Byline: Viviana. Lo Buono, Rosanna. Palmeri, Simona. De Salvo, Matteo. Berenati, Agata. Greco, Rosella. Ciurleo, Chiara. Sorbera, Vincenzo. Cimino, Francesco. Corallo, Placido. Bramanti, Silvia. Marino, Giuseppe. Di Lorenzo, Lilla. Bonanno
Anxiety and depression in Parkinson's disease (PD) reduce well-being of the patients. Emotional alterations influence motor skills and cognitive performance; moreover, they contribute significantly and independently to worsen rehabilitative treatment response. We investigated anxiety, depression, and quality of life in PD patients subjected to multidisciplinary rehabilitative training. The self-controlled study included 100 PD patients (49 males and 51 females with the mean age of 64.66 years) admitted to 60 days hospitalization rehabilitative program, between January 2017 and December 2018. Motor, cognitive, linguistic abilities, and functional independence were evaluated at admission (T0 baseline visit) and 60 days after (T1) the multidisciplinary rehabilitation including motor exercises, speech therapies, and cognitive intervention. The multidisciplinary rehabilitation improved functional status in PD patients and exerted its positive effects on mood, motor abilities, autonomy in the activities of daily life, perception of quality of life, cognitive performance and speech skills. Non-motor symptoms may worsen severe disability and reduce quality of life. They are often poorly recognized and inadequately treated. Nonetheless, multidisciplinary rehabilitative training represents an optimal strategy to improve disease management. The study was approved by Istituito di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi 'Bonino-Pulejo' Ethical Committee (approval No. 6/2016) in June 2016.
Parkinson's disease (PD) is a neurodegenerative disorder related to dopaminergic innervation loss in the substantia nigra. PD is characterized by motor symptoms including tremor, postural instability, muscle rigidity and bradykinesia (Bhat et al., 2018) and non-motor symptoms such as cognitive impairment, olfactory dysfunctions and mood alterations (Van Laar and Jain, 2004).
Non-motor symptoms in PD represent one of the major challenges faced in the management of disease. These symptoms are often underdiagnosed and do not respond adequately to dopaminergic therapy (Fabbri et al., 2017; Ztaou et al., 2018). Non-motor symptoms, like depression or anxiety (Palmeri et al., 2017) may impair patient's quality of life (QoL), worsen daily living activities, reduce the opportunities of leisure and a normal social life and compromise psychological well-being (D'Iorio et al., 2017; Ciurleo et al., 2018; Lerman et al., 2019). Several studies also showed the influence of emotional disturbances on motor skills, in particular on walking speed and gait initiation reaction time (Avanzino et al., 2018; Jazaeri et al., 2018). Episodic anxiety has been associated with motor fluctuations (Chen and Marsh, 2014) and freezing episodes are highly correlated with the presence of panic disorders (Lauterbach et al., 2003).
PD patients frequently present mild cognitive impairment (MCI). MCI indicates a syndrome of cognitive decline greater than expected based on age and the level of education, however, does not interfere with the ability to perform daily life activities (Petersen et al, 2014).
This decreased cognitive performance in multiple domains represents a risk factor for the increase of anxiety and depression (Corallo et al., 2017; Petkus et al., 2019). It has been shown that depressive mood affects...