Brain Functioning and Personality Changes in Parkinson’s Disease
Although the characteristic symptoms of Parkinson’s disease (PD) involve motor functions such as tremor, rigidity, slowness of movement and loss of postural reflex, there are other neurological and psychiatric symptoms present in later stages of the disease which point to definite changes in brain function and personality of PD patients.
Cognitive Abilities in Parkinson’s Disease
Cognitive disturbances, as well as mood and behavior alterations, can be as traumatic and frustrating as any physical problem, both for the patient as well as the caregiver. Cognitive deficits can be present even in the early stages of Parkinson’s disease, gradually worsening as the disease progresses, and may ultimately lead to dementia. A person with PD is at a greater risk of developing dementia and this risk gradually increases in proportion to the duration of the disease.
Cognition relates to higher level functions of the brain and may be defined as the mental process involved in gaining knowledge and understanding, which includes the process of thinking, knowing, learning, remembering, decision making, judging and problem solving. Language, imagination, perception and planning are the necessary components.
People with PD often have trouble processing two cognitive acts simultaneously. Mild cognitive impairment may be present in most people with PD. Stress, depression, sleep disturbances, or medication can lead to such changes.
The cognitive deficits seen in PD patients (subcortical dementia) are similar to those caused by frontal lobe damage. Due to the degeneration of the cells of the part of the brain known as substantia nigra in the basal ganglia, there is deficiency of the chemical transmitter dopamine. As a result, there is dysfunction of the circuits connecting the frontal lobe of the brain and the basal ganglia, causing problems with memory, language, concentration, attention, visuo-spatial functions, and executive function of the brain.
Memory Loss in Parkinson’s Disease
Anything that affects cognition can affect memory too. However, sometimes it becomes difficult to differentiate memory loss or impairment due to PD from that due to normal aging process.
Subcortical cognitive deficits, as seen typically in PD patients, are characterized more by problems with memory recall (especially of recent events) than by memory formation, decrease in mental speed or slowed thinking (bradyphrenia), and apathy. It is not that PD patients suffering from bradyphrenia are unable to think. It is only that their thinking process is slow, so they need time to answer questions or make decisions.
Executive impairment may be more pronounced than language deficit. Executive functions involve higher level thinking skills such as logical thinking, prioritizing, organizing, planning, and executing. Dementia may be accompanied by psychosis, agitation, and sleep disturbances.
Personality Changes in Parkinson’s Disease
Personality changes occur frequently in people with PD. Frontal cortical damage could account for some of the behavioral and personality changes that are seen in PD patients, such as depression, mental lethargy, mood swings, and irritability. On the other hand, obsessive compulsive behavior such as binge-eating, hypersexuality, and pathological gambling may be related to some drugs used to treat PD.
A Parkinson’s personality is often mentioned in relation to PD patients. Certain personality traits have been noted in people with PD which includes being hard-working, ambitious, serious-minded, dogmatic and honest. They are less likely to have any addictions to alcohol, tobacco or drugs. These traits may be present even before the development of PD. One theory that may explain this is that loss of dopamine (which is thought to be responsible for these personality traits) starts long before the manifestation of motor symptoms.
I cannot stop doing distracting stupid and prejudicial whishes of the moment.I take requip. It is because of Requip? Shall I stop it ?
Luisa Barreto
Speak to your doctor.
My wife was on Requip then Requip XL, was unbelievably compulsive on both even where the dose was reduced below 10mg the compulsive behaviour continued until the specialist removed requip and introduced Leva Dopa
My grandma has been sufferring from PD for 30+ years, she is currently 82 years old and lives in a frail care unit. I wanted to ask you whether dimentia and aggression are particular symptoms of PD?
The problem is, she has been in hospital a lot the past year and she claims the staff at the frail care abuses her, the problem is, we have heard a lot of stories about her:
1) Apparently she refuses to eat at times
2) She is very aggressive towards the staff
3) Stuborness
4) Apparently she has kicked and hit the staff
5) Screams and Shouts
The latest is; the staff claims she fell out of her bed and my grandma claims they hit her.
The other problem is; the way people claim she is at the “Home” and the way she is infront of us is as if it is two TOTALLY different people????
PLEASE HELP!!!
you have to listen to your gut.my grandmothers both were in a home at the same place.when we visited my one grandmom said she was not a diabetic anymore and there for she didnt get her insulin.we didnt really know what to think so i went to vistit my other grandma in the next hall.she cried and whispered they were hitting her and they werent giving her any insulin. she begged me to take her home.i asked the staff about this and they said the same thing.they were very violent and combative patients.i couldnt believe this cause my one grandma only had been there a week.so i went home to think this through.3 days later i got a call my grandma was dead.then the following monday i get a call my other grandmom was dead.to this day i feel so guilty for not listening to them.i dont trust people who act like the elderly are bad.i think it shows a reflection on the nurses.would it hurt anything to have her home for a week with home care.and try to listen to your heart.hope the best for you….thelma
hello
my father is 81 and has been diagnosed with pd for 1 year. he just now is starting inappropriate behavior with the cleaning lady. he is making inappropriate remarks to her and just recently exposed himself to her. this is very upsetting for his family members. it is out of character for him. when we called his neurologist she said that it wasn’t his meds and that if it was his meds he would be doing it alot more. it is more compulsive behavior if the meds were causing this behavior. we do not know what to do. any help would be appreciated.
@ Sone Janson – we have the same problem with my ex-husband. He behaves completely differently with friends than he does with immediate family. Its like he not only has PD but schizophrenia also together with OCD and Bi-polar. As his wife and mother of his only child, I do not recognise this man, he is no where close to the man I married and has not been for over 25 years BUT I have tried and tried to help, support and be there for him with very little thanks, respect or understanding for me and my needs and the pain that I have been suffering. PD, the meds, symptoms, medical personnel and the OCD’s that go with it destroy families and make you feel you are loosing your mind as a carer. I wish I knew how to lobby for the drug companies and medical profession to take responsibility for these vile and evil medications.