Stemmingsfluctuaties bij patiënten met de ziekte van Parkinson*

Objective

To assess the frequency of anxiety and mood fluctuations in Parkinson’s disease patients who suffer from motor fluctuations and to explore the possibility of a link between the occurrence of these anxiety and mood fluctuations and motor fluctuations.

Design

Systematic literature review and meta-analysis.

Method

We looked in PubMed, Medline and the Cochrane Library for studies on anxiety and mood fluctuations in Parkinson’s disease patients with motor fluctuations published up to and including January 2018. In the meta-analysis, we calculated a weighted mean of the percentage of Parkinson’s disease patients with anxiety and mood fluctuations.

Results

We found 10 studies of which 9 met our quality criteria. Anxiety fluctuations occurred in 3.1% to 67.7% of the Parkinson’s disease patients with motor fluctuations, with a weighted mean of 35.4%. For fluctuations of depressive symptoms, the percentages ranged from 2.1% to 71.4%, with a weighted mean of 34.9%. The frequency of panic symptom fluctuations ranged from 3.1% to 54.5%, with a weighted mean of 37.1%. Symptoms of anxiety and depression were more often present during motor ‘off’ periods than during ‘on’ periods.

Conclusion

Anxiety and mood fluctuations frequently occur in Parkinson’s disease patients with motor fluctuations. In clinical practice, more attention for these symptoms would be desirable. The methods used to assess fluctuation symptoms vary widely between studies. Development of a more standardised and validated assessment method is not only desirable, but also necessary for adequate diagnosis, treatment and scientific study of both motor and non-motor symptom fluctuations.

Conflict of interest and financial support: none declared.