Since James Parkinson's initial subjective clinical impression (1817), the individuation of behavioral features underpinning the occurrence of Parkinson’s disease has always proved fascinating to neurologists. The first hypothesis suggested the presence of a specific personality profile: repression and overcontrol of emotional reactions, mental rigidity, affectively inconstant and passive, along with a persistent anxiety and depression were the main traits retrospectively told by family members of Parkinson’s disease patients.
However, for over two centuries empirical evidence on the existence of a Parkinsonian personality emerging before clinical symptoms remained vague.
New quantitative and systematic reviews from neuroscientists Antonio Cerasa and Gabriella Santangelo have re-opened this long-standing debate.
“Patients with Parkinson’s disease are described anywhere in the world as individuals high on introversion, neuroticism and harm avoidance and low on novelty seeking,” Cerasa said.
“Despite the large amount of evidence, the existence of premorbid personality profile in Parkinson patients remained obscure until 2010,” explains Gabriella Santangelo. “Indeed, in the last few years new prospective studies have provided clear empirical supports. In particular, a Swedish long-term epidemiological study examined data from a cohort study on more than 29,000 twins. After 39 years they identified 197 Parkinsonian cases that were characterized by high-level of neuroticism and introversion.
“This specific evidence was perfectly confirmed by a meta-analytic study evaluating data from 17 different clinical studies and by a systematic review of two centuries of literature,” adds Gabriella Santangelo.
Cerasa concludes, “The evidence provided so far confirmed James Parkinson's clinical impression that personality profile is an important hallmark of clinical course of Parkinson’ disease, which should be used to assess subjects' vulnerability into daily clinical practice.”
The main clinical implication of the empirical evidence is that the assessment of personality could be also useful for identifying who would benefit from behavioral intervention, which could indirectly contribute to ameliorate patients’ own perception of physical, emotional and well-being – as underlined by Santangelo and Cerasa.
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Cerasa A. Re-examining the Parkinsonian Personality hypothesis: A systematic review. Personality and Individual Differences 2018; 130: 41-50. doi: 10.1016/j.paid.2018.03.045
Santangelo G, Garramone F, Baiano C, D'Iorio A, Piscopo F, Raimo S, Vitale C. Personality and Parkinson's disease: A meta-analysis. Parkinsonism Relat Disord. 2018; 49:67-7. doi: 10.1016/j.parkreldis.2018.01.013.