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Prediction of Parkinson’s disease subsequent to severe depression: a ten-year follow-up study

Journal of Neural Transmission volume 122, pages 789–797 (2015)Cite this article

Abstract

Major depressive disorder (MDD) has been associated with an increased risk of subsequent Parkinson’s disease (PD) in case–control and cohort studies. However, depression alone is unlikely to be a useful marker of prodromal PD due to its low specificity. In this longitudinal observational study, we assessed whether the presence of other potential markers of prodromal PD predicts the subsequent development of PD in MDD patients. Of 57 patients with severe MDD but no diagnosis of PD who underwent a structured interview, olfactory and motor investigation and transcranial sonography at baseline, 46 (36 women; mean age 54.9 ± 11.7 years) could be followed for up to 11 (median, 10) years. Three patients (2 women; age 64, 65 and 70 years) developed definite PD after 1, 7, and 9 years, respectively. The combined finding of mild asymmetric motor slowing, idiopathic hyposmia, and substantia nigra hyperechogenicity predicted subsequent PD in all patients who could be followed for longer than 1 year. Out of the whole study cohort, only the subjects with subsequent PD presented with the triad of asymmetric motor slowing, idiopathic hyposmia, and substantia nigra hyperechogenicity in combination with at least two out of four reportable risk factors (family history of PD, current non-smoker, non-coffee drinker, constipation) at baseline investigation. Post-hoc analysis revealed that additional rating of eye and eye-lid motor abnormalities might further improve the prediction of PD in larger cohorts. Findings of this pilot-study suggest that MDD patients at risk of subsequent PD can be identified using an inexpensive non-invasive diagnostic battery.

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The authors have no financial interests that relate to research covered in this article.

Author information

Affiliations

  1. Department of Neurology, University of Rostock, Rostock, Germany

    Uwe Walter, Robert Heilmann, Lara Kaulitz & Reiner Benecke

  2. Department of Otorhinolaryngology, Head and Neck Surgery, University of Rostock, Rostock, Germany

    Tino Just

  3. Department of Nuclear Medicine, University of Rostock, Rostock, Germany

    Bernd Joachim Krause

  4. Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany

    Jacqueline Höppner

  5. Klinik und Poliklinik fuer Neurologie, Universitaetsmedizin Rostock, Gehlsheimer Str. 20, 18147, Rostock, Germany

    Uwe Walter

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  1. Uwe Walter
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  2. Robert Heilmann
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  3. Lara Kaulitz
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  4. Tino Just
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  5. Bernd Joachim Krause
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  6. Reiner Benecke
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  7. Jacqueline Höppner
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Correspondence to Uwe Walter.

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Walter, U., Heilmann, R., Kaulitz, L. et al. Prediction of Parkinson’s disease subsequent to severe depression: a ten-year follow-up study. J Neural Transm 122, 789–797 (2015). https://doi.org/10.1007/s00702-014-1313-0

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  • DOI: https://doi.org/10.1007/s00702-014-1313-0

Keywords

  • Parkinsonism
  • Major depressive disorder
  • Transcranial ultrasound
  • Hyposmia
  • Motor testing
  • Substantia nigra