Preexisting Bipolar Disorder Influences the Subsequent Phenotype of Parkinson's Disease.

Content Provider	Europe PMC
Author	Onofrj, Marco Di Iorio, Angelo Carrarini, Claudia Russo, Mirella Franciotti, Raffaella Espay, Alberto J. Boylan, Laura S. Taylor, John‐Paul Di Giannantonio, Massimo Martinotti, Giovanni Valente, Enza M. Thomas, Astrid Bonanni, Laura Delli Pizzi, Stefano Dono, Fedele Sensi, StefanoL.
Abstract	AbstractBackgroundPatients with bipolar spectrum disorders (BSDs) exhibit an increased risk of Parkinson's disease (PD).ObjectiveThe aim is to investigate whether a previous diagnosis of BSDs influences the phenotype of PD.MethodsOf 2660 PD patients followed for at least 6 years (6–27), 250 (BSD‐PD) had BSDs, 6–20 years before PD diagnosis; 48%–43% had a PD or BSD family history, and 34 carried glucocerebrosidase (GBA) and Parkin (PRKN) mutations. The cohort was split into a subset of 213 BSD‐PD patients, compared with 426 matched PD patients without BSDs, and a subset of 34 BSD‐PD and 79 PD patients carrying GBA or PRKN mutations. Carriers of mutations absent in BSD‐PD patients and of synuclein triplication were excluded. Structured clinical interviews and mood disorder questionnaires assessed BSDs. Linear mixed models evaluated the assessment scales over time. Thirteen BSD‐PD patients underwent subthalamic nucleus deep brain stimulation (STN‐DBS) and were compared with 27 matched STN‐DBS‐treated PD patients.ResultsCompared to PD patients, BSD‐PD showed (1) higher frequency of family history of PD (odds ratio [OR] 3.31; 2.32–4.71) and BSDs (OR 6.20; 4.11–9.35) 5); (2) higher incidence of impulse control disorders (hazard ratio [HR] 5.95, 3.89–9.09); (3) higher frequency of functional disorders occurring before PD therapy (HR, 5.67, 3.95–8.15); (4) earlier occurrence of delusions or mild dementia (HR, 7.70, 5.55–10.69; HR, 1.43, 1.16–1.75); and (5) earlier mortality (1.48; 1.11–1.97). Genetic BSD‐PD subjects exhibited clinical features indistinguishable from nongenetic BSD‐PD subjects. STN‐DBS‐treated BSD‐PD patients showed no improvements in quality of life compared to the control group.ConclusionsBSDs as a prodrome to PD unfavorably shape their course and are associated with detrimental neuropsychiatric features and treatment outcomes. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC9292484&blobtype=pdf
Page Count	13
ISSN	08853185
Journal	Movement Disorders [Mov Disord]
Volume Number	36
DOI	10.1002/mds.28745
PubMed Central reference number	PMC9292484
Issue Number	12
PubMed reference number	34427338
e-ISSN	15318257
Language	English
Publisher	John Wiley & Sons, Inc.
Publisher Date	2021-08-24
Publisher Place	Hoboken, USA
Access Restriction	Open
Rights License	This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
Subject Keyword	bipolar spectrum disorders glucocerebrosidase mutation parkin mutation Parkinson's disease subthalamic nucleus deep brain stimulation
Content Type	Text
Resource Type	Article
Subject	Neurology Neurology (clinical)