Paula Wolfson, wtop.com
WASHINGTON – Parkinson’s disease is a debilitating disease, marked in its advanced stages by tremors, imbalance, stiffness and slurred speech.
Most of the focus over the years has been on treating these physical symptoms, but results from the largest international study of Parkinson’s patients shows depression may be the biggest hurdle they face.
The data, released in November, are already starting to have an impact on treatment.
“This is a very massive, powerful study, and if it comes out with a conclusion that depression is the most important contributor to disability, then we have to take this seriously,” says Dr. Zoltan Mari, a Parkinson’s expert and assistant professor in the Department of Neurology at Johns Hopkins.
The Parkinson’s Disease and Movement Disorders Center at Johns Hopkins that Mari leads has been designated as a National Parkinson Foundation Center of Excellence. It was one of 20 facilities worldwide that took part in the foundation’s long-term study of more than 5,500 patients that began in 2009.
Mari says he was not shocked by the early study results. He says doctors have been seeing an increasing number of patients with depression and anxiety, which are caused by chemical changes in the body related to Parkinson’s. Mari adds that treatment for motor problems is more effective when mood issues are under control.
Betsy McCormack of Silver Spring, Md. is living proof. After her Parkinson’s diagnosis, tests found a sharp decline in the level of chemicals in her brain that influence mood.
“I had only 20 percent functioning of my dopamine, so 80 percent was gone — missing,” McCormack says.
She was referred to a psychiatrist with special training in movement disorders who found an anti-depressant that would work in concert with her Parkinson’s medication. McCormack says with her depression in check, she has been able to devote herself to building her strength.
“If I am too depressed to get off the couch to exercise, then I don’t do as well in my Parkinson’s,” she says.
Mari says more Parkinson’s patients need to get the coordinated care for body and mind that McCormack has received. He says the biggest change in treatment emanating from the study is a call for doctors to screen Parkinson’s patients for depression on an annual basis.
Patients also are being urged to report any change in mood to their health care team.