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Parkinson Disease: HELP
Articles by Anthony S. David
Based on 7 articles published since 2008

Between 2008 and 2019, A. S. David wrote the following 7 articles about Parkinson Disease.
+ Citations + Abstracts
1 Guideline Managing impulse control behaviours in Parkinson's disease: practical guidelines. 2013

Macphee, Graeme J A / Chaudhuri, K Ray / David, Anthony S / Worth, Paul / Wood, Brian. ·Southern General Hospital, Glasgow, UK. graeme.macphee@ggc.scot.nhs.uk ·Br J Hosp Med (Lond) · Pubmed #23665786.

ABSTRACT: -- No abstract --

2 Review Clinical spectrum of impulse control disorders in Parkinson's disease. 2015

Weintraub, Daniel / David, Anthony S / Evans, Andrew H / Grant, Jon E / Stacy, Mark. ·Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA; Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA. ·Mov Disord · Pubmed #25370355.

ABSTRACT: Impulse control disorders (ICDs), including compulsive gambling, buying, sexual behavior, and eating, are a serious and increasingly recognized psychiatric complication in Parkinson's disease (PD). Other impulsive-compulsive behaviors (ICBs) have been described in PD, including punding (stereotyped, repetitive, purposeless behaviors) and dopamine dysregulation syndrome (DDS; compulsive PD medication overuse). ICDs have been most closely related to the use of dopamine agonists (DAs), perhaps more so at higher doses; in contrast, DDS is primarily associated with shorter-acting, higher-potency dopaminergic medications, such as apomorphine and levodopa. Possible risk factors for ICDs include male sex, younger age and younger age at PD onset, a pre-PD history of ICDs, and a personal or family history of substance abuse, bipolar disorder, or gambling problems. Given the paucity of treatment options and potentially serious consequences, it is critical for PD patients to be monitored closely for development of ICDs as part of routine clinical care.

3 Review Deep brain stimulation: a return journey from psychiatry to neurology. 2013

Ashkan, Keyoumars / Shotbolt, Paul / David, Anthony S / Samuel, Michael. ·Department of Neurosurgery, King's College Hospital, Denmark Hill, London SE5 9RS, UK. k.ashkan@nhs.net ·Postgrad Med J · Pubmed #23503892.

ABSTRACT: Deep brain stimulation (DBS) has emerged as an effective neurosurgical tool to treat a range of conditions. Its use in movement disorders such as Parkinson's disease, tremor and dystonia is now well established and has been approved by the National Institute of Clinical Excellence (NICE). The NICE does, however, emphasise the need for a multidisciplinary team to manage these patients. Such a team is traditionally composed of neurologists, neurosurgeons and neuropsychologists. Neuropsychiatrists, however, are increasingly recognised as essential members given many psychiatric considerations that may arise in patients undergoing DBS. Patient selection, assessment of competence to consent and treatment of postoperative psychiatric disease are just a few areas where neuropsychiatric input is invaluable. Partly driven by this close team working and partly based on the early history of DBS for psychiatric disorders, there is increasing interest in re-exploring the potential of neurosurgery to treat patients with psychiatric disease, such as depression and obsessive-compulsive disorder. Although the clinical experience and evidence with DBS in this group of patients are steadily increasing, many questions remain unanswered. Yet, the characteristics of optimal surgical candidates, the best choice of DBS target, the most effective stimulating parameters and the extent of postoperative improvement are not clear for most psychiatric conditions. Further research is therefore required to define how DBS can be best utilised to improve the quality of life of patients with psychiatric disease.

4 Review Impulse control disorders and dopamine dysregulation in Parkinson's disease: a broader conceptual framework. 2011

Okai, D / Samuel, M / Askey-Jones, S / David, A S / Brown, R G. ·Section of Cognitive Psychiatry, Institute of Psychiatry, King's College London, UK. ·Eur J Neurol · Pubmed #21615625.

ABSTRACT: BACKGROUND: Impulse control disorders (ICDs) and dopamine dysregulation syndrome (DDS) in Parkinson's disease are motivation-based behaviours that involve repetitive occurrences of impulsive and uncontrolled activity. Psychiatric classification is currently inconsistent and unclear. An accurate conceptualisation of these problems is important to guide research and treatment. METHODS AND RESULTS: The review considers conceptual and methodological problems underlying the diagnosis of ICDs and the assessment of their severity. Whilst having features of obsessive-compulsive spectrum model, ICD-5 may bring them together for the first time into a single category of behavioural addictions. Whilst matching clinical and biological evidence, any such psychiatric classification in Parkinson's disease will remain complicated by the interactions of pathophysiology and medication and fail to capture the range of subthreshold but still clinically significant symptomatology. CONCLUSIONS: A non-diagnostic, dimensional construct of disinhibitory psychopathology may be a useful tool to guide research and inform treatment. The role of dysphoria is suggested as a further important factor in driving some of these problem behaviours. This opens the opportunity for adjunctive psychological approaches in management.

5 Article Predictors of response to a cognitive behavioral intervention for impulse control behaviors in Parkinson's disease. 2015

Okai, David / Askey-Jones, Sally / Samuel, Michael / David, Anthony S / Brown, Richard G. ·King's College London, Institute of Psychiatry, Psychology and Neuroscience, Section of Cognitive Neuropsychiatry, Department of Psychosis studies, London, United Kingdom; Oxford University Hospitals NHS Trust, Oxford, United Kingdom. ·Mov Disord · Pubmed #25546340.

ABSTRACT: BACKGROUND: Limited trial evidence suggests that cognitive-behavioral therapy (CBT) may be effective in managing impulse control behavior (ICBs) in Parkinson's disease. AIMS: To examine predictors of outcome in trial, participants (N=42) receiving treatment immediately or after a waiting time. METHODS: Dependent variables were Clinical Global Impression of Change (CGI-C) and the Neuropsychiatric Inventory (NPI). Baseline demographic and clinical variables were independent variables. RESULTS: Better CGI-C was predicted by fewer ICBs, taking a dopamine agonist, lower levodopa (l-dopa) equivalent dose (LEDD), higher social functioning, and lower NPI severity before treatment. Improvement on the NPI was predicted by lower LEDD, lower anxiety, lower baseline global clinical severity, and higher social functioning. CONCLUSIONS: Patients with lower burden of ICBs and other psychiatric symptomatology, better social functioning, and lower dose of antiparkinsonian medication may benefit more from CBT. However, we cannot yet identify individual patients with sufficient confidence at this stage to target treatment.

6 Article The role of self-awareness and cognitive dysfunction in Parkinson's disease with and without impulse-control disorder. 2013

Mack, Joel / Okai, David / Brown, Richard G / Askey-Jones, Sally / Chaudhuri, K Ray / Martin, Anne / Samuel, Michael / David, Anthony S. ·Dept. of Psychiatry, Oregon Health and Science University, Portland, OR, USA. mack@ohsu.edu ·J Neuropsychiatry Clin Neurosci · Pubmed #23686032.

ABSTRACT: The aim of this study was to investigate the clinical, neuropsychological, and self-awareness correlates of impulse-control disorder (ICD) in a group of 17 Parkinson's disease (PD) subjects with an active ICD and a comparison group of 17 PD subjects without ICD. Self-awareness was assessed with the Beck Cognitive Insight Scale and patient-caregiver discrepancy scores from ratings on the Dysexecutive Questionnaire and the Everyday Memory Questionnaire-Revised. Self-awareness was comparable or increased in those with ICD, versus those without, and measures of neuropsychological functioning did not differ between the two groups. Those with ICD had more motor complications of PD therapy and were more likely to be on an antidepressant than those without ICD, whereas dopaminergic medication profiles were comparable between the two groups. In this group, PD patients with current ICDs were aware of their impulsivity. Although executive dysfunction may contribute to ICD behavior, it is not a necessary component. The awareness of the inability to resist these motivated behaviors may be a source of increased depression.

7 Article Trial of CBT for impulse control behaviors affecting Parkinson patients and their caregivers. 2013

Okai, David / Askey-Jones, Sally / Samuel, Michael / O'Sullivan, Sean S / Chaudhuri, K Ray / Martin, Anne / Mack, Joel / Brown, Richard G / David, Anthony S. ·Departments of Psychosis Studies, King's College Hospital, London. ·Neurology · Pubmed #23325911.

ABSTRACT: OBJECTIVE: To test the effects of a novel cognitive-behavioral therapy (CBT)-based intervention delivered by a nurse therapist to patients with Parkinson disease (PD) with clinically significant impulse control behaviors (ICB). METHODS: This was a randomized controlled trial comparing up to 12 sessions of a CBT-based intervention compared to a waiting list control condition with standard medical care (SMC). A total of 27 patients were randomized to the intervention and 17 to the waiting list. Patients with a Mini-Mental State Examination score of <24 were excluded. The coprimary outcomes were overall symptom severity and neuropsychiatric disturbances in the patients and carer burden and distress after 6 months. Secondary outcome measures included depression and anxiety, marital satisfaction, and work and social adjustment in patients plus general psychiatric morbidity and marital satisfaction in carers. RESULTS: There was a significant improvement in global symptom severity in the CBT intervention group vs controls, from a mean score consistent with moderate to one of mild illness-related symptoms (χ(2) = 16.46, p < 0.001). Neuropsychiatric disturbances also improved significantly (p = 0.03), as did levels of anxiety and depression and adjustment. Measures of carer burden and distress showed changes in the desired direction in the intervention group but did not change significantly. General psychiatric morbidity did improve significantly in the carers of patients given CBT. CONCLUSIONS: This CBT-based intervention is the first to show efficacy in ICB related to PD in terms of patient outcomes. The hoped-for alleviation of carer burden was not observed. The study demonstrates the feasibility and potential benefit of a psychosocial treatment approach for these disturbances at least in the short term, and encourages further larger-scale clinical trials. CLASSIFICATION OF EVIDENCE: The study provides Class IV evidence that CBT plus SMC is more effective than SMC alone in reducing the severity of ICB in PD, based upon Clinical Global Impression assessment (χ(2) = 16.46, p < 0.001): baseline to 6-month follow-up, reduction in symptom severity CBT group, 4.0-2.5; SMC alone group, 3.7-3.5.