Parkinson’s Disease (PD) is widely known for its motor symptoms, but non-motor symptoms including temperature dysregulation significantly impact quality life of people with PD. PD can disrupt temperature regulation causing issues in abnormal sweating or changes in temperature perception (Coon & Low, 2018). Previous research suggested a link between temperature dysregulation and mood disturbances such as depression and anxiety, as thermoregulation and temperature perception are related to emotional processing and interoception (i.e., the perception of the physiological state of the body) (Crucianelli et al., 2024; Crucianelli & Ehrsson, 2023). Nevertheless, the relationship between thermoregulation dysfunction and neuropsychiatric disturbances including mental health symptoms in PD remains unexplored.
A total of 222 patients diagnosed with PD (Mean age = 62.62 years, SD = 7.26), participated in this cross-sectional study to examine the relationship between thermoregulation dysfunction and neuropsychiatric disturbances in patients with PD, specifically focusing on depression, anxiety and apathy. Clinical evaluations included the Scales for Outcomes in Parkinson’s Disease for Autonomic Symptoms (SCOPA-AUT) to assess autonomic dysfunction including thermoregulation, the Hamilton Depression Rating Scale (HDRS), the Hamilton Anxiety Rating Scale (HARS), and the Apathy Evaluation Scale (AES). Cognitive function was measured using the Montreal Cognitive Assessment (MOCA), and motor symptoms were assessed using the Unified Parkinson’s Disease Rating Scale (UPDRS).
Descriptive statistics revealed a mean disease duration of 10.26 years (SD = 4.39) and a mean Levodopa Equivalent Daily Dose (LEDD) of 1012.38 mg (SD = 458.34). Spearman’s correlation analysis showed a significant positive relationship between thermoregulation dysfunction (SCOPA-AUT-thermo scores) and both depression (rho = 0.269, p < 0.001) and anxiety (rho = 0.312, p < 0.001). These results suggest that increased autonomic dysfunction, particularly thermoregulatory dysfunction is associated with higher levels of depression and anxiety. However, no significant correlations were observed between thermoregulation dysfunction and apathy (rho = 0.055, p = 0.488) or cognitive function (MOCA) (rho = 0.058, p = 0.485), indicating that thermoregulatory dysfunction does not directly influence apathy or cognitive performance.
Additionally, a strong positive correlation was observed between depression and anxiety (rho = 0.811, p < 0.001), which is consistent with previous research indicating a strong link between these two mood disorders in PD (Coon & Low, 2018). Moderate correlations were also found between depression and apathy (rho = 0.267, p < 0.001), as well as anxiety with apathy (rho = 0.192, p = 0.007). Cognitive function was negatively correlated with apathy (rho = -0.158, p = 0.040), suggesting that higher levels of apathy are associated with poorer cognitive performance.
Our findings suggest that temperature dysregulation in PD may significantly influence mood disturbances, particularly depression and anxiety, but does not appear to have a direct relationship with apathy or cognitive decline. This study highlights the importance of addressing thermoregulation dysfunction in the management of non-motor symptoms in PD. Future research should further explore the mechanisms linking autonomic dysfunction and mental health to develop targeted interventions aimed at improving patient overall well-being.