Pseudobulbar affect (PBA) is a condition characterized by frequent, uncontrollable outbursts of crying or laughing that do not match how the person actually feels. It can affect people with Parkinson's disease as well as those with brain injury or other neurologic conditions.
In the later stages of Parkinson's disease (PD) some people will develop cognitive changes that ultimately lead to dementia and some of those people can exhibit reactive behaviours, usually involving anxiety, anger and aggression. This can include verbal outbursts such as shouting, swearing, or name-calling.
These can range from depression and anxiety to hallucinations, memory problems and dementia. Anxiety and depression are two of the most common mental health symptoms that affect people with Parkinson's. Nearly half of all people with Parkinson's have experienced one of these issues.
Not everyone develops every symptom of Parkinson's disease, but if you're affected, non-motor symptoms including depression, anxiety, anger and irritability can have a huge impact on your quality of life and those around you.
The most common symptoms experienced by people who have been diagnosed with Parkinson's disease are anxiety and depression. The patient is understandably anxious, fearful about how their lives will change in general and how functional impairment caused by the disease will manifest itself.
Mental disturbances have been described in patients with Parkinson's Disease (PD). Of these, the common conditions are delirium and psychosis. Delirium has been attributed to change of environment, especially hospital stay and infections; while psychosis is due to drugs like dopamine agonists.
Symptoms usually begin gradually and worsen over time. As the disease progresses, people may have difficulty walking and talking. They may also have mental and behavioral changes, sleep problems, depression, memory difficulties, and fatigue.
Pseudobulbar affect (PBA) is a neurological symptom of inappropriate and uncontrollable laughter or crying that occurs secondary to a variety of neurological conditions, including parkinsonian disorders.
The “parkinsonian personality” has been described as compulsive, industrious, introverted, morally rigid, punctual, serious, stoic, and quiet (2, 3).
It is important to note that underlying the anger, aggression, agitation, irritability, personality changes or apathy, may be cognitive decline, depression, anxiety or psychosis. For example, in the first case above, the person with Parkinson's is outwardly angry and aggressive.
Parkinson's disease Dementia or PD Dementia can make a patient very aggressive. Parkinson's Dementia Aggression germinating from Parkinson's disease Dementia can lead patients to behave erratically, experience sudden anger outbursts, feel constantly irritated, and always be in a state of restlessness.
Although tremor in particular tends to worsen when a person is anxious or under stress, all the symptoms of PD, including slowness, stiffness, and balance problems, can worsen. Symptoms, particularly tremor, can become less responsive to medication.
To start, Parkinson's disease symptoms and stress can disturb communication and quality time together. A partner with Parkinson's may not feel up to eating out or taking an annual vacation. Body language may become less clear, and slurred speech and facial masking can further confuse conversation.
There were only sporadic significant correlations between empathy scores and cognitive variables. Conclusions: PD patients show a stage dependent empathy score decrease which is driven mainly by cognitive aspects of empathy. However, emotional empathy aspects are not reduced.
Acute akinesia (Parkinson's crisis)
A rare but life-threatening complication of Parkinson's disease, with a sudden worsening of motor symptoms and severe akinesia. Triggers include infections, surgery, gastrointestinal disease and changes in medication.
How quickly they get worse varies substantially, perhaps because there may be multiple underlying causes of the disease. In most cases, symptoms change slowly, with substantive progression taking place over the space of many months or years.
In fact, recent research confirms that the average life expectancy for a patient with PD onset at age 60 is 23.3 years (83.3 total years of age). This is directly comparable to the latest United States Life Tables published in 2020 as part of the National Vital Statistics Reports.
The two of the biggest causes of death for people with Parkinson's are Falls and Pneumonia: Falls – Parkinson's patients are typically at an increased risk of falls due to postural instability and other symptoms of Parkinson's.
Addictive Syndromes in Parkinson's Disease
The most common are pathological gambling, hypersexuality, compulsive shopping, and compulsive eating. In this review, we follow the taxonomy of the Diagnostic and Statistical Manual of Mental Disorders IV and refer to these as disorders of impulse control.
Psychiatric symptoms, such as depression, anxiety, hallucination, delusion, apathy and anhedonia, impulsive and compulsive behaviors, and cognitive dysfunction, appears to be manifesting in most PD patients (Fig. 1).
They also became more reluctant to expose themselves to pain. The scientists also found that the dopamine-enhancing Parkinson's drug, levodopa, made healthy people more selfish, wiping out the normal tendency to prefer to receive an electric shock themselves, while sparing those around them.
Multiple system atrophy – the cousin of Parkinson's disease.