Insights into the Pathophysiology of Psychiatric Symptoms in Central Nervous System Disorders: Implications for Early and Differential Diagnosis |
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Authors: | Giulia Menculini Elena Chipi Federico Paolini Paoletti Lorenzo Gaetani Pasquale Nigro Simone Simoni Andrea Mancini Nicola Tambasco Massimiliano Di Filippo Alfonso Tortorella Lucilla Parnetti |
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Affiliation: | 1.Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Piazzale Lucio Severi 1, 06132 Perugia, Italy;2.Section of Neurology, Department of Medicine and Surgery, University of Perugia, Piazzale Gambuli 1, 06132 Perugia, Italy; (E.C.); (F.P.P.); (L.G.); (P.N.); (S.S.); (A.M.); (N.T.); (M.D.F.); (L.P.) |
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Abstract: | Different psychopathological manifestations, such as affective, psychotic, obsessive-compulsive symptoms, and impulse control disturbances, may occur in most central nervous system (CNS) disorders including neurodegenerative and neuroinflammatory diseases. Psychiatric symptoms often represent the clinical onset of such disorders, thus potentially leading to misdiagnosis, delay in treatment, and a worse outcome. In this review, psychiatric symptoms observed along the course of several neurological diseases, namely Alzheimer’s disease, fronto-temporal dementia, Parkinson’s disease, Huntington’s disease, and multiple sclerosis, are discussed, as well as the involved brain circuits and molecular/synaptic alterations. Special attention has been paid to the emerging role of fluid biomarkers in early detection of these neurodegenerative diseases. The frequent occurrence of psychiatric symptoms in neurological diseases, even as the first clinical manifestations, should prompt neurologists and psychiatrists to share a common clinico-biological background and a coordinated diagnostic approach. |
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Keywords: | central nervous system disorders neurodegenerative diseases neuroinflammatory diseases psychiatric symptoms pathophysiology biomarkers cerebrospinal fluid early diagnosis differential diagnosis |
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