Current treatment of behavioral and cognitive symptoms of Parkinson's disease

• Published in: Parkinsonism & related disorders 2019-02, Vol.59, p.65-73
• Main Author: Rektorova, Irena
• Format: Article
• Language: English
• Subjects: Apathy; Behavioral; Cognitive; Cognitive Dysfunction - drug therapy; Cognitive Dysfunction - etiology; Cognitive Dysfunction - therapy; Dementia; Dementia - drug therapy; Dementia - etiology; Dementia - therapy; Disruptive, Impulse Control, and Conduct Disorders - drug therapy; Disruptive, Impulse Control, and Conduct Disorders - etiology; Disruptive, Impulse Control, and Conduct Disorders - therapy; Dopaminergic; Humans; Impulse control disorders; Mild cognitive impairment; Parkinson Disease - complications; Parkinson Disease - drug therapy; Parkinson Disease - therapy; Parkinson's disease; Psychosis; Psychotic Disorders - drug therapy; Psychotic Disorders - etiology; Psychotic Disorders - therapy; treatment
• ISSN: 1353-8020; 1873-5126
• DOI: 10.1016/j.parkreldis.2019.02.042

Cognitive and behavioral symptoms are common in Parkinson's disease, may occur even in the prodromal stages of the disease, worsen with disease progression, and surpass motor symptoms as the major factors affecting patient quality of life and caregiver burden. The symptoms may be caused by the disease pathology or they may represent adverse effects of treatment, or both etiological factors may contribute. Although many of these symptoms are related to dopaminergic dysfunction or dopaminergic medication, other neurotransmitters are involved as well. Behavioral symptoms including impulse control disorders, apathy, psychosis, as well as mild cognitive impairment and dementia are reviewed with a special focus on current treatment approaches. •Behavioral symptoms of PD may be triggered by manipulation of dopaminergic treatment.•STN stimulation and continuous dopaminergic infusions may reduce hyperdopaminergic behaviors.•Cholinesterase inhibitors impact on cognition, behavior, and daily activities in PD-dementia.