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Accuracy of Machine Learning Using the Montreal Cognitive Assessment for the Diagnosis of Cognitive Impairment in Parkinson’s Disease
Junbeom Jeon, Kiyong Kim, Kyeongmin Baek, Seok Jong Chung, Jeehee Yoon, Yun Joong Kim
J Mov Disord. 2022;15(2):132-139.   Published online May 26, 2022
DOI: https://doi.org/10.14802/jmd.22012
  • 1,150 View
  • 87 Download
AbstractAbstract PDFSupplementary Material
Objective
The Montreal Cognitive Assessment (MoCA) is recommended for assessing general cognition in Parkinson’s disease (PD). Several cutoffs of MoCA scores for diagnosing PD with cognitive impairment (PD-CI) have been proposed, with varying sensitivity and specificity. This study investigated the utility of machine learning algorithms using MoCA cognitive domain scores for improving diagnostic performance for PD-CI.
Methods
In total, 2,069 MoCA results were obtained from 397 patients with PD enrolled in the Parkinson’s Progression Markers Initiative database with a diagnosis of cognitive status based on comprehensive neuropsychological assessments. Using the same number of MoCA results randomly sampled from patients with PD with normal cognition or PD-CI, discriminant validity was compared between machine learning (logistic regression, support vector machine, or random forest) with domain scores and a cutoff method.
Results
Based on cognitive status classification using a dataset that permitted sampling of MoCA results from the same individual (n = 221 per group), no difference was observed in accuracy between the cutoff value method (0.74 ± 0.03) and machine learning (0.78 ± 0.03). Using a more stringent dataset that excluded MoCA results (n = 101 per group) from the same patients, the accuracy of the cutoff method (0.66 ± 0.05), but not that of machine learning (0.74 ± 0.07), was significantly reduced. Inclusion of cognitive complaints as an additional variable improved the accuracy of classification using the machine learning method (0.87–0.89).
Conclusion
Machine learning analysis using MoCA domain scores is a valid method for screening cognitive impairment in PD.
Factors Associated with Medication Beliefs in Patients with Parkinson’s Disease: A Cross-Sectional Study
Sung Reul Kim, Ji Young Kim, Hye Young Kim, Hui Young So, Sun Ju Chung
J Mov Disord. 2021;14(2):133-143.   Published online May 3, 2021
DOI: https://doi.org/10.14802/jmd.20147
  • 3,735 View
  • 105 Download
  • 3 Citations
AbstractAbstract PDFSupplementary Material
Objective
Medication beliefs are a significant determinant of medication adherence in chronic illness. This study aimed to identify demographic, clinical, and medication-related factors associated with medication beliefs in patients with Parkinson’s disease (PD).
Methods
We used a descriptive cross-sectional design with a convenience sample of 173 PD patients who had been taking antiparkinson drugs for more than one year.
Results
The subjects who believed PD medication was more necessary had more severe illness, younger age of onset, longer illness duration, and longer duration of levodopa therapy. They had higher levels of non-motor symptoms and depression, number of medication uses, number of drugs, and levodopa equivalent dose, and they reported fluctuation of motor symptoms and dyskinesia. The subjects who used catechol-O-methyltransferase (COMT) inhibitors, dopamine agonists, amantadine, and monoamine oxidase-B (MAO-B) inhibitors had significantly higher necessity scores than those who did not use them. The subjects who had higher concerns about PD medications had higher levels of non-motor symptoms and depression. The subjects using amantadine and anticholinergics had significantly higher concern scores than those who did not use them. Positive necessity-concerns differentials were associated with severe illness, the presence of motor fluctuation and dyskinesia, and the use of COMT inhibitors. Based on stepwise multiple regression, the most significant factors influencing necessity beliefs were severe illness, followed by depression and motor fluctuation.
Conclusion
Severe illness, higher levels of depression, and motor fluctuation are independent factors influencing patients’ beliefs regarding medication necessity. Therefore, these characteristics should be considered in medication belief assessment and interventions for PD patients.

Citations

Citations to this article as recorded by  
  • Effect of Pillbox Organizers with Alarms on Adherence to Pharmacotherapy in Parkinson Disease Patients Taking Three and More Daily Doses of Dopaminergic Medications
    Igor Straka, Michal Minar, Milan Grofik, Matej Skorvanek, Veronika Bolekova, Andrea Gazova, Jan Kyselovic, Peter Valkovic
    Journal of Personalized Medicine.2022; 12(2): 179.     CrossRef
  • Factors Related to Beliefs about Medication in Ischemic Stroke Patients
    Gye-Gyoung Kim, Sung-Hee Yoo, Man-Seok Park, Hyun-Young Park, Jae-Kwan Cha
    Journal of Clinical Medicine.2022; 11(13): 3825.     CrossRef
  • Lycium barbarum polysaccharide improves dopamine metabolism and symptoms in an MPTP-induced model of Parkinson’s disease
    Jiangbo Song, Lian Liu, Zhiquan Li, Ting Mao, Jianfei Zhang, Lei Zhou, Xin Chen, Yunzhu Shang, Tao Sun, Yuxin Luo, Yu Jiang, Duan Tan, Xiaoling Tong, Fangyin Dai
    BMC Medicine.2022;[Epub]     CrossRef
The Non-Motor Symptom Profile of Progressive Supranuclear Palsy
Sudhakar Pushpa Chaithra, Shweta Prasad, Vikram Venkappayya Holla, Albert Stezin, Nitish Kamble, Ravi Yadav, Pramod Kumar Pal
J Mov Disord. 2020;13(2):118-126.   Published online April 6, 2020
DOI: https://doi.org/10.14802/jmd.19066
  • 5,528 View
  • 224 Download
  • 8 Citations
AbstractAbstract PDF
Objective
Non-motor symptoms (NMSs) significantly contribute to increased morbidity and poor quality of life in patients with parkinsonian disorders. This study aims to explore the profile of NMSs in patients with progressive supranuclear palsy (PSP) using the validated Non-Motor Symptom Scale (NMSS).
Methods
Seventy-six patients with PSP were evaluated in this study. Motor symptoms and NMSs were evaluated using the PSP Rating Scale (PSPRS), Unified Parkinson’s Disease Rating Scale-III, Montreal Cognitive Assessment, Hamilton Depression (HAMD) and Anxiety Rating Scales, Parkinson’s Disease Sleep Scale (PDSS) and NMSS. NMS severity and prevalence were also compared between patients with PSP-Richardson syndrome (PSP-RS) and those with PSP-parkinsonism.
Results
All subjects in this cohort reported at least 2 NMSs. The most prevalent NMSs in patients with PSP were in the domains of sleep/fatigue, mood/cognition, and sexual function. The least prevalent NMSs were in the domains of cardiovascular including falls, and perceptual problems/hallucinations. Significant correlations were observed between the NMSS scores and HAM-D, PDSS, PSPRS scores and PSPRS sub-scores. The severity of NMSs was unrelated to the duration of illness. Patients with PSP-RS reported a higher severity of drooling, altered smell/taste, depression and altered interest in sex and a higher prevalence of sexual dysfunction.
Conclusion
NMSs are commonly observed in patients with PSP, and the domains of sleep, mood and sexual function are most commonly affected. These symptoms contribute significantly to disease morbidity, and clinicians should pay adequate attention to identifying and addressing these symptoms.

Citations

Citations to this article as recorded by  
  • A Systematic Review of Apathy and Depression in Progressive Supranuclear Palsy
    Joshua Flavell, Peter J. Nestor
    Journal of Geriatric Psychiatry and Neurology.2022; 35(3): 280.     CrossRef
  • The Burden of Progressive Supranuclear Palsy on Patients, Caregivers, and Healthcare Systems by PSP Phenotype: A Cross-Sectional Study
    Demetris Pillas, Alexander Klein, Teresa Gasalla, Andreja Avbersek, Alexander Thompson, Jack Wright, Jennifer Mellor, Anna Scowcroft
    Frontiers in Neurology.2022;[Epub]     CrossRef
  • Autonomic dysfunction in progressive supranuclear palsy
    Francesca Baschieri, Maria Vitiello, Pietro Cortelli, Giovanna Calandra-Buonaura, Francesca Morgante
    Journal of Neurology.2022;[Epub]     CrossRef
  • Fatigue in hypokinetic, hyperkinetic, and functional movement disorders
    Ilaria Antonella Di Vico, Giovanni Cirillo, Alessandro Tessitore, Mattia Siciliano, Massimo Venturelli, Cristian Falup-Pecurariu, Gioacchino Tedeschi, Francesca Morgante, Michele Tinazzi
    Parkinsonism & Related Disorders.2021; 86: 114.     CrossRef
  • Prevalence and Characteristics of Polyneuropathy in Atypical Parkinsonian Syndromes: An Explorative Study
    Rachel Rohmann, Eva Kühn, Raphael Scherbaum, Lovis Hilker, Saskia Kools, Leonard Scholz, Katharina Müller, Sophie Huckemann, Christiane Schneider-Gold, Ralf Gold, Kalliopi Pitarokoili, Lars Tönges, Eun Hae Kwon
    Brain Sciences.2021; 11(7): 879.     CrossRef
  • Understanding fatigue in progressive supranuclear palsy
    Jong Hyeon Ahn, Joomee Song, Dong Yeong Lee, Jinyoung Youn, Jin Whan Cho
    Scientific Reports.2021;[Epub]     CrossRef
  • “Parkinson’s disease” on the way to progressive supranuclear palsy: a review on PSP-parkinsonism
    Ján Necpál, Miroslav Borsek, Bibiána Jeleňová
    Neurological Sciences.2021; 42(12): 4927.     CrossRef
  • Clinical progression of progressive supranuclear palsy: impact of trials bias and phenotype variants
    Duncan Street, Maura Malpetti, Timothy Rittman, Boyd C P Ghosh, Alexander G Murley, Ian Coyle-Gilchrist, Luca Passamonti, James B Rowe
    Brain Communications.2021;[Epub]     CrossRef
Individual Therapeutic Singing Program for Vocal Quality and Depression in Parkinson’s Disease
Eun Young Han, Ji Young Yun, Hyun Ju Chong, Kyoung-Gyu Choi
J Mov Disord. 2018;11(3):121-128.   Published online August 9, 2018
DOI: https://doi.org/10.14802/jmd.17078
  • 10,056 View
  • 253 Download
  • 8 Citations
AbstractAbstract PDFSupplementary Material
Objective
Patients with Parkinson’s disease (PD) frequently experience depression associated with voice problems. Singing involves the use of similar muscles and the neural networks associated with vocal function and emotional response. The purpose of this study is to enhance vocal quality and depressive symptoms of patients with PD using individual singing program.
Methods
The Individual Therapeutic Singing Program for PD (ITSP-PD) was conducted by a certified music therapist. In total, nine PD patients with a subjective voice problem or depression participated in 6 sessions over 2 weeks. We measured the Maximum Phonation Time (MPT) via the Praat test, the Voice Handicap Index (VHI), the Voice-Related Quality of Life (V-RQOL) and the Geriatric Depression Scale (GDS).
Results
In total, 8 out of 9 patients completed all the sessions; 6 out of 8 patients participated in the follow-up test after 6 months. A statistically significant change in MPT (p = 0.011) was observed between the pre- and post-tests. The VHI (p = 0.035) and the GDS (p = 0.018) were significantly lower in the post-test. In the pre-, post-, and follow-up tests, the MPT (p = 0.030), V-RQOL (p = 0.008), and GDS (p = 0.009) were significantly changed.
Conclusion
The ITSP-PD based on neurological singing therapy for PD showed therapeutic possibility for vocal function and depression in patients with PD. Our findings suggest the need for a randomized study to examine the continuing positive effects of the ITSP-PD over a longer period of time.

Citations

Citations to this article as recorded by  
  • Group singing improves both physical and psychological wellbeing in people with and without chronic health conditions: A narrative review
    Quinn Campbell, Sally Bodkin-Allen, Nicola Swain
    Journal of Health Psychology.2022; 27(8): 1897.     CrossRef
  • Defining the Therapeutic Singing Voice: Further Examination of the Everyday Singing Practices of Music Therapists
    Martina C Bingham, Elizabeth K Schwartz, Anthony Meadows
    Music Therapy Perspectives.2022; 40(1): 3.     CrossRef
  • Music affects functional brain connectivity and is effective in the treatment of neurological disorders
    Luisa Speranza, Salvatore Pulcrano, Carla Perrone-Capano, Umberto di Porzio, Floriana Volpicelli
    Reviews in the Neurosciences.2022; 33(7): 789.     CrossRef
  • Acute effects of singing on cardiovascular biomarkers
    Kamila Somayaji, Mogen Frenkel, Luai Tabaza, Alexis Visotcky, Tanya Kruse Ruck, Ernest Kwesi Ofori, Michael E. Widlansky, Jacquelyn Kulinski
    Frontiers in Cardiovascular Medicine.2022;[Epub]     CrossRef
  • Music Therapy and Parkinson’s Disease: A Systematic Review from 2015–2020
    Manuel Joaquín Machado Sotomayor, Víctor Arufe-Giráldez, Gerardo Ruíz-Rico, Rubén Navarro-Patón
    International Journal of Environmental Research and Public Health.2021; 18(21): 11618.     CrossRef
  • The use of music as an arts-based method in migrant health research: a scoping review protocol
    Fran Garry, Sylvia Murphy Tighe, Anne MacFarlane, Helen Phelan
    HRB Open Research.2020; 3: 75.     CrossRef
  • Walking the thin white line – managing voice in the older adult
    Jacqui Allen, Anna Miles
    Speech, Language and Hearing.2019; 22(1): 25.     CrossRef
  • Music Therapy and Music-Based Interventions for Movement Disorders
    Kerry Devlin, Jumana T. Alshaikh, Alexander Pantelyat
    Current Neurology and Neuroscience Reports.2019;[Epub]     CrossRef
Sleepiness and Depression in Parkinson’s Disease Patients Treated with Ropinirole and Levodopa
Suk Yun Kang, Ho-Sung Ryu, Mun-Kyung Sunwoo, Sang-Jin Kim, Jong-Sam Baik, Mee-Young Park, Hyung-Eun Park, Joong-Seok Kim, Kyum-Yil Kwon, Seong-Beom Koh, Young-Eun Kim, Mi-Kyong Lee, Jong-Min Kim, Sun Ju Chung, Young-Ho Sohn
J Mov Disord. 2017;10(3):123-129.   Published online September 22, 2017
DOI: https://doi.org/10.14802/jmd.17048
  • 6,573 View
  • 183 Download
  • 8 Citations
AbstractAbstract PDF
Objective
We aimed to investigate the effect of ropinirole on excessive daytime sleepiness (EDS) and depression in Parkinson’s disease (PD) with a large population.
Methods
We conducted a cross-sectional observational study at nine hospitals in Korea between April 24, 2013, and April 22, 2015. We analyzed the demographic and clinical features, other medical history, history of antiparkinsonian medication within 6 months, Hoehn and Yahr stage (HY stage), Unified Parkinson’s Disease Rating Scale (UPDRS) part II and III, Epworth Sleepiness Scale (ESS), and 30-item Geriatric Depression Scale (GDS-30).
Results
Four-hundred-thirteen patients with PD (mean age: 65.2 ± 9.0 years; men: 227 patients) were analyzed. Multivariate logistic regression analysis showed that age at examination, UPDRS II, and GDS-30 were independent risk factors for EDS and that sex, UPDRS II, and ESS were independent risk factors for depression.
Conclusion
Our large group study did not find any significant associations of ropinirole with EDS and depression in Korean PD patients.

Citations

Citations to this article as recorded by  
  • Excessive daytime sleepiness in Parkinson's disease: A systematic review and meta-analysis
    Fei Feng, YingYing Cai, YanBing Hou, Ruwei Ou, Zheng Jiang, HuiFang Shang
    Parkinsonism & Related Disorders.2021; 85: 133.     CrossRef
  • Sleep Disorders and Cognitive Dysfunctions in Parkinson’s Disease: A Meta-Analytic Study
    Gianpaolo Maggi, Luigi Trojano, Paolo Barone, Gabriella Santangelo
    Neuropsychology Review.2021; 31(4): 643.     CrossRef
  • Longitudinal risk factors for developing depressive symptoms in Parkinson's disease
    Tarek Antar, Huw R. Morris, Faraz Faghri, Hampton L. Leonard, Mike A. Nalls, Andrew B. Singleton, Hirotaka Iwaki
    Journal of the Neurological Sciences.2021; 429: 117615.     CrossRef
  • The effect and safety of ropinirole in the treatment of Parkinson disease
    Jiali Zhu, Min Chen
    Medicine.2021; 100(46): e27653.     CrossRef
  • Pramipexole regulates depression-like behavior via dopamine D3 receptor in a mouse model of Parkinson’s disease
    Shi-Zhuang Wei, Xiao-Yu Yao, Chen-Tao Wang, An-Qi Dong, Dan Li, Yu-Ting Zhang, Chao Ren, Jin-Bao Zhang, Cheng-Jie Mao, Fen Wang, Chun-Feng Liu
    Brain Research Bulletin.2021; 177: 363.     CrossRef
  • A selective D2 dopamine receptor agonist alleviates depression through up-regulation of tyrosine hydroxylase and increased neurogenesis in hippocampus of the prenatally stressed rats
    Mahino Fatima, Mir Hilal Ahmad, Saurabh Srivastav, Moshahid Alam Rizvi, A.C. Mondal
    Neurochemistry International.2020; 136: 104730.     CrossRef
  • ‘Dopamine agonist Phobia’ in Parkinson’s disease: when does it matter? Implications for non-motor symptoms and personalized medicine
    Silvia Rota, Iro Boura, Lucia Batzu, Nataliya Titova, Peter Jenner, Cristian Falup-Pecurariu, K Ray Chaudhuri
    Expert Review of Neurotherapeutics.2020; 20(9): 953.     CrossRef
  • An Investigation on the Clinical Features and Neurochemical Changes in Parkinson's Disease With Depression
    Teng-Hong Lian, Peng Guo, Li-Jun Zuo, Yang Hu, Shu-Yang Yu, Li Liu, Zhao Jin, Qiu-Jin Yu, Rui-Dan Wang, Li-Xia Li, Ying-Shan Piao, Wei Zhang
    Frontiers in Psychiatry.2019;[Epub]     CrossRef

JMD : Journal of Movement Disorders