Religiosity in patients with Parkinson’s disease

OBJECTIVE. To study clinical correlates of religiosity in Parkinson's disease (PD). METHODS. Measures of life goals, religiosity, mood, and neuropsychologic function were assessed in 22 persons with mid-stage PD and 20 age-matched healthy controls. Levodopa dose equivalents (LDE) were also computed for the patients. RESULTS. Relative to other major life goals parkinsonian patients were significantly more likely to report that "my religion or life philosophy" was less important than were age-matched controls. Scores on a battery of religiosity scales were consistently lower for Parkinson's patients than those of age-matched controls. While Mini Mental State Exam, logical memory recall, Stroop, and selected (depression and anxiety) mood scales reliably distinguished patients from controls, only measures of prefrontal function correlated with religiosity scores. CONCLUSIONS. Patients with PD express less interest in religion and report consistently lower scores on measures of religiosity than age-matched controls. Prefrontal dopaminergic networks may support motivational aspects of religiosity.Office of Research and Development; Medical Research Service; Department of Veteran's Affair

Side of onset in Parkinson's disease and alterations in religiosity: Novel behavioral phenotypes

Abstract. Behavioral neurologists have long been interested in changes in religiosity following circumscribed brain lesions. Advances in neuroimaging and cognitive experimental techniques have been added to these classical lesion-correlational approaches in attempt to understand changes in religiosity due to brain damage. In this paper we assess processing dynamics of religious cognition in patients with Parkinson's disease (PD). We administered a four-condition story-based priming procedure, and then covertly probed for changes in religious belief. Story-based priming emphasized mortality salience, religious ritual, and beauty in nature (Aesthetic). In neurologically intact controls, religious belief-scores significantly increased following the Aesthetic prime condition. When comparing effects of right (RO) versus left onset (LO) in PD patients, a double-dissociation in religious belief-scores emerged based on prime condition. RO patients exhibited a significant increase in belief following the Aesthetic prime condition and LO patients significantly increased belief in the religious ritual prime condition. Results covaried with executive function measures. This suggests lateral cerebral specialization for ritual-based (left frontal) versus aesthetic-based (right frontal) religious cognition. Patient-centered individualized treatment plans should take religiosity into consideration as a complex disease-associated phenomenon connected to other clinical variables and health outcomes

Design issues in crossover trials involving patients with Parkinson’s disease

Background and objectivesCrossover designs are frequently used to assess treatments for patients with Parkinson’s disease. Typically, two-period two-treatment trials include a washout period between the 2 periods and assume that the washout period is sufficiently long to eliminate carryover effects. A complementary strategy might be to jointly model carryover and treatment effects, though this has rarely been done in Parkinson’s disease crossover studies. The primary objective of this research is to demonstrate a modeling approach that assesses treatment and carryover effects in one unified mixed model analysis and to examine how it performs in a simulation study and a real data analysis example, as compared to other data analytic approaches used in Parkinson’s disease crossover studies.MethodsWe examined how three different methods of analysis (standard crossover t-test, mixed model with a carryover term included in model statement, and mixed model with no carryover term) performed in a simulation study and illustrated the methods in a real data example in Parkinson’s disease.ResultsThe simulation study based on the presence of a carryover effect indicated that mixed models with a carryover term and an unstructured correlation matrix provided unbiased estimates of treatment effect and appropriate type I error. The methods are illustrated in a real data example involving Parkinson’s disease. Our literature review revealed that a majority of crossover studies included a washout period but did not assess whether the washout was sufficiently long to eliminate the possibility of carryover.DiscussionWe recommend using a mixed model with a carryover term and an unstructured correlation matrix to obtain unbiased estimates of treatment effect

Neuropharmacological Treatment of Mental Dysfunction in Parkinson’s Disease

Many patients with Parkinson's Disease (PD) experience significant cognitive and mood impairment -even early in the course of the disease. These mental impairments are only partially responsive to levodopa treatment and are often as disabling as the motor impairment, particularly in mid and late stages of the disease. Investigators have recently begun a search for new agents that can effectively treat mental dysfunction of PD. Although there have been only a handful of properly controlled clinical trials of interventions targeted at amelioration of mental dysfunction in PD, progress has been made. Based on the available evidence, targeting catecholaminergic and cholinergic function may be an effective strategy for amelioration of cognitve, mood and psychiatric disturbances in PD

Side of Onset in Parkinson’s Disease and Alterations in Religiosity: Novel Behavioral Phenotypes

Behavioral neurologists have long been interested in changes in religiosity following circumscribed brain lesions. Advances in neuroimaging and cognitive experimental techniques have been added to these classical lesion-correlational approaches in attempt to understand changes in religiosity due to brain damage. In this paper we assess processing dynamics of religious cognition in patients with Parkinson’s disease (PD). We administered a four-condition story-based priming procedure, and then covertly probed for changes in religious belief. Story-based priming emphasized mortality salience, religious ritual, and beauty in nature (Aesthetic). In neurologically intact controls, religious belief-scores significantly increased following the Aesthetic prime condition. When comparing effects of right (RO) versus left onset (LO) in PD patients, a double-dissociation in religious belief-scores emerged based on prime condition. RO patients exhibited a significant increase in belief following the Aesthetic prime condition and LO patients significantly increased belief in the religious ritual prime condition. Results covaried with executive function measures. This suggests lateral cerebral specialization for ritual-based (left frontal) versus aesthetic-based (right frontal) religious cognition. Patient-centered individualized treatment plans should take religiosity into consideration as a complex disease-associated phenomenon connected to other clinical variables and health outcomes