A Study On Psychosis And Apathy Symptoms In Parkinson’s Disease

Objective: To study the prevalence,clinical characteristics and risk factors of Parkinson’s disease psychosis(PDP)and apathy in China,analyze the role of gene or imaging indicators in early recognition and diagnosis.Methods: In a crosssectional study,149 PD patients were assessed with the enhanced Scale for the Assessment of Positive Symptoms in PD and the relevant factors were analyzed.In the prospective cohort study,141 PD patients were assessed with Lille apathy scale,and the relevant factors were analyzed.Then we followed up apathy symptoms for 2.5 years.Results: We identified 40.27% PDP patients(minor hallucination 32.89%,hallucination and delusion 22.49%),who had lower quality of life.Patients in PDP group were older and had a longer disease duration and severe disease.The equivalent dose of levodopa was higher,among which Madopar and Trastal were higher.In addition,dyskinesia was more common and non-motor symptoms were more serious.In addition,our study found that the CT genotype variant and T allele of the rs36212175 SNP in DRD3 gene,and the GC genotype variant and C allele of the rs1801028 SNP in DRD2 gene were significantly associated with PDP.48.23% patients were with apathy.The apathy group had a higher proportion of male patients,more advanced disease,increased depression symptom and lower quality of life.In addition,higher white matter hyperintensities(WMH)severity was significantly associated with apathy but not depression.The logistic regression analyses with different models demonstrated that WMH severity was an independent risk factor for apathy.The linear regression analysis also suggested apathy severity positively correlated with the baseline WMH severity(?=0.959,p < 0.001).These changes were also observed in apathy progression.Conclusions: PDP and apathy are common in PD patients in China,which worsen the quality of life of the patients.DRD3 and DRD2 genes may be helpful for PDP recognition.WMH maybe a predictor for the occurrence and progression of apathy,Clinicians should give patients early attention and timely intervention.