THE EFFECT OF DOPAMINERGIC THERAPY ON COGNITIVE IMPAIRMENTS, ANXIETY, AND DEPRESSION IN PARKINSON’S DISEASE

The standard treatment for Parkinson’s disease (PD) still includes the use of levodopa and other dopaminergic agents, which are aimed primarily at reducing motor deficits. At the same time, it has been established that dopaminergic therapy also affects other non-motor symptoms of the disease, in particular cognitive and affective disorders. However, there are a limited number of studies devoted to this problem in the domestic literature.

The aim of the study is to assess the dynamics of cognitive impairment, anxiety and depression in patients with PD during dopaminergic therapy.

Material and methods. The study covered 96 people with PD (45.8 % of men, 54.2 % of women), the median age was 68.0 [61.0; 74.0] years, the median duration of the disease was 5.0 [3.0; 8.0] years. Motor and cognitive impairments, anxiety, and depression were assessed during the period of the worst condition before taking antiparkinsonian drugs (OFF period) and during the period of the best condition after taking the drugs (ON period).

Results. In patients with clinically pronounced anxiety (HADS-A ≥ 11), dopaminergic therapy reduced its severity from 13.0 [11.0; 15.0] points to 10.0 [8.0; 12.5] points (p < 0.001), and in patients with clinically pronounced depression (HADS-D ≥ 11), the therapy reduced it from 13.0 [12.0; 14.0] points to 10.0 [8.75; 13.0] points (p < 0.001). The mean score on the MoCA scale increased during therapy from 19.64±4.99 to 23.45±4.97 (p < 0.001), and the mean time spent on the study decreased from 603.58±166.11 sec to 507.86±141.25 sec (p < 0.001). In particular, dopaminergic therapy led to an improvement in such sections of the MoCA scale as delayed recall, abstraction and visual-spatial functions. The severity of the dynamics of cognitive and affective disorders during dopaminergic therapy did not depend on the equivalent daily dose of levodopa, as well as on the severity of the reduction in motor deficit and the stage of the disease according to the modified Hoehn-Yahr scale.

Conclusion. In patients with PD, dopaminergic therapy may improve cognitive functions, especially delayed recall, abstraction, and visual-spatial functions; and reduce anxiety and depression, if it is present.

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