in the Han PD group were similar to those in the Hui PD group (P>0.05). However, the subscale scores of recall domain and language domain in the Han PD group were significantly different from those in the Hui PD group (P<0.05). No significant difference was noted in the orientation, memory and calculation domains between the two PD groups (P>0.05). This study first showed the recall domain and language domain were different between the Han PD patients and the Hui PD patients. Depression, anxiety, apathy, irritability, euphoria and night time behavior disturbances were less presented in the Hui PD patients. All these differences may be related to the different ethnicity, which would be helpful for clinical physicians to recognize the different non-motor symptoms in Chinese PD patients with different ethnicity.

Key words

Parkinson’s disease neuropsychiatric symptoms cognitive impairment Han Chinese Hui Chinese 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Martinez–Martin P, Rodriguez–Blazquez C, Forjaz MJ, et al. Measurement of nonmotor symptoms in clinical practice. Int Rev Neurobiol, 2017,133:291–345CrossRefGoogle Scholar
  2. 2.
    Garbayo E, Ansorena E, Blanco–Prieto MJ. Drug development in Parkinson’s disease: From emerging molecules to innovative drug delivery systems. Maturitas, 2013,76(3):272–278CrossRefGoogle Scholar
  3. 3.
    Kalia SK, Sankar T, Lozano AM. Deep brain stimulation for Parkinson’s disease and other movement disorders. Curr Opin Neurol, 2013,26(4):374–380CrossRefGoogle Scholar
  4. 4.
    Rodriguez–Oroz MC, Moro E, Krack P. Long–term outcomes of surgical therapies for Parkinson’s disease. Mov Disord, 2012,27(14):1718–1728CrossRefGoogle Scholar
  5. 5.
    Coune PG, Schneider BL, Aebischer P. Parkinson’s disease: gene therapies. Cold Spring Harb Perspect Med, 2012,2(4):a009431CrossRefGoogle Scholar
  6. 6.
    Monteiro L, Souza–Machado A, Valderramas S, et al. The effect of levodopa on pulmonary function in Parkinson’s disease: a systematic review and metaanalysis. Clin Ther, 2012,34(5):1049–1055CrossRefGoogle Scholar
  7. 7.
    Politis M, Lindvall O. Clinical application of stem cell therapy in Parkinson’s disease. BMC Med, 2012,10:1CrossRefGoogle Scholar
  8. 8.
    Lohle M, Reichmann H. Clinical neuroprotection in Parkinson’s disease–still waiting for the breakthrough. J Neurol Sci, 2010,289(1–2):104–114CrossRefGoogle Scholar
  9. 9.
    Zhang ZX, Roman GC, Hong Z, et al. Parkinson’s disease in China: prevalence in Beijing, Xi’an, and Shanghai. Lancet, 2005,365(9459):595–597CrossRefGoogle Scholar
  10. 10.
    Lang AE, Lozano AM. Parkinson’s disease. First of two parts. N Engl J Med, 1998,339(15): 1044–1053CrossRefGoogle Scholar
  11. 11.
    Ramirez A, Heimbach A, Gründemann J, et al Hereditary parkinsonism with dementia is caused by mutations in ATP13A2, encoding a lysosomal type 5 P–type ATPase. Nat Genet, 2006,38(10):1184–1191CrossRefGoogle Scholar
  12. 12.
    Li G, Zhang Z, Xia H, et al. Analysis of Thr12Met and Ala1144Thr mutations of the ATP13A2 gene in Parkinson’s disease patients in Xinjiang Uygur and Han ethnic groups. Med Sci Monit, 2014,20:2177–2182CrossRefGoogle Scholar
  13. 13.
    Luo Q, Yang X, Yao Y, et al. T313M polymorphism of the PINK1 gene in Parkinson’s disease. Exp Ther Med, 2014,8(1):286–290CrossRefGoogle Scholar
  14. 14.
    Shang Y, Zhang X, Li Y, et al. Comparison of clinical symptoms for Uygur and Han Parkinson’s disease patients. Zhonghua Yi Xue Za Zhi (Chinese), 2014,94(1):31–35Google Scholar
  15. 15.
    Hughes AJ, Daniel SE, Kilford L, et al. Accuracy of clinical diagnosis of idiopathic Parkinson’s: a clinicpathological study of 100 cases. J Neurol Neurosurg Psychiatry, 1992,55(3):181–184CrossRefGoogle Scholar
  16. 16.
    Li H, Zhang M, Chen L, et al. Nonmotor symptoms are independently associated with impaired health–related quality of life in Chinese patients with Parkinson’s disease. Mov Disord, 2010,25(16):2740–2746CrossRefGoogle Scholar
  17. 17.
    Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology, 1967,17(5):427–442CrossRefGoogle Scholar
  18. 18.
    Folstein MF, Folstein SE, McHugh PR. “Mini–mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res, 1975,12(3):189–198CrossRefGoogle Scholar
  19. 19.
    Jin YL, Zhang H, Gao YZ, et al. Neuropsychiatric symptoms in patients with vascular dementia in mainland China. Transl Neurosci, 2015,6(1):157–161CrossRefGoogle Scholar
  20. 20.
    Klepac N, Hajnsek S, Trkulja V. Impact of pre–morbid depression on health–related quality of life in nondemented Parkinson’s disease patients. Parkinsonism Relat Disord, 2010,16(1):21–27CrossRefGoogle Scholar
  21. 21.
    Cummings JL, Mega M, Gray K, et al. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 1994, 44(12):2308–2314CrossRefGoogle Scholar
  22. 22.
    Cummings JL. The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology, 1997,48:S10–S16CrossRefGoogle Scholar
  23. 23.
    Leroi I, Pantula H, McDonald K, et al. Neuropsychiatric symptoms in Parkinson’s disease with mild cognitive impairment and dementia. Parkinsons Dis, 2012,2012:308097Google Scholar
  24. 24.
    Leung VP, Lam LC, Chiu HF, et al. Validation study of the Chinese version of the neuropsychiatric inventory (CNPI). Int J Geriatr Psychiatry, 2001,16(8):789–793CrossRefGoogle Scholar
  25. 25.
    Wang T, Xiao S, Li X, et al. Reliability and validity of the Chinese version of the neuropsychiatric inventory in mainland China. Int J Geriatr Psychiatry, 2012,27(5):539–544CrossRefGoogle Scholar
  26. 26.
    Braak H, Del Tredici K, Rüb U, et al. Staging of brain pathology related to sporadic Parkinson’s disease. Neurobiol Aging, 2003,24(2):197–211CrossRefGoogle Scholar
  27. 27.
    Skogseth RE, Bronnick K, Pereira JB, et al. Associations between cerebrospinal fluid biomarkers and cognition in early untreated Parkinson’s disease. J Parkinsons Dis, 2015,5(4):783–792CrossRefGoogle Scholar
  28. 28.
    Aarsland D, Tandberg E, Larsen JP, et al. Frequency of dementia in Parkinson disease. Arch Neurol, 1996,53(6):538–542CrossRefGoogle Scholar
  29. 29.
    Tsai CF, Lee YT, Lee WJ, et al. Depression of family caregivers is associated with disagreements on lifesustaining preferences for treating patients with dementia. PLoS One, 2015,10(7):e0133711CrossRefGoogle Scholar
  30. 30.
    Cooney JW, Stacy M. Neuropsychiatric Issues in Parkinson’s disease. Curr Neurol Neurosci Rep, 2016,16(5):49CrossRefGoogle Scholar
  31. 31.
    Aarsland D, Larsen JP, Lim NG, et al. Range of neuropsychiatric disturbances in patients with Parkinson’s disease. J Neurol Neurosurg Psychiatry, 1999,67(4):492–496CrossRefGoogle Scholar
  32. 32.
    Fénelon G, Alves G. Epidemiology of psychosis in Parkinson’s disease. J Neurol Sci, 2010,289(1–2):12–17CrossRefGoogle Scholar
  33. 33.
    Pereira JB, Svenningsson P, Weintraub D, et al. Initial cognitive decline is associated with cortical thinning in early Parkinson disease. Neurology, 2014,82(22):2017–2025CrossRefGoogle Scholar
  34. 34.
    Aarsland D, Bronnick K, Williams–Gray C, et al. Mild cognitive impairment in Parkinson disease: a multicenter pooled analysis. Neurology, 2010,75(12):1062–1069CrossRefGoogle Scholar
  35. 35.
    Caviness JN, Driver–Dunckley E, Connor DJ, et al. Defining mild cognitive impairment in Parkinson’s disease. Mov Disord, 2007,22(9):1272–1277CrossRefGoogle Scholar

Copyright information

© Huazhong University of Science and Technology 2019

Authors and Affiliations

  • Mei-ling Yao
    • 1
  • Hong Zhang
    • 1
    • 2
    Email author
  • Yan Xu
    • 1
    • 2
  • Sheng-ming Zhang
    • 1
    • 2
  • Yong-zhe Gao
    • 1
    • 2
  • Min Shu
    • 1
    • 2
  • Jun-Jian Zhang
    • 1
    • 2
  1. 1.Department of NeurologyZhongnan Hospital of Wuhan UniversityWuhanChina
  2. 2.Teaching and Research Section of NeuropsychiatryZhongnan Hospital of Wuhan UniversityWuhanChina

Personalised recommendations