Translational Science of Psychosis in Parkinsons Disease

Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by loss of dopamine in the substantia nigra. It is predominantly a motor disorder but has shown to present with psychosis in few cases. Psychotic symptoms result from chronic treatment with few anti- Parkinson’s medications, ranging from depression, delusions to visual hallucinations, eventually progressing to auditory hallucinations in a few cases. Presence of psychotic symptoms with loss of insight is indicative of late stage of Parkinson’s disease and has poor prognosis. Accurate diagnosis of symptoms can be difficult due to significant overlapping clinical presentations which can be an admixture of underlying disease, exacerbation of pre-existing psychiatric illness or iatrogenic. The article below portrays the complex interplay between Parkinson’s disease psychosis, medications and underlying disease process which heralds early identification of the symptoms using diagnostic tools and imaging techniques to improve the health of individuals and the community by “translating” findings into diagnostic tools and medicines. It also highlights the dire need to develop neuroprotective drugs as a mode of primary prevention of psychosis. We cannot underemphasize the need to educate the patient and caregiver to seek medical attention at earliest for prompt identification and application of disease modifying therapies to reduce disability and morbidity associated with it and limit nursing home placements