A number of non-motor features are known to precede motor manifestation of Parkinson’s disease (PD). Depression has long been recognized as a frequent accompanying up to 10-45% of PD patients, in fact, there have been several case reports of depression preceding the onset of PD. It has became clear that PD can have a prodromal stage, a period during which neurodegeneration has begun, but motor signs permitting classical diagnosis are not defined. Studies have suggested that depressive symptoms may precede motor symptoms in 30% of patients and the relationship between depression and subsequent PD appears to be strongest in the few years preceding the onset of motor symptoms (gustafsson et al) but it may exist earlier. A retrospective study of patients with Parkinson’s disease reported that at the time of
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The serotonergic hypothesis, proposed by Mayeux and colleagues, interprets the overall reduction of serotonin in PD as a physiological compensatory mechanism for the reduced availability of striatal dopamine increasing risk factor for depression 31,32 33. The dopaminergic hypothesis of Fibiger is based on the fact that not only the nigrostriatal, but also the mesocortical and mesolimbic dopaminergic projections degenerate in PD. As these projections play an important role in selfreward mechanisms, it is hypothesized that damage to these reward-related systems may be a risk factor for depression34 (LEENTJENS ET AL). These findings support the view that depression can be early premotor manifestation of PD. Why predict PD? depression is a common and potentially debilitating aspect of Parkinson’s disease, (Postuma et al.), it has an adverse effect on the quality of patients’ lives. So, the most elusive goal in neurodegeneration is a neuroprotective agent, that could positively impact on quality of life and clinical outcomes in patients with
The serotonergic hypothesis, proposed by Mayeux and colleagues, interprets the overall reduction of serotonin in PD as a physiological compensatory mechanism for the reduced availability of striatal dopamine increasing risk factor for depression 31,32 33. The dopaminergic hypothesis of Fibiger is based on the fact that not only the nigrostriatal, but also the mesocortical and mesolimbic dopaminergic projections degenerate in PD. As these projections play an important role in selfreward mechanisms, it is hypothesized that damage to these reward-related systems may be a risk factor for depression34 (LEENTJENS ET AL). These findings support the view that depression can be early premotor manifestation of PD. Why predict PD? depression is a common and potentially debilitating aspect of Parkinson’s disease, (Postuma et al.), it has an adverse effect on the quality of patients’ lives. So, the most elusive goal in neurodegeneration is a neuroprotective agent, that could positively impact on quality of life and clinical outcomes in patients with