The Cognitive Neuropsychiatry of Parkinson’s Disease by Patrick McNamara

By Patrick McNamara

Sufferers with Parkinson's sickness (PD) undergo such a lot visibly with such motor deficits as tremor and pressure and not more evidently with quite a number nonmotor indicators, together with autonomic disorder, temper problems, and cognitive impairment. The neuropsychiatric disturbances of PD could be as disabling as its motor problems; yet they've got only in the near past began to be studied intensively through clinicians and scientists. during this ebook, Patrick McNamara examines the main neuropsychiatric syndromes of PD intimately and provides a cognitive conception that money owed for either their neurology and their phenomenology. McNamara bargains an up to date overview of present wisdom of such neuropsychiatric manifestations of PD as cognitive deficits, character alterations, speech and language indicators, sleep problems, apathy, psychosis, and dementia. He argues that the cognitive, temper, and character signs of PD stem from the weakening or suppression of the agentic facets of the self. McNamara's examine might result in stronger therapy for Parkinson's sufferers. yet its overarching target is to reach at a greater knowing of the human brain and its breakdown styles in sufferers with PD. The human mind-brain is an intricate and intricate constitution patched jointly to provide what we name the self. after we discover the disruption of the self constitution that happens with a number of the neuropsychiatric issues linked to PD, McNamara argues, we get a glimpse into the internal workings of the main stunning constitution of the self: the agentic self, the self that acts.

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This is a crucial fact because it affects the diverse phenomenology of the neuropsychiatric disorders of PD including the personality changes, the apathy, depression, and anxiety syndromes of PD. In the latter case (anxiety), the contributing factor may be overstimulation of the limbic DA systems due to loss of descending inhibition on limbic system sites attributable to impairment in PFC due ultimately to loss of DA signal in PFC. Similarly, depression and apathy may result when the PFC and executive control system are dysfunctional.

Stage 4: Basal prosencephalon and mesocortex pathology of stage 3 plus prosencephalic lesions, anteromedial temporal mesocortex and allocortex (CA-2 plexus). Stage 5: Neocortex pathology of stage 4 plus lesions in prefrontal cortex and sensory association neocortical areas. Stage 6: Neocortex pathology of stage 5 plus lesions in first-order sensory association cortex, premotor cortex, and primary sensory and motor cortex. , & Del Tredici, K. (2004). Stages in the development of Parkinson’s disease-related pathology.

Kaasinen et al. (2001), in contrast, reported that the novelty-seeking personality trait did not significantly correlate with [18F]fluorodopa uptake in any of the brain regions they studied. Instead, they found a highly significant positive correlation between right caudate [18F]fluorodopa uptake and a harm-avoidance trait in their sample of 47 PD patients. More recently, Tomer and Aharon-Peretz (2004) reported that patients with greater DA loss in the left hemisphere evidenced reduced novelty seeking whereas patients with reduced DA in the right hemisphere reported higher harm avoidance than that of matched healthy controls.

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