The candidate is a geriatric psychiatrist with fellowship training in the clinical evaluation and treatment of movement disorders. He plans to use this unique training to develop a career in clinical research investigating the neuropsychiatric aspects of Parkinson's disease (PD) and other diseases of aging. To accomplish this goal, he has developed a comprehensive research and training program in which he will learn to use quantitative statistical methods and clinical trial methodologies to better characterize and treat anxiety syndromes in PD. The career development and research plan will benefit from the infrastructure provided by: 1) The Johns Hopkins Institute for Clinical and Translational Research, which offers a variety of programs and services to facilitate the research projects of faculty investigators, 2) the Bloomberg School of Public Health at Johns Hopkins provides access to formal coursework and seminars relevant to the proposed project, and 3) the Morris K. Udall Parkinson's Disease Research Center (PDRC) at Johns Hopkins. The PDRC provides resources for recruitment, assessment, specialized testing, and other aspects of clinical and basic science research involving patients with PD. Anxiety disturbances are common in patients with PD. They affect up to 40% of patients and adversely affect physical disability and quality of life. Despite this, there is only limited information on the clinical characterization and pathophysiology and there have been no randomized controlled trials of pharmacologic treatment. The principal scientific objective for this K23 award is to gain an understanding of the clinical phenomenology of anxiety syndromes in PD and use that knowledge to better target and test pharmacologic treatments. The proposed work will provide further clinical characterization of anxiety syndromes in PD patients with respect to their association with the on- and off- motor state, comorbid psychiatric, and other non-motor features of PD, and treatment response. This proposal will attempt to identify empirically valid subtypes of anxiety associated with PD-specific features using latent class analysis. To translate findings from these investigations into clinical interventions, the second aim is to conduct an 8-week intervention study for anxiety in PD comparing pramipexole, an evidence-based treatment for motor symptoms and motor fluctuations to placebo. The pilot intervention will provide data and experiential training that, when combined with formal coursework and mentorship, will help develop the skills needed to design and conduct an R01 funded clinical trial and begin an independent career as an interventions researcher.

Public Health Relevance

Parkinson's disease is the second most common neurodegenerative disorder of aging. Anxiety disturbances are more common in Parkinson's disease than in other populations, cause disability, and worsen quality of life, and in some cases, appear to be related to the clinical features of Parkinson's disease. In order to better understand anxiety disturbances in Parkinson's disease, the proposed work investigates clinical features associated with anxiety and conducts an 8-week intervention study that will help guide clinical practice and begin the process of establishing evidence-based treatment of anxiety disorders in Parkinson's disease.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Mentored Patient-Oriented Research Career Development Award (K23)
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National Institute on Aging Initial Review Group (NIA)
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Chen, Wen G
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Johns Hopkins University
Internal Medicine/Medicine
Schools of Medicine
United States
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Hinkle, Jared T; Perepezko, Kate; Bakker, Catherine C et al. (2018) Domain-specific cognitive impairment in non-demented Parkinson's disease psychosis. Int J Geriatr Psychiatry 33:e131-e139
Hinkle, Jared T; Perepezko, Kate; Mills, Kelly A et al. (2018) Dopamine transporter availability reflects gastrointestinal dysautonomia in early Parkinson disease. Parkinsonism Relat Disord 55:8-14
Broen, Martinus P G; Leentjens, A F G; Hinkle, J T et al. (2018) Clinical Markers of Anxiety Subtypes in Parkinson Disease. J Geriatr Psychiatry Neurol 31:55-62
Hinkle, Jared T; Perepezko, Kate; Mari, Zoltan et al. (2018) Perceived Treatment Status of Fluctuations in Parkinson Disease Impacts Suicidality. Am J Geriatr Psychiatry 26:700-710
Hinkle, Jared T; Perepezko, Kate; Rosenthal, Liana S et al. (2018) Markers of impaired motor and cognitive volition in Parkinson's disease: Correlates of dopamine dysregulation syndrome, impulse control disorder, and dyskinesias. Parkinsonism Relat Disord 47:50-56
Hinkle, Jared Thomas; Perepezko, Kate; Bakker, Catherine C et al. (2018) Onset and Remission of Psychosis in Parkinson's Disease: Pharmacologic and Motoric Markers. Mov Disord Clin Pract 5:31-38
Pontone, Gregory M; Mari, Zoltan; Perepezko, Kate et al. (2017) Personality and reported quality of life in Parkinson's disease. Int J Geriatr Psychiatry 32:324-330
Mills, Kelly A; Mari, Zoltan; Bakker, Catherine et al. (2016) Gait function and locus coeruleus Lewy body pathology in 51 Parkinson's disease patients. Parkinsonism Relat Disord 33:102-106
Taylor, Jacob; Anderson, William S; Brandt, Jason et al. (2016) Neuropsychiatric Complications of Parkinson Disease Treatments: Importance of Multidisciplinary Care. Am J Geriatr Psychiatry 24:1171-1180
Hirao, Kentaro; Pontone, Gregory M; Smith, Gwenn S (2015) Molecular imaging of neuropsychiatric symptoms in Alzheimer's and Parkinson's disease. Neurosci Biobehav Rev 49:157-70