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Associations of specific psychiatric disorders with isolated focal dystonia, and monogenic and idiopathic Parkinson’s disease

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Abstract

Comorbidity of psychiatric disorders in patients with movement disorders is common. Often, psychiatric symptoms manifest before the onset of the movement disorder, thus not representing a mere reaction to its burden. How the disease mechanisms of psychiatric and movement disorders are related is still poorly understood. The aim of the present study was to compare prevalence rates of specific psychiatric disorders between different movement disorders including isolated focal dystonia (IFD, N = 91), monogenic Parkinson’s disease (PD, N = 41), idiopathic PD (N = 45), and a sample from a Northern Germany general population (TACOS Study; N = 4075). Our results indicate an odds ratio (OR) of 2.6 [confidence interval (CI) 1.7–4.0] for general axis I disorders in IFD, an OR of 2.5 (CI 1.4–4.7) in monogenic PD, and an OR of 1.4 (CI 0.8–2.6) in idiopathic PD. More specifically, the monogenic PD group showed the highest ORs for affective disorders including depression (OR = 4.9), bipolar disorder (OR = 17.4), and hypomanic episodes (OR = 17.0), whereas IFD expressed the highest rates of anxiety disorders (OR = 3.3). Psychotic symptoms were only observed in the PD groups but not in IFD. Our findings underline the notion that psychiatric disorders are part of the phenotypic spectrum of movement disorders. Moreover, they suggest that IFD, monogenic PD, and idiopathic PD are associated with specific psychiatric disorders indicating disturbances in a different neural circuitry for sensorimotor control.

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Acknowledgements

We gratefully thank all the participants for their invaluable collaboration. Special thanks go to Jessica Shakra and Liv Wenzel for their valuable contribution to this project. This work was supported by a grant from the Dystonia Medical Research Foundation, the Bachmann-Strauss Foundation, and the Volkswagen Foundation. CK is a recipient of a Schilling Award from the Hermann and Lilly Schilling Foundation.

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Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany

    Susanne Steinlechner, Hans-Jürgen Rumpf & Meike Kasten

  2. Helios Fachklinik Schleswig, Schleswig, Germany

    Susanne Steinlechner

  3. Department of Neurology, Westküstenklinikum Heide, Heide, Germany

    Johann Hagenah

  4. Institute of Social Medicine and Prevention, University Medicine Greifswald, Greifswald, Germany

    Christian Meyer & Ulrich John

  5. Institute of Neurogenetics, University of Lübeck, Lübeck, Germany

    Tobias Bäumer, Norbert Brüggemann, Meike Kasten, Alexander Münchau & Christine Klein

  6. Department of Neurology, University of Hamburg, Hamburg, Germany

    Tobias Bäumer & Alexander Münchau

  7. Department of Neurology, University of Lübeck, Lübeck, Germany

    Norbert Brüggemann

  8. Department of Psychiatry and Psychotherapy and Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Münster, Albert-Schweitzer-Straße 11, 48149, Münster, Germany

    Rebekka Lencer

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  1. Susanne Steinlechner
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Correspondence to Rebekka Lencer.

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Ethical statement

This study has been approved by the ethics committees of the Universities of Luebeck and Hamburg in accordance with the Declaration of Helsinki and its later amendments. All participants gave their written informed consent prior to their inclusion in the study.

Conflicts of interest

The authors report no competing interests related to the research covered in this article.

Disclosures

Dr. Steinlechner reports no disclosures. Dr. Hagenah receives research support from the Bachmann-Strauss Dystonia Parkinson Foundation, the Neuroscience Department of the Concord General Repatration Hospital in Australia. He received honoraria as an invited speaker from GlaxoSmithKline and Boehringer Ingelheim. Dr. Rumpf reports no disclosures. Dr. Meyer reports no disclosures. Dr. Bäumer reports no disclosures. Dr. Kasten received research support from the German Research Foundation (DFG, KA 3179/2-1) and an intramural career development grant from the University of Lübeck. Dr. Münchau received commercial research support from Pharm Allergan, Ipsen, Merz Pharmaceuticals, Actelion, honoraria for lectures from Pharm Allergan, Ipsen, Merz Pharmaceuticals, Actelion, GlaxoSmithKline, Desitin, and Teva. He is supported by the Possehl-Stiftung, Lübeck. Further support by the Tourette Syndrome Association (Germany) and European Huntington Disease Network is acknowledged. A. Münchau receives academic research support through the “Multicentre Tics in Children Studies (EMTICS)” as part of the FP 7 program (HEALTH.2011.2.2.1-3), from the Deutsche Forschungsgemeinschaft (DFG; projects 1692/3-1, 4-1, SFB 936) and from the Bundesministerium für Bildung und Forschung (BMBF; DysTract consortium). Dr. Klein is a member of the editorial board of “Neurology” and has served as an editor of the “Continuum Issue Neurogenetics 2008” and as faculty at the Annual Meetings of the American Academy of Neurology since 2004. She received consulting fees from Boehringer Ingelheim and Centogene and honoraria for speaking from Boehringer Ingelheim and Merz Pharma. Dr. Klein is the recipient of a career development award from the Hermann and Lilly Schilling Foundation. She is funded by the Volkswagen Foundation, the Deutsche Forschungsgemeinschaft, and received institutional support from the University of Luebeck for genetics research. Dr. Lencer reports no disclosures.

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Steinlechner, S., Hagenah, J., Rumpf, HJ. et al. Associations of specific psychiatric disorders with isolated focal dystonia, and monogenic and idiopathic Parkinson’s disease. J Neurol 264, 1076–1084 (2017). https://doi.org/10.1007/s00415-017-8488-x

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