Impaired frontal lobe functions in patients with Parkinson's disease and psychosis

Naveen Thota, Abhishek Lenka, Lija George, Shantala Hegde, Shyam Sundar Arumugham, Shweta Prasad, Albert Stezin, Nitish Kamble, Ravi Yadav, Pramod Kumar Pal*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

Introduction Patients with Parkinson's disease (PD) may develop several non-motor symptoms (NMS). Psychosis is one of the debilitating NMS of PD. The neurobiology of psychosis is not fully understood. This study aims to compare the frontal lobe functions of PD patients with and without psychosis using the Frontal Assessment Battery (FAB). Methodology This study included 69 patients with PD; 34 with psychosis (PD-P) and 35 without psychosis (PD-NP). Mini Mental Status Examination (MMSE) was used to screen for cognitive impairment. Unified Parkinson's disease Rating scale part-III (UPDRS-III) was used to measure the severity and Hoehn and Yahr score (H&Y) was used to measure the stage of PD. Frontal lobe functions were assessed by FAB. Results The PD-P and PD-NP groups were comparable for age (58.7 ± 8.4 vs 55.7 ± 8.2, p = 0.14), age at onset of symptoms (51.4 ± 8.1 vs 50.0 ± 8.8, p = 0.48), gender distribution (men: 88%vs 80%, p = 0.51), MMSE (28.2 ± 1.9 vs 28.7 ± 1.2 p = 0.12), levodopa equivalent dose/day (736.0 ± 376.3 vs 625.2 ± 332.2, p = 0.19), UPDRS-III OFF-score (36.7 ± 8.8 vs 35.4 ± 13.2, p = 0.64), UPDRS-III ON-score (13.2 ± 5.4 vs 12.4 ± 6.6, p = 0.44) and H&Y stage (2.3 ± 0.3 vs 2.3 ± 0.3, p = 0.07). PD-P group had lower total FAB score compared to PD-NP group (13.9 ± 2.2 vs 16.5 ± 1.8, p < 0.01). On the FAB, PD-P group had lower scores compared to PD-NP in lexical fluency (FAB-2), programming (FAB-3), sensitivity to interference (FAB-4) and inhibitory control (FAB-5). Conclusion Patients with PD-P had significant frontal lobe dysfunction compared to PD-NP. FAB may be a simple and useful bedside tool to assess frontal dysfunction in patients with PD in a busy neurological set up.

Original languageEnglish
Pages (from-to)192-195
Number of pages4
JournalAsian Journal of Psychiatry
Volume30
DOIs
Publication statusPublished - Dec 2017
Externally publishedYes

Keywords

  • Frontal assessment battery
  • Parkinson's disease
  • Psychosis
  • Visual hallucinations

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