Neuropsychiatric Symptoms and Cognitive Function in Parkinson's Disease
Summary
Parkinson’s disease is classically defined by its motor manifestations, yet non-motor features such as depression, anxiety, apathy, psychosis and impulse-control disorders impose a profound burden on patients and caregivers. These neuropsychiatric symptoms often co-occur with cognitive deficits in domains of executive function, attention, memory and visuospatial processing. Dysregulation of dopaminergic, serotonergic and cholinergic pathways, as well as Lewy body pathology spreading beyond the substantia nigra, underpin this symptom complex. Apathy, characterised by diminished motivation and goal-directed behaviour, frequently emerges in early or prodromal stages and predicts more rapid cognitive decline. Psychotic phenomena, including hallucinations and delusions, become increasingly prevalent as dementia develops, while depression and anxiety may fluctuate across disease progression. Neuroimaging studies reveal altered connectivity between the striatum, prefrontal cortex and limbic networks, correlating with both behavioural and cognitive changes. Recognition of these interlinked features is essential for prognostic assessment and for tailoring interventions that extend beyond dopaminergic replacement to encompass cognitive rehabilitation, neuromodulation and serotonergic or cholinergic therapies.
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Neuropsychiatric Symptoms and Cognitive Function in Parkinson's Disease publication trend
The graph below shows the total number of articles in neuropsychiatric symptoms and cognitive function in parkinson's disease across all publications each year (not limited to Nature Index journals).
Technical terms
Apathy: A reduction in motivation and goal-directed behaviour, often preceding cognitive decline.
Anhedonia: A diminished capacity to experience pleasure, commonly measured alongside apathy in Parkinson’s disease.
Executive function: Cognitive processes for planning, decision-making and flexible thinking, often impaired in Parkinson’s disease.
Dopamine transporter imaging: Neuroimaging technique that quantifies striatal dopaminergic innervation and predicts motivational symptom risk.
Mild cognitive impairment: An intermediate stage of cognitive decline, preceding dementia and marked by deficits in one or more domains without functional loss.
References
- The impact of psychiatric comorbidity on Parkinson's disease outcomes: a systematic review and meta-analysis. The Lancet Regional Health - Europe (2024).
- Longitudinal decline in striatal dopamine transporter binding in Parkinson’s disease: associations with apathy and anhedonia. Journal of Neurology Neurosurgery & Psychiatry (2023).
- Apathy in Parkinson’s Disease: Clinical Patterns and Neurobiological Basis. Cells (2023).
- Neuropsychiatric Symptoms in Parkinson′s Disease with Mild Cognitive Impairment and Dementia. Parkinson's Disease (2012).
- Mild behavioral impairment in Parkinson's disease is associated with altered corticostriatal connectivity. NeuroImage Clinical (2020).
- Apathy as a behavioural marker of cognitive impairment in Parkinson’s disease: a longitudinal analysis. Journal of Neurology (2019).
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