Objective: To describe the neuropsychiatric symptoms of Early-Onset Parkinson’s Disease (EOPD) patients in an incident cohort study from 1991 to 2010 in Olmsted County, Minnesota (USA).

Background: Neuropsychiatric symptoms, such as depression, psychosis, anxiety, apathy, impulse control disorder/dopamine dysregulation syndrome (DDS), are common among patients with Parkinson’s disease (PD). However, data in the literature are insufficient in the EOPD population.

Method: We used the Mayo Clinic Data Management tool to identify patients with a diagnosis of Parkinson’s disease (1991-2010). A movement disorder specialist reviewed all medical records to confirm the clinical diagnosis of PD. Patients with motor symptoms onset between the ages of 21 and 55 were classified as EOPD patients. Medical records of EOPD patients were reviewed to identify their neuropsychiatric symptoms. In an additional analysis, data from EOPD patients with motor symptoms onset before the age of 50 were reviewed.

Results: 25 incident EOPD patients (17 males and 8 females) were identified. Median age at motor onset was 50.4 years. 19 (76%) patients had neuropsychiatric symptoms; 17 (68%) suffered from depression, 6 (24%) from psychosis, 19 (76%) from anxiety, 5 (20%) from apathy, 5 (20%) from impulse control disorder and 2 (8%) from dopamine dysregulation syndrome (DDS). Shifting the cut-off age of EOPD to 50 years old did not affect the observed neuropsychiatric phenotypes. Neuropsychiatric symptoms preceded motor onset in 29% (5) of the patients with depression, 32% (6) of the patients with anxiety, and 40% (2) of the patients with apathy. Psychosis, impulse control disorder and dopamine dysregulation syndrome only occurred after motor onset. Median time from motor onset to depression onset was 1.6 years, 8.1 years for psychosis, 0.9 years for anxiety, 0.8 years for apathy, 5.1 years for impulse control disorder and 6.1 years for dopamine dysregulation syndrome.

Conclusion: Neuropsychiatric symptoms are frequent in EOPD patients. These data highlight the high burden of neuropsychiatric symptoms in this young and active population also preceding the diagnosis of EOPD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/neuropsychiatric-symptoms-in-early-onset-parkinsons-disease/