Evidence map›Paper›PMID 36371868›Full record

ArticleParkinsonism & related disorders2022

'Anxious fluctuators' a subgroup of Parkinson's disease with high anxiety and problematic on-off fluctuations.

Gregory M Pontone, Kate M Perepezko, Jared T Hinkle, Joseph J Gallo, Stephen Grill, Jeannie-Marie Leoutsakos, Kelly A Mills, Howard D Weiss, Zoltan Mari

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Parkinsonism & related disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 2 pooled it
3.9field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.

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  19. Anxiety Change After Dopamine Therapy in Parkinson Disease is Independent of Motor Improvement.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Gregory M PontoneDepartment of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA. Electronic address: gpontone@jhmi.edu.
Kate M PerepezkoDepartment of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Jared T HinkleMedical Scientist Training Program, Johns Hopkins School of Medicine, Baltimore, MD, USA; Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Joseph J GalloJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Stephen GrillDepartment of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA; Parkinson's and Movement Disorder Center of Maryland, Baltimore, MD, USA.
Jeannie-Marie LeoutsakosJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Kelly A MillsDepartment of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Howard D WeissDepartment of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Zoltan MariLou Ruvo Center for Brain Health, Cleveland Clinic Nevada, Las Vegas, NV, USA.
Johns Hopkins University · USCleveland Clinic · US

Funding

MEDICAL SCIENTIST TRAINING PROGRAMT32GM007309 · NIGMS · JOHNS HOPKINS UNIVERSITY · PI COX, ANDREA L · 1985 to 2019
$43.2M
Medical Scientist Training ProgramT32GM136577 · NIGMS · JOHNS HOPKINS UNIVERSITY · PI ANDREA L COX · 2020 to 2026
$13.4M
Visual hallucinations and memory impairment in Parkinson's Disease: The role of hippocampal networksR01MH123552 · NIMH · JOHNS HOPKINS UNIVERSITY · PI BAKKER, ARNOLD, PONTONE, GREGORY MICHAEL · 2021 to 2025
$3.1M
Anxiety in Parkinson's: Use of quantitative methods to guide rational treatmentK23AG044441 · NIA · JOHNS HOPKINS UNIVERSITY · PI PONTONE, GREGORY MICHAEL · 2014 to 2018
$1.0M
Astrocyte NLRP3 inflammasome activation in Parkinson's diseaseF30AG067643 · NIA · JOHNS HOPKINS UNIVERSITY · PI HINKLE, JARED · 2020 to 2022
$153k
NIA NIH HHS F30 AG067643NIA NIH HHS K23 AG044441NIGMS NIH HHS T32 GM007309NIGMS NIH HHS T32 GM136577NIMH NIH HHS R01 MH123552
6 · The paper itself

Abstract

Anxiety that occurs in association with on-off dopamine medication fluctuations is a major cause of distress, dysfunction, and lower quality of life in people with Parkinson's disease (PD). However, the association between anxiety and on-off fluctuations is poorly understood and it is difficult to predict which patients will suffer from this atypical form of anxiety. To understand whether fluctuating anxiety in PD exists as part of an endophenotype that is associated with other signs or symptoms, we prospectively assessed the change in anxiety and a battery of clinical variables when transitioning from the off-dopamine medication state to the on state in 200 people with PD. We performed latent profile analysis with observed variables as latent profile indicators measuring the on-off-state difference in anxiety, depression, motor function, daily functioning, and the wearing off questionnaire 19 item scale (WOQ-19) in order to model unobserved (i.e., latent) profiles. A two-class model produced the best fit. The majority of participants, 69%, were categorized as having a 'typical on-off response' compared to a second profile constituting 31% of the sample who experienced a worsening in anxiety in the off state that was three times that of other participants. This profile referred to as "anxious fluctuators" had a Hamilton Anxiety Rating Scale change between the off and on medication state of 10.22(32.85) compared to 3.27 (7.62), higher depression scores, greater disability and was less likely to improve on select WOQ-19 items when in the on-state. Anxious fluctuators were more likely to be male and have a family history of anxiety disorder. Given the adverse impact of this profile we believe it may be important to distinguish patients with a typical on-off response from those with this more problematic course of fluctuations.

Indexed as

Parkinson DiseaseAnxietyAnxiety DisordersDopamineDopamine AgentsFemaleHumansMaleQuality of LifeDopamineDopamine AgentsAnxietyDepressionDopamineFluctuationsNonmotorParkinson's disease

Identifiers

PMID36371868
PMCPMC9722648
OpenAlexW4308192741

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.