S50

Monday, 10 December 2007 Anxiety, 26% in Paranoid Ideation, 19% in Psychoticism and 72% in Sleep Disorders. All the subscales scores (except for Phobic Anxiety and Paranoid Ideation) showed a signicant positive correlation (p < 0.01) with the daily Ldopa dose; disease duration positively correlated (p < 0.01) with Phobic Anxiety and Paranoid Ideation scores. Conclusion: We found high frequencies of psychopathological symptoms in our cohort of PD patients. In agreement with data in literature, we conrm an high presence of sleep disorders, anxiety and depression in PD but we also underline the presence of obsessive and compulsive symptom in about half of the subjects; furthermore in a quarter of the sample we found pathological scores in paranoid ideation subscale. Our results show that psychiatric disturbances are frequent and deserve special attention in the PD management. The relevance of predisposing personality traits in symptoms development needs further assessment.

p < 0.0001, respectively). In patients with young onset PD, depression rather than dementia was strongly correlated with the appearance of psychosis. Conclusion: Dementia in PD was related to older age of symptoms onset and old age. Depression was associated with dementia or early age of PD onset. Depression seemed to contribute to the appearance of psychosis even more than dementia, especially in patients with younger age of symptoms onset.

1.163 Psychomotor retardation in depression: Bradykinesia or paucity of movement?

1 Lausanne,

S. Aybek1 , A. Berney, A. Salarian, S. Valloton, K. Aminian, F. Vingerhoets Switzerland

Objective: Psychomotor retardation is part of Major Depression (MD) diagnosis criteria and has been assimilated to bradykinesia, even though its pathophysiological mechanisms are unknown and there is a clear lack of objective measurement. We conducted a pilot study to evaluate bradykinesia, posture and gait parameters in MD patients with a new ambulatory system, allowing continuous motor measurements. Method: Four patients with DSM-IV MD (age 5811 y) and seven healthy controls (age 6210 y) were asked to carry on with their usual activities while being recorded for 6 hours by a recently validated wireless autonomous ambulatory system, containing miniature gyroscopes, datalogger, battery and ash memory. It allows to continuously record upper limbs movements [speed, amplitude and activity (% of time with movement)], posture (% of time standing, walking, lying or sitting) and gait parameters (speed, cadence, stance, double support, stride). Results: The hands activity was signicantly lower in depressed patients, as compared to controls (MD: 40%, controls: 60%; p < 0.05). Speed of hand movements (p = 0.13) and their amplitude (p = 0.71) were similar to controls. MD patients had a trend to spend more time lying or sitting than controls (p = 0.06) but did not differ in terms of any gait parameters. Conclusion: Our newly validated ambulatory long-term monitoring system allowed to show that patients with MD displayed less hand movements than controls and tended to spend more time lying or sitting over 6 hours, but did not differ in terms of speed and amplitude of movement, nor in gait parameters. These results suggest that psychomotor retardation classically described in MD might be the expression of a paucity of movement rather than a bradykinesia as observed in parkinsonism and might involved different (non-dopaminergic) mechanisms.

1.165 Parkinsons disease and dysmotivation for exercise

1 San

L. Jaffe1 Diego, USA Objective: Apathy is an established neurobehavioral disturbance of Parkinsons disease (PD). Apathy or dysmotivation for exercise can be particularly disabling for PD patients but little is known regarding the relationship between apathy and exercise. My objective was to study the pattern of PD patients and their lack of follow-through with an exercise program. And to assess in these patients whether the difculty is due to the effects of a hypodopaminergic state or rather due to impairments in executive functiion such as planning and goal-setting. Method: The clinic records of two patients (R.S. and J.B.) were reviewed with reference to their histories of PD, depression, dementia, and other medical illnesses that might predispose them to an inability to follow through with a physical therapy program. The therapy departments protocol for treating PD patients was also analysed. Results: Both patients were dopamine responsive, adequately treated for depression, and had no evidence of dementia. One patient had problems with knee degenerative joint disease and this pain improved during the course of physical therpay. But neither patient found any ability to persue or become motivated to exercise even for a short period after the formal physical therapy course was completed. Conclusion: Exercise is an important part of Parkinsons disease treatment but it is hindered not only by the physical barriers that PD sets up. In our two patients it was also hindered by apathy. This did not appear to be due to a deciency of dopamine in our study patients, and would suggest that frontosubcortical systems play a signicant role. Treament directed towards these nonmotor circuits may be benecial for motivating patients more towards exercise. Furthermore, a redirection of our efforts in physical therapy for these PD patients needs to be examined.

1.164 Psychiatric symptoms in Parkinsons disease: An assessment in 486 Italian patients C. Siri1 , D. De Gaspari, M. Schiavella, S. Goldwurm, R. Cilia, I.U. Isaias, G. Pezzoli, A. Antonini 1 Milano, Italy Objective: Many studies focus on psychiatric and behavioral disturbances in Parkinsons disease (PD). This study evaluates the presence and frequency of psychopathological symptoms in PD patients. Method: We asked to 486 PD patients without dementia to answer to a self-assessment questionnaire, the Symptom Check List 90 (SCL-90), which evaluates a broad range of psychological problems and symptoms of psychopathology. Results: Mean clinical and demographic characteristics of our cohort were: age 65.8610.26 y, gender M 285/F 201; age at PD onset 53.4510.88 y; PD duration 12.15.98 y; UPDRSIII 20.6311.35; H&Y 2.340.72. 71 patients were on levodopa monotherapy (Ldopa) and 415 were using dopamine agonists (in monotherapy or combined with Ldopa). Mean Ldopa equivalent daily dose (LEDDS) was 794.2885.9 mg/die. Analysis of SCL-90 subscales showed the following frequencies of pathological scores (>1): 56% of the participants scored pathological in Somatization, 47% in Obsessive-Compulsive, 33% in Interpersonal Sensitivity, 47% in Depression, 46% in Anxiety, 14% in Hostility, 24% in Phobic

1.166 Diagnosis of personality structure and cognition in patients with Parkinsons disease
1 Milan,

M. Schiavella1 , C. Siri, R. Cilia, G. Pezzoli, A. Antonini, D. De Gaspari Italy

Objective: To investigate personality structure and cognitive status of PD patients in order to assess if specic behavioural changes are caused by a premorbid personality structure. Method: Amongst 486 PD patients who were assessed with SCL90 scale we identied 18 patients (15 male and 3 female) with disease duration over 10 years who scored 3 or more at three subscales: ObsessiveCompulsive, Paranoid Ideation and Psychoticism. Clinical features: age 618.7 yrs; age at onset 52.09.7 yrs; disease duration 121.6 yrs; levodopa equivalent daily dosage (all on combined LDopa + dopamine agonists) 1092.2326.2 mg/die. MMSE and FAB were used to evaluate general cognition and frontal functions. We used Rorschachs test in order