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Role of Neuropsychiatric Assessment in Diagnosis and Research

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Atypical Parkinsonian Disorders

Part of the book series: Current Clinical Neurology ((CCNEU))

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Abstract

Although the basal ganglia have traditionally been considered as primarily involved in the regulation of motor functioning, their role in the integration of emotions with cognitive and motor behavior is increasingly recognized. Psychiatric symptoms, including disturbance of affect (anxiety and depression), perception (hallucinations), thought (delusions), as well as behavioral and personality changes (apathy and disinhibition) are commonly observed in most basal ganglia diseases. They produce increased suffering and distress both for the patients themselves as well as for the caregivers, and are associated with increased need for care. Thus, psychiatric symptoms should not be viewed as a secondary or additional feature of the movement disorders, but rather, representing important and inherent aspects of these disorders. Although this is true for Parkinson’s disease (PD), it is even more so for several of the atypical parkinsonian disorders, where psychiatric symptoms may represent key features of the clinical syndrome. For instance, in dementia with Lewy bodies, visual hallucinations are among the three cardinal features (1), and in focal lesions of the caudate, neuropsychiatric symptoms occur more commonly than motor disorders (2). Knowledge of the wide variety of psychiatric symptoms and having the diagnostic skills to identify and optimize treatment of these symptoms are thus of major importance in the management of patients with movement disorders. In addition to providing important diagnostic information, they help elucidate the relationship between key brain circuits and psychiatric symptoms.

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Author information

Authors and Affiliations

  1. Centre for Neuro and Geriatric Psychiatric Research, Rogaland Central Hospital, Stavanger, Norway

    Dag Aarsland PhD & Uwe Ehrt MD

  2. Wolfson Centre for Age-Related Diseases, Kings College London, London, UK

    Clive Ballard PhD

Authors
  1. Dag Aarsland PhD
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  2. Uwe Ehrt MD
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  3. Clive Ballard PhD
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Editor information

Editors and Affiliations

  1. Movement Disorder Program, Department of Neurology, University of Louisville School of Medicine, Louisville, KY

    Irene Litvan MD (Raymond Lee Lebby Professor of Parkinson Disease Research, Director) (Raymond Lee Lebby Professor of Parkinson Disease Research, Director)

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© 2005 Humana Press Inc., Totowa, NJ

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Aarsland, D., Ehrt, U., Ballard, C. (2005). Role of Neuropsychiatric Assessment in Diagnosis and Research. In: Litvan, I. (eds) Atypical Parkinsonian Disorders. Current Clinical Neurology. Humana Press. https://doi.org/10.1385/1-59259-834-X:163

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  • DOI: https://doi.org/10.1385/1-59259-834-X:163

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