Objective: Investigate the correlation between depression and other non-motor symptoms, such as cognitive impairment and gastrointestinal (GI) dysfunction in Parkinson’s disease (PD).

Background: In addition to its recognized motor features, PD is associated with neuropsychiatric comorbidities, with depression being most prevalent at 35-40% [1-2]. Other non-motor symptoms, such as cognitive difficulties and gut-related problems, have been reported in PD, but these symptoms could be exacerbated with existing depressive symptoms. Studies have indicated that moderate to severe depression can impair executive functions and memory in PD, while neuroimaging evidence in clinically depressed patients reveals frontal and temporal lobe abnormalities [3]. There is also evidence suggesting that PD patients with depression reported more common constipation and positive correlations between the Beck Depression Inventory (BDI) and severe constipation [4-5].

Method: Correlational analyses between depression and other non-motor symptoms are conducted with data collected from the Pacific Parkinson’s Research Centre at the University of British Columbia. Assessments evaluating depression (BDI-II), cognition (MoCA), and GI symptoms (ROME III) are collected in PD cohorts of observational initiatives—Bjorn Moller Research Repository and Vancouver Parkinson’s Research Initiative. Preliminary results are also utilized from an ongoing probiotics trial investigating depressive symptoms and gut dysbiosis in PD, allowing further analyses with the Inventory of Depressive Symptomatology (IDS-C) and PD Cognitive Rating Scale (PD-CRS).

Results: Predicted results indicate higher depression scores are significantly associated with lower cognitive scores and greater severity of GI symptoms in PD individuals. Moderate positive correlations are anticipated between BDI-II scores and constipation severity, as well as negative correlations between BDI-II and MoCA scores. Exploratory analyses from the probiotics trial dataset are expected to show similar relationships between the IDS-C and PD-CRS, suggesting individuals with more severe depressive symptoms exhibit greater cognitive and GI burden.

Conclusion: Investigating these correlations allows us to understand the effect of mood on cognitive functioning and gut health, providing insight into how these non-motor symptoms address frontotemporal and gut–brain axis involvement in PD.

References: 1. Aarsland D. Depression in Parkinson disease-epidemiology, mechanisms and management. Nat Rev Neurol. 2012 Jan;8(1):35–47.
2. Timmer MHM, Van Beek MHCT, Bloem BR, Esselink RAJ. What a neurologist should know about depression in Parkinson’s disease. Pract Neurol. 2017 Oct;17(5):359–68.
3. Norman S, Tröster AI, Fields JA, Brooks R. Effects of Depression and Parkinson’s Disease on Cognitive Functioning. JNP. 2002 Feb;14(1):31–6. doi:10.1176/jnp.14.1.31
4. Sakakibara R, Ogata T, Aiba Y, Tateno F, Uchiyama T, Yamamoto T. Does Depression Contribute to the Bladder and Bowel Complaint in Parkinson’s Disease Patients? Movement Disord Clin Pract. 2021 Feb;8(2):240–4.
5. Chang TY, Chen YH, Chang MH, Lin CH. Is there a close association of depression with either constipation or dysosmia in Parkinson’s disease? Sci Rep. 2020 Sep 23;10(1):15476. doi:10.1038/s41598-020-72381-0

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MDS Abstracts - https://www.mdsabstracts.org/abstract/evaluating-the-relationship-between-depression-and-other-non-motor-symptoms-in-parkinsons-disease/