Association between dopaminergic dysfunction and anxiety in de novo Parkinson's disease

Abstract

Objectives: To explore the relationships between nigrostriatal dysfunction and neuropsychiatric symptoms (including anxiety, depression and apathy) in a large cohort of newly diagnosed, drug-naïve Parkinson disease (PD) patients compared to a cohort of healthy controls (HC).

Methods: This is a cross-sectional analysis of the Parkinson's Progression Markers Initiative (PPMI) cohort at baseline, including 405 PD patients and 187 HC. Nigrostriatal degeneration was evaluated by means of SPECT DAT scan. Relationships between neuropsychiatric symptoms and DAT uptakes were analysed by means of stepwise multiple regression analysis.

Results: In the PD group, lower DAT uptake in the right caudate was associated with higher STAI trait subscore (β = -2.939, 95%CI: -4.634 to -1.254, p = 0.001). Depression and apathy scores were not related with DAT uptakes. No associations were found in the HC group.

Conclusions: Our cross-sectional analysis of the PPMI data shows that lower caudate DAT uptake is associated with higher level of anxiety. The data strengthens the relationship between dopaminergic dysfunction and neuropsychiatric symptoms in early PD.

Keywords: Anxiety; Apathy; DAT; Depression; Dopaminergic; Non motor symptoms; Parkinson's disease; SPECT.