nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2024-6-105-111nnp-2425Research ArticleREVIEWSОБЗОРЫComorbidity of sialorrhea and depression in patients with Parkinson's disease, their mutual influence on the severity of symptoms and the success of therapyКоморбидность сиалореи и депрессии у пациентов с болезнью Паркинсона, их взаимное влияние на выраженность симптоматики и успех проводимой терапииhttps://orcid.org/0000-0003-2266-9197ЗахаровД. В.ZakharovD. V.

 192019, Санкт-Петербург, ул. Бехтерева, 3 

 3, Bekhtereva St., St. Petersburg 192019 

zaharov_dv@mail.ruhttps://orcid.org/0009-0001-2218-2162КокареваД. Д.KokarevaD. D.

 192019, Санкт-Петербург, ул. Бехтерева, 3 

 3, Bekhtereva St., St. Petersburg 192019 

ФГБУ «Национальный медицинский исследовательский центр психиатрии и неврологии им. В.М. Бехтерева»РоссияV.M. Bekhterev National Research Medical Center for Psychiatry and Neurology, Ministry of Health of RussiaRussian Federation202417122024166105111Copyright © Zakharov D.V., Kokareva D.D., 20242024Захаров Д.В., Кокарева Д.Д.Zakharov D.V., Kokareva D.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/2425

Depression and sialorrhea are among the most common and distressing non-motor symptoms of Parkinson's disease at all stages of the disease. They impair the patient's quality of life and ability to function and mutually reinforce each other in the context of comorbidity. To date, the exact pathophysiological mechanisms underlying the development of these conditions and the contribution of dopaminergic regulatory system dysfunctions to their development are unclear. Although there are established methods to treat both depression and sialorrhea, there is still no recommended standardized therapeutic approach to correct their combination in Parkinson's disease with the possibility of reducing polypharmacy. Botulinum toxin therapy has several potential advantages and is considered a possible universal remedy for achieving stable remission of these disorders.

Депрессия и сиалорея относятся к числу наиболее частых и обременительных немоторных симптомов болезни Паркинсона на всех стадиях заболевания, они негативно влияют на качество жизни, функциональную трудоспособность пациентов и взаимно усиливаются в рамках коморбидности. До настоящего времени остаются не выясненными точные патофизиологические механизмы, лежащие в основе развития данных состояний, а также вклад в него нарушений в системе дофаминергической регуляции. Несмотря на наличие устоявшихся методов лечения как депрессии, так и сиалореи, на сегодняшний день не существует рекомендованного стандартизированного терапевтического подхода для коррекции их сочетания при болезни Паркинсона с возможностью сокращения полипрагмазии. Терапия ботулиническим токсином имеет ряд потенциальных преимуществ, а также, с учетом современных данных, рассматривается в качестве возможного универсального средства, влияющего на достижение стойкости ремиссии данных состояний.

коморбидная депрессиясиалореядепрессия и сиалореядепрессия при болезни Паркинсонаботулинический токсинремиссияcomorbid depressionsialorrheadepression and sialorrheadepression in Parkinson's diseasebotulinum toxinremissionReferencesOu Z, Pan J, Tang S, et al. Global Trends in the Incidence, Prevalence, and Years Lived With Disability of Parkinson's Disease in 204 Countries/Territories From 1990 to 2019. Front Public Health. 2021 Dec 7;9:776847. doi: 10.3389/fpubh.2021.776847Ou Z, Pan J, Tang S, et al. Global Trends in the Incidence, Prevalence, and Years Lived With Disability of Parkinson's Disease in 204 Countries/Territories From 1990 to 2019. Front Public Health. 2021 Dec 7;9:776847. doi: 10.3389/fpubh.2021.776847GBD 2015 Neurological Disorders Collaborator Group. Global, regional, and national burden of neurological disorders during 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Neurol. 2017 Nov;16(11):877-97. doi: 10.1016/S1474-4422(17)30299-5. Epub 2017 Sep 17.GBD 2015 Neurological Disorders Collaborator Group. Global, regional, and national burden of neurological disorders during 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Neurol. 2017 Nov;16(11):877-97. doi: 10.1016/S1474-4422(17)30299-5. Epub 2017 Sep 17.Dorsey ER, Bloem BR. The Parkinson Pandemic – A Call to Action. JAMA Neurol. 2018 Jan 1;75(1):9-10. doi: 10.1001/jamaneurol.2017.3299Dorsey ER, Bloem BR. The Parkinson Pandemic – A Call to Action. JAMA Neurol. 2018 Jan 1;75(1):9-10. doi: 10.1001/jamaneurol.2017.3299Todorova A, Jenner P, Ray Chaudhuri K. Non-motor Parkinson's: integral to motor Parkinson's, yet often neglected. Pract Neurol. 2014 Oct;14(5):310-22. doi: 10.1136/practneurol-2013-000741. Epub 2014 Apr 3.Todorova A, Jenner P, Ray Chaudhuri K. Non-motor Parkinson's: integral to motor Parkinson's, yet often neglected. Pract Neurol. 2014 Oct;14(5):310-22. doi: 10.1136/practneurol-2013-000741. Epub 2014 Apr 3.Bergmans B, Clark V, Isaacson SH, Bäumer T. Recommendations for a paradigm shift in approach to increase the recognition and treatment of sialorrhea in Parkinson's disease. Clin Park Relat Disord. 2023 Oct 11;9:100223. doi: 10.1016/j.prdoa.2023.100223. Erratum in: Clin Park Relat Disord. 2024 Apr18;10:100250. doi: 10.1016/j.prdoa.2024.100250.Bergmans B, Clark V, Isaacson SH, Bäumer T. Recommendations for a paradigm shift in approach to increase the recognition and treatment of sialorrhea in Parkinson's disease. Clin Park Relat Disord. 2023 Oct 11;9:100223. doi: 10.1016/j.prdoa.2023.100223. Erratum in: Clin Park Relat Disord. 2024 Apr18;10:100250. doi: 10.1016/j.prdoa.2024.100250.Martinez-Martin P, Rodriguez-Blazquez C, Kurtis MM, Chaudhuri KR; NMSS Validation Group. The impact of non-motor symptoms on health-related quality of life of patients with Parkinson's disease. Mov Disord. 2011 Feb 15;26(3):399-406. doi: 10.1002/mds.23462. Epub 2011 Jan 24.Martinez-Martin P, Rodriguez-Blazquez C, Kurtis MM, Chaudhuri KR; NMSS Validation Group. The impact of non-motor symptoms on health-related quality of life of patients with Parkinson's disease. Mov Disord. 2011 Feb 15;26(3):399-406. doi: 10.1002/mds.23462. Epub 2011 Jan 24.Barone P, Antonini A, Colosimo C, et al; PRIAMO study group. The PRIAMO study: A multicenter assessment of nonmotor symptoms and their impact on quality of life in Parkinson's disease. Mov Disord. 2009 Aug 15;24(11):1641-9. doi: 10.1002/mds.22643Barone P, Antonini A, Colosimo C, et al; PRIAMO study group. The PRIAMO study: A multicenter assessment of nonmotor symptoms and their impact on quality of life in Parkinson's disease. Mov Disord. 2009 Aug 15;24(11):1641-9. doi: 10.1002/mds.22643Ehgoetz Martens KA, Shine JM. The interactions between non-motor symptoms of Parkinson's disease. Expert Rev Neurother. 2018 Jun;18(6):457- 60. doi: 10.1080/14737175.2018.1472578. Epub 2018 May 8.Ehgoetz Martens KA, Shine JM. The interactions between non-motor symptoms of Parkinson's disease. Expert Rev Neurother. 2018 Jun;18(6):457- 60. doi: 10.1080/14737175.2018.1472578. Epub 2018 May 8.Jellinger KA. Neuropathology of Nonmotor Symptoms of Parkinson's Disease. Int Rev Neurobiol. 2017;133:13-62. doi: 10.1016/bs.irn.2017.05.005. Epub 2017 Jun 27.Jellinger KA. Neuropathology of Nonmotor Symptoms of Parkinson's Disease. Int Rev Neurobiol. 2017;133:13-62. doi: 10.1016/bs.irn.2017.05.005. Epub 2017 Jun 27.Schrag A. Quality of life and depression in Parkinson's disease. J Neurol Sci. 2006 Oct 25;248(1-2):151-7. doi: 10.1016/j.jns.2006.05.030. Epub 2006 Jun 21.Schrag A. Quality of life and depression in Parkinson's disease. J Neurol Sci. 2006 Oct 25;248(1-2):151-7. doi: 10.1016/j.jns.2006.05.030. Epub 2006 Jun 21.Gallagher DA, Lees AJ, Schrag A. What are the most important nonmotor symptoms in patients with Parkinson's disease and are we missing them? Mov Disord. 2010 Nov 15;25(15):2493-500. doi: 10.1002/mds.23394Gallagher DA, Lees AJ, Schrag A. What are the most important nonmotor symptoms in patients with Parkinson's disease and are we missing them? Mov Disord. 2010 Nov 15;25(15):2493-500. doi: 10.1002/mds.23394Aarsland D, Bronnick K, Alves G, et al. The spectrum of neuropsychiatric symptoms in patients with early untreated Parkinson's disease. J Neurol Neurosurg Psychiatry. 2009 Aug;80(8):928-30. doi: 10.1136/jnnp.2008.166959Aarsland D, Bronnick K, Alves G, et al. The spectrum of neuropsychiatric symptoms in patients with early untreated Parkinson's disease. J Neurol Neurosurg Psychiatry. 2009 Aug;80(8):928-30. doi: 10.1136/jnnp.2008.166959Hughes TA, Ross HF, Mindham RH, Spokes EG. Mortality in Parkinson's disease and its association with dementia and depression. Acta Neurol Scand. 2004 Aug;110(2):118- 23. doi: 10.1111/j.1600-0404.2004.00292.xHughes TA, Ross HF, Mindham RH, Spokes EG. Mortality in Parkinson's disease and its association with dementia and depression. Acta Neurol Scand. 2004 Aug;110(2):118- 23. doi: 10.1111/j.1600-0404.2004.00292.xBarbero P, Busso M, Artusi CA, et al. Ultrasound-guided Botulinum Toxin-A Injections: A Method of Treating Sialorrhea. J Vis Exp. 2016 Nov 9;(117):54606. doi: 10.3791/54606Barbero P, Busso M, Artusi CA, et al. Ultrasound-guided Botulinum Toxin-A Injections: A Method of Treating Sialorrhea. J Vis Exp. 2016 Nov 9;(117):54606. doi: 10.3791/54606Soundy A, Stubbs B, Roskell C. The experience of Parkinson's disease: a systematic review and meta-ethnography. Scientific World Journal. 2014;2014:613592. doi: 10.1155/2014/613592. Epub 2014 Nov 30.Soundy A, Stubbs B, Roskell C. The experience of Parkinson's disease: a systematic review and meta-ethnography. Scientific World Journal. 2014;2014:613592. doi: 10.1155/2014/613592. Epub 2014 Nov 30.Van den Akker M, Buntinx F, Knottnerus JA. Comorbidity or multimorbidity: what's in a name? A review of literature. Eur J General Pract. 1996;2(2):65-70. doi: 10.3109/13814789609162146Van den Akker M, Buntinx F, Knottnerus JA. Comorbidity or multimorbidity: what's in a name? A review of literature. Eur J General Pract. 1996;2(2):65-70. doi: 10.3109/13814789609162146Kalia LV, Lang AE. Parkinson's disease. Lancet. 2015 Aug 29;386(9996):896-912. doi: 10.1016/S0140-6736(14)61393-3. Epub 2015 Apr 19.Kalia LV, Lang AE. Parkinson's disease. Lancet. 2015 Aug 29;386(9996):896-912. doi: 10.1016/S0140-6736(14)61393-3. Epub 2015 Apr 19.MacMahon Copas AN, McComish SF, Fletcher JM, Caldwell MA. The Pathogenesis of Parkinson's Disease: A Complex Interplay Between Astrocytes, Microglia, and T Lymphocytes? Front Neurol. 2021 May 26;12:666737. doi: 10.3389/fneur.2021.666737MacMahon Copas AN, McComish SF, Fletcher JM, Caldwell MA. The Pathogenesis of Parkinson's Disease: A Complex Interplay Between Astrocytes, Microglia, and T Lymphocytes? Front Neurol. 2021 May 26;12:666737. doi: 10.3389/fneur.2021.666737Левин ОС. Диагностика и лечение депрессии при болезни Паркинсона. Нервные болезни. 2006;(2):2-8. [Levin OS. Diagnosis and treatment of depression in Parkinson's disease. Nervnye bolezni. 2006;(2):2-8 (In Russ.)].Levin OS. Diagnosis and treatment of depression in Parkinson's disease. Nervnye bolezni. 2006;(2):2-8 (In Russ.).Jankovic J. Parkinson's disease: clinical features and diagnosis. J Neurol Neurosurg Psychiatry. 2008 Apr;79(4):368-76. doi: 10.1136/jnnp.2007.131045Jankovic J. Parkinson's disease: clinical features and diagnosis. J Neurol Neurosurg Psychiatry. 2008 Apr;79(4):368-76. doi: 10.1136/jnnp.2007.131045Schapira AHV, Chaudhuri KR, Jenner P. Non-motor features of Parkinson disease. Nat Rev Neurosci. 2017 Jul;18(7):435-50. doi: 10.1038/nrn.2017.62. Epub 2017 Jun 8. Erratum in: Nat Rev Neurosci. 2017 Aug;18(8):509. doi: 10.1038/nrn.2017.91Schapira AHV, Chaudhuri KR, Jenner P. Non-motor features of Parkinson disease. Nat Rev Neurosci. 2017 Jul;18(7):435-50. doi: 10.1038/nrn.2017.62. Epub 2017 Jun 8. Erratum in: Nat Rev Neurosci. 2017 Aug;18(8):509. doi: 10.1038/nrn.2017.91Marsh L. Depression and Parkinson's disease: current knowledge. Curr Neurol Neurosci Rep. 2013 Dec;13(12):409. doi: 10.1007/s11910-013-0409-5Marsh L. Depression and Parkinson's disease: current knowledge. Curr Neurol Neurosci Rep. 2013 Dec;13(12):409. doi: 10.1007/s11910-013-0409-5Santangelo G, Cuoco S, Pellecchia MT, et al. Comparative cognitive and neuropsychiatric profiles between Parkinson's disease, multiple system atrophy and progressive supranuclear palsy. J Neurol. 2018 Nov;265(11):2602- 13. doi: 10.1007/s00415-018-9038-x. Epub 2018 Sep 3.Santangelo G, Cuoco S, Pellecchia MT, et al. Comparative cognitive and neuropsychiatric profiles between Parkinson's disease, multiple system atrophy and progressive supranuclear palsy. J Neurol. 2018 Nov;265(11):2602- 13. doi: 10.1007/s00415-018-9038-x. Epub 2018 Sep 3.Aarsland D, Pahlhagen S, Ballard CG, et al. Depression in Parkinson disease – epidemiology, mechanisms and management. Nat Rev Neurol. 2011 Dec 26;8(1):35-47. doi: 10.1038/nrneurol.2011.189Aarsland D, Pahlhagen S, Ballard CG, et al. Depression in Parkinson disease – epidemiology, mechanisms and management. Nat Rev Neurol. 2011 Dec 26;8(1):35-47. doi: 10.1038/nrneurol.2011.189Marg S, Walz B, Blenau W. The effects of dopamine receptor agonists and antagonists on the secretory rate of cockroach (Periplaneta americana) salivary glands. J Insect Physiol. 2004 Sep;50(9):821-30. doi: 10.1016/j.jinsphys.2004.06.004Marg S, Walz B, Blenau W. The effects of dopamine receptor agonists and antagonists on the secretory rate of cockroach (Periplaneta americana) salivary glands. J Insect Physiol. 2004 Sep;50(9):821-30. doi: 10.1016/j.jinsphys.2004.06.004Koga T, Kobashi M, Mizutani M, et al. Area postrema mediates gastric motor response induced by apomorphine in rats. Brain Res. 2003 Jan 17;960(1-2):122-31. doi: 10.1016/s0006-8993(02)03801-5Koga T, Kobashi M, Mizutani M, et al. Area postrema mediates gastric motor response induced by apomorphine in rats. Brain Res. 2003 Jan 17;960(1-2):122-31. doi: 10.1016/s0006-8993(02)03801-5Michalek R, Templeton D. The role of dopamine in salivation in the rat parotid gland. Gen Pharmacol. 1986;17(4):473-6. doi: 10.1016/0306-3623(86)90196-5Michalek R, Templeton D. The role of dopamine in salivation in the rat parotid gland. Gen Pharmacol. 1986;17(4):473-6. doi: 10.1016/0306-3623(86)90196-5Tomassoni D, Traini E, Mancini M, et al. Dopamine, vesicular transporters, and dopamine receptor expression in rat major salivary glands. Am J Physiol Regul Integr Comp Physiol. 2015 Sep;309(5):R585-93. doi: 10.1152/ajpregu.00455.2014. Epub 2015 Jul 1.Tomassoni D, Traini E, Mancini M, et al. Dopamine, vesicular transporters, and dopamine receptor expression in rat major salivary glands. Am J Physiol Regul Integr Comp Physiol. 2015 Sep;309(5):R585-93. doi: 10.1152/ajpregu.00455.2014. Epub 2015 Jul 1.Gholami N, Hosseini Sabzvari B, Razzaghi A, Salah S. Effect of stress, anxiety and depression on unstimulated salivary flow rate and xerostomia. J Dent Res Dent Clin Dent Prospects. 2017 Fall;11(4):247-52. doi: 10.15171/joddd.2017.043. Epub 2017 Dec 13.Gholami N, Hosseini Sabzvari B, Razzaghi A, Salah S. Effect of stress, anxiety and depression on unstimulated salivary flow rate and xerostomia. J Dent Res Dent Clin Dent Prospects. 2017 Fall;11(4):247-52. doi: 10.15171/joddd.2017.043. Epub 2017 Dec 13.Cui J, Qin Y, Tian Y, et al. Activities of daily living as a longitudinal moderator of the effect of autonomic dysfunction on anxiety and depression of Parkinson's patients. Brain Behav. 2021 Aug;11(8):e2297. doi: 10.1002/brb3.2297Cui J, Qin Y, Tian Y, et al. Activities of daily living as a longitudinal moderator of the effect of autonomic dysfunction on anxiety and depression of Parkinson's patients. Brain Behav. 2021 Aug;11(8):e2297. doi: 10.1002/brb3.2297Sklerov M, Shih CH, Browner N, et al. Longitudinal change in autonomic symptoms predicts activities of daily living and depression in Parkinson's disease. Clin Auton Res. 2020 Jun;30(3):223-30. doi: 10.1007/s10286-020- 00672-7. Epub 2020 Feb 20.Sklerov M, Shih CH, Browner N, et al. Longitudinal change in autonomic symptoms predicts activities of daily living and depression in Parkinson's disease. Clin Auton Res. 2020 Jun;30(3):223-30. doi: 10.1007/s10286-020- 00672-7. Epub 2020 Feb 20.Matsubara T, Suzuki K, Fujita H, et al. Autonomic Symptoms Correlate with NonAutonomic Non-Motor Symptoms and Sleep Problems in Patients with Parkinson's Disease. Eur Neurol. 2018;80(3-4):193-9. doi: 10.1159/000495797. Epub 2018 Dec 20.Matsubara T, Suzuki K, Fujita H, et al. Autonomic Symptoms Correlate with NonAutonomic Non-Motor Symptoms and Sleep Problems in Patients with Parkinson's Disease. Eur Neurol. 2018;80(3-4):193-9. doi: 10.1159/000495797. Epub 2018 Dec 20.Busfield BL, Wechsler H. Studies of salivation in depression. A comparison of salivation rates in depressed, schizoaffective depressed, nondepressed hospitalized patients, and in normal controls. Arch Gen Psychiatry. 1961 Jan;4:10-5. doi: 10.1001/archpsyc.1961.01710070012002Busfield BL, Wechsler H. Studies of salivation in depression. A comparison of salivation rates in depressed, schizoaffective depressed, nondepressed hospitalized patients, and in normal controls. Arch Gen Psychiatry. 1961 Jan;4:10-5. doi: 10.1001/archpsyc.1961.01710070012002Ou R, Guo X, Wei Q, et al. Prevalence and clinical correlates of drooling in Parkinson disease: a study on 518 Chinese patients. Parkinsonism Relat Disord. 2015 Mar;21(3):211- 5. doi: 10.1016/j.parkreldis.2014.12.004. Epub 2014 Dec 16.Ou R, Guo X, Wei Q, et al. Prevalence and clinical correlates of drooling in Parkinson disease: a study on 518 Chinese patients. Parkinsonism Relat Disord. 2015 Mar;21(3):211- 5. doi: 10.1016/j.parkreldis.2014.12.004. Epub 2014 Dec 16.Rascol O, Negre-Pages L, Damier P, et al; COPARK Study Group. Correction to: Excessive buccal saliva in patients with Parkinson's disease of the French COPARK cohort. J Neural Transm (Vienna). 2021 Jun;128(6):871-2. doi: 10.1007/s00702-020-02264-1. Erratum for: J Neural Transm (Vienna). 2020 Dec;127(12):1607-17. doi: 10.1007/s00702-020-02249-0Rascol O, Negre-Pages L, Damier P, et al; COPARK Study Group. Correction to: Excessive buccal saliva in patients with Parkinson's disease of the French COPARK cohort. J Neural Transm (Vienna). 2021 Jun;128(6):871-2. doi: 10.1007/s00702-020-02264-1. Erratum for: J Neural Transm (Vienna). 2020 Dec;127(12):1607-17. doi: 10.1007/s00702-020-02249-0Gotham AM, Brown RG, Marsden CD. Depression in Parkinson's disease: a quantitative and qualitative analysis. J Neurol Neurosurg Psychiatry. 1986 Apr;49(4):381-9. doi: 10.1136/jnnp.49.4.381Gotham AM, Brown RG, Marsden CD. Depression in Parkinson's disease: a quantitative and qualitative analysis. J Neurol Neurosurg Psychiatry. 1986 Apr;49(4):381-9. doi: 10.1136/jnnp.49.4.381Marinus J, Zhu K, Marras C, et al. Risk factors for non-motor symptoms in Parkinson's disease. Lancet Neurol. 2018 Jun;17(6):559-68. doi: 10.1016/S1474-4422(18)30127-3. Epub 2018 Apr 23.Marinus J, Zhu K, Marras C, et al. Risk factors for non-motor symptoms in Parkinson's disease. Lancet Neurol. 2018 Jun;17(6):559-68. doi: 10.1016/S1474-4422(18)30127-3. Epub 2018 Apr 23.Assogna F, Pellicano C, Savini C, et al. Drug Choices and Advancements for Managing Depression in Parkinson's Disease. Curr Neuropharmacol. 2020;18(4):277-87. doi: 10.2174/1570159X17666191016094857Assogna F, Pellicano C, Savini C, et al. Drug Choices and Advancements for Managing Depression in Parkinson's Disease. Curr Neuropharmacol. 2020;18(4):277-87. doi: 10.2174/1570159X17666191016094857Santangelo G, Garramone F, Baiano C, et al. Personality and Parkinson's disease: A meta-analysis. Parkinsonism Relat Disord. 2018 Apr;49:67-74. doi: 10.1016/j.parkreldis.2018.01.013. Epub 2018 Jan 12.Santangelo G, Garramone F, Baiano C, et al. Personality and Parkinson's disease: A meta-analysis. Parkinsonism Relat Disord. 2018 Apr;49:67-74. doi: 10.1016/j.parkreldis.2018.01.013. Epub 2018 Jan 12.Lakraj AA, Moghimi N, Jabbari B. Sialorrhea: anatomy, pathophysiology and treatment with emphasis on the role of botulinum toxins. Toxins (Basel). 2013 May 21;5(5):1010- 31. doi: 10.3390/toxins5051010Lakraj AA, Moghimi N, Jabbari B. Sialorrhea: anatomy, pathophysiology and treatment with emphasis on the role of botulinum toxins. Toxins (Basel). 2013 May 21;5(5):1010- 31. doi: 10.3390/toxins5051010Scully C, Limeres J, Gleeson M, et al. Drooling. J Oral Pathol Med. 2009 Apr;38(4):321-7. doi: 10.1111/j.1600-0714.2008.00727.x. Epub 2009 Feb 23.Scully C, Limeres J, Gleeson M, et al. Drooling. J Oral Pathol Med. 2009 Apr;38(4):321-7. doi: 10.1111/j.1600-0714.2008.00727.x. Epub 2009 Feb 23.Захаров ДВ, Кокарева ДД. Сиалорея как мультидисциплинарная проблема. Обзор возможных причин и терапевтических решений. Нервные болезни. 2023;(2):32-8. doi: 10.24412/2226- 0757-2023-12842Zakharov DV, Kokareva DD. Sialorrhea as a multidisciplinary problem.The review of potential causes and therapeutic solutions. Nervnye bolezni. 2023;(2):32-8. doi: 10.24412/2226-0757-2023-12842 (In Russ.).Hockstein NG, Samadi DS, Gendron K, Handler SD. Sialorrhea: a management challenge. Am Fam Physician. 2004 Jun 1;69(11):2628-34.Hockstein NG, Samadi DS, Gendron K, Handler SD. Sialorrhea: a management challenge. Am Fam Physician. 2004 Jun 1;69(11):2628-34.Isaacson J, Patel S, Torres-Yaghi Y, Pagan F. Sialorrhea in Parkinson's Disease. Toxins (Basel). 2020 Oct 31;12(11):691. doi: 10.3390/toxins12110691Isaacson J, Patel S, Torres-Yaghi Y, Pagan F. Sialorrhea in Parkinson's Disease. Toxins (Basel). 2020 Oct 31;12(11):691. doi: 10.3390/toxins12110691Mathew RJ, Weinman M, Claghorn JL. Xerostomia and sialorrhea in depression. Am J Psychiatry. 1979 Nov;136(11):1476-7. doi: 10.1176/ajp.136.11.1476 46. Freudenreich O. Drug-induced sialorrhea. Drugs Today (Barc). 2005 Jun;41(6):411-8. doi: 10.1358/dot.2005.41.6.893628Mathew RJ, Weinman M, Claghorn JL. Xerostomia and sialorrhea in depression. Am J Psychiatry. 1979 Nov;136(11):1476-7. doi: 10.1176/ajp.136.11.1476 46. Freudenreich O. Drug-induced sialorrhea. Drugs Today (Barc). 2005 Jun;41(6):411-8. doi: 10.1358/dot.2005.41.6.893628Sahan E, Kilicarslan T, Kirpinar I. Sialorrhoea associated with sertraline use. Scott Med J. 2019 Nov;64(4):159-61. doi: 10.1177/0036933019875051. Epub 2019 Sep 10.Sahan E, Kilicarslan T, Kirpinar I. Sialorrhoea associated with sertraline use. Scott Med J. 2019 Nov;64(4):159-61. doi: 10.1177/0036933019875051. Epub 2019 Sep 10.Клинические рекомендации. Болезнь Паркинсона, вторичный паркинсонизм и другие заболевания, проявляющиеся синдромом паркинсонизма. 2023. ID: 716. Доступно по ссылке: https://cr.minzdrav.gov.ru/schema/716_1?ysclid=m35mk09a9c104611465Clinical guidelines. Parkinson's disease, secondary parkinsonism and other diseases manifested by parkinsonism syndrome. 2023. ID: 716. Available at: https://cr.minzdrav.gov.ru/schema/716_1?ysclid=m35mk09a9c104611465 (In Russ.).Seppi K, Ray Chaudhuri K, Coelho M, et al; the collaborators of the Parkinson's Disease Update on Non-Motor Symptoms Study Group on behalf of the Movement Disorders Society Evidence-Based Medicine Committee. Update on treatments for nonmotor symptoms of Parkinson's disease – an evidence-based medicine review. Mov Disord. 2019 Feb;34(2):180-98. doi: 10.1002/mds.27602. Epub 2019 Jan 17. Erratum in: Mov Disord. 2019 May;34(5):765. doi: 10.1002/mds.27684Seppi K, Ray Chaudhuri K, Coelho M, et al; the collaborators of the Parkinson's Disease Update on Non-Motor Symptoms Study Group on behalf of the Movement Disorders Society Evidence-Based Medicine Committee. Update on treatments for nonmotor symptoms of Parkinson's disease – an evidence-based medicine review. Mov Disord. 2019 Feb;34(2):180-98. doi: 10.1002/mds.27602. Epub 2019 Jan 17. Erratum in: Mov Disord. 2019 May;34(5):765. doi: 10.1002/mds.27684Prange S, Klinger H, Laurencin C, et al. Depression in Patients with Parkinson's Disease: Current Understanding of its Neurobiology and Implications for Treatment. Drugs Aging. 2022 Jun;39(6):417-39. doi: 10.1007/s40266-022-00942-1. Epub 2022 Jun 16.Prange S, Klinger H, Laurencin C, et al. Depression in Patients with Parkinson's Disease: Current Understanding of its Neurobiology and Implications for Treatment. Drugs Aging. 2022 Jun;39(6):417-39. doi: 10.1007/s40266-022-00942-1. Epub 2022 Jun 16.Weintraub D, Moberg PJ, Duda JE, et al. Recognition and treatment of depression in Parkinson's disease. J Geriatr Psychiatry Neurol. 2003 Sep;16(3):178-83. doi: 10.1177/0891988703256053Weintraub D, Moberg PJ, Duda JE, et al. Recognition and treatment of depression in Parkinson's disease. J Geriatr Psychiatry Neurol. 2003 Sep;16(3):178-83. doi: 10.1177/0891988703256053Mendlewicz J. Towards achieving remission in the treatment of depression. Dialogues Clin Neurosci. 2008;10(4):371-5. doi: 10.31887/DCNS.2008.10.4/jmendlewiczMendlewicz J. Towards achieving remission in the treatment of depression. Dialogues Clin Neurosci. 2008;10(4):371-5. doi: 10.31887/DCNS.2008.10.4/jmendlewiczPrisnie JC, Sajobi TT, Wang M, et al. Effects of depression and anxiety on quality of life in five common neurological disorders. Gen Hosp Psychiatry. 2018 May-Jun;52:58-63. doi: 10.1016/j.genhosppsych.2018.03.009. Epub 2018 Apr 4.Prisnie JC, Sajobi TT, Wang M, et al. Effects of depression and anxiety on quality of life in five common neurological disorders. Gen Hosp Psychiatry. 2018 May-Jun;52:58-63. doi: 10.1016/j.genhosppsych.2018.03.009. Epub 2018 Apr 4.Riedel O, Bitters D, Amann U, et al. Estimating the prevalence of Parkinson's disease (PD) and proportions of patients with associated dementia and depression among the older adults based on secondary claims data. Int J Geriatr Psychiatry. 2016 Aug;31(8):938-43. doi: 10.1002/gps.4414. Epub 2016 Jan 14.Riedel O, Bitters D, Amann U, et al. Estimating the prevalence of Parkinson's disease (PD) and proportions of patients with associated dementia and depression among the older adults based on secondary claims data. Int J Geriatr Psychiatry. 2016 Aug;31(8):938-43. doi: 10.1002/gps.4414. Epub 2016 Jan 14.Kalf JG, de Swart BJ, Borm GF, et al. Prevalence and definition of drooling in Parkinson's disease: a systematic review. J Neurol. 2009 Sep;256(9):1391-6. doi: 10.1007/s00415-009-5098-2. Epub 2009 Mar 14.Kalf JG, de Swart BJ, Borm GF, et al. Prevalence and definition of drooling in Parkinson's disease: a systematic review. J Neurol. 2009 Sep;256(9):1391-6. doi: 10.1007/s00415-009-5098-2. Epub 2009 Mar 14.Van Wamelen DJ, Leta V, Johnson J, et al. Drooling in Parkinson's Disease: Prevalence and Progression from the Non-motor International Longitudinal Study. Dysphagia. 2020 Dec;35(6):955-61. doi: 10.1007/s00455-020-10102-5. Epub 2020 Mar 4.Van Wamelen DJ, Leta V, Johnson J, et al. Drooling in Parkinson's Disease: Prevalence and Progression from the Non-motor International Longitudinal Study. Dysphagia. 2020 Dec;35(6):955-61. doi: 10.1007/s00455-020-10102-5. Epub 2020 Mar 4.Malek N, Lawton MA, Grosset KA, et al; PRoBaND Clinical Consortium. Autonomic Dysfunction in Early Parkinson's Disease: Results from the United Kingdom Tracking Parkinson's Study. Mov Disord Clin Pract. 2016 Nov 24;4(4):509-16. doi: 10.1002/mdc3.12454Malek N, Lawton MA, Grosset KA, et al; PRoBaND Clinical Consortium. Autonomic Dysfunction in Early Parkinson's Disease: Results from the United Kingdom Tracking Parkinson's Study. Mov Disord Clin Pract. 2016 Nov 24;4(4):509-16. doi: 10.1002/mdc3.12454Hsu YT, Liao CC, Chang SN, et al. Increased Risk of Depression in Patients with Parkinson Disease: A Nationwide Cohort Study. Am J Geriatr Psychiatry. 2015 Sep;23(9):934-40. doi: 10.1016/j.jagp.2014.10.011. Epub 2014 Nov 6.Hsu YT, Liao CC, Chang SN, et al. Increased Risk of Depression in Patients with Parkinson Disease: A Nationwide Cohort Study. Am J Geriatr Psychiatry. 2015 Sep;23(9):934-40. doi: 10.1016/j.jagp.2014.10.011. Epub 2014 Nov 6.Martinez-Poles J, Nedkova-Hristova V, Escribano-Paredes JB, et al. Incobotulinumtoxin A for Sialorrhea in Neurological Disorders: A Real-Life Experience. Toxins (Basel). 2018 May 28;10(6):217. doi: 10.3390/toxins10060217Martinez-Poles J, Nedkova-Hristova V, Escribano-Paredes JB, et al. Incobotulinumtoxin A for Sialorrhea in Neurological Disorders: A Real-Life Experience. Toxins (Basel). 2018 May 28;10(6):217. doi: 10.3390/toxins10060217Jost WH, Friedman A, Michel O, et al. SIAXI: Placebo-controlled, randomized, double-blind study of incobotulinumtoxinA for sialorrhea. Neurology. 2019 Apr 23;92(17):e1982-e1991. doi: 10.1212/WNL.0000000000007368. Epub 2019 Mar 27.Jost WH, Friedman A, Michel O, et al. SIAXI: Placebo-controlled, randomized, double-blind study of incobotulinumtoxinA for sialorrhea. Neurology. 2019 Apr 23;92(17):e1982-e1991. doi: 10.1212/WNL.0000000000007368. Epub 2019 Mar 27.Jankovic J. Botulinum toxin: State of the art. Mov Disord. 2017 Aug;32(8):1131-8. doi: 10.1002/mds.27072. Epub 2017 Jun 22.Jankovic J. Botulinum toxin: State of the art. Mov Disord. 2017 Aug;32(8):1131-8. doi: 10.1002/mds.27072. Epub 2017 Jun 22.Hosp C, Naumann MK, Hamm H. Botulinum Toxin Treatment of Autonomic Disorders: Focal Hyperhidrosis and Sialorrhea. Semin Neurol. 2016 Feb;36(1):20-8. doi: 10.1055/s-0035-1571214. Epub 2016 Feb 11.Hosp C, Naumann MK, Hamm H. Botulinum Toxin Treatment of Autonomic Disorders: Focal Hyperhidrosis and Sialorrhea. Semin Neurol. 2016 Feb;36(1):20-8. doi: 10.1055/s-0035-1571214. Epub 2016 Feb 11.Castren E. Is mood chemistry? Nat Rev Neurosci. 2005 Mar;6(3):241-6. doi: 10.1038/nrn1629 64. Ibragic S, Matak I, Dracic A, et al. Effects of botulinum toxin type A facial injection on monoamines and their metabolites in sensory, limbic and motor brain regions in rats. Neurosci Lett. 2016 Mar 23;617:213-7. doi: 10.1016/j.neulet.2016.02.020Castren E. Is mood chemistry? Nat Rev Neurosci. 2005 Mar;6(3):241-6. doi: 10.1038/nrn1629 64. Ibragic S, Matak I, Dracic A, et al. Effects of botulinum toxin type A facial injection on monoamines and their metabolites in sensory, limbic and motor brain regions in rats. Neurosci Lett. 2016 Mar 23;617:213-7. doi: 10.1016/j.neulet.2016.02.020Finzi E. Botulinum Toxin Treatment for Depression: A New Paradigm for Psychiatry. Toxins (Basel). 2023 May 14;15(5):336. doi: 10.3390/toxins15050336 66. Wollmer MA, Magid M, Kruger THC, Finzi E. Treatment of Depression with Botulinum Toxin. Toxins (Basel). 2022 May 31;14(6):383. doi: 10.3390/toxins14060383Finzi E. Botulinum Toxin Treatment for Depression: A New Paradigm for Psychiatry. Toxins (Basel). 2023 May 14;15(5):336. doi: 10.3390/toxins15050336 66. Wollmer MA, Magid M, Kruger THC, Finzi E. Treatment of Depression with Botulinum Toxin. Toxins (Basel). 2022 May 31;14(6):383. doi: 10.3390/toxins14060383Arnone D, Galadari H, Rodgers CJ, et al. Efficacy of onabotulinumtoxinA in the treatment of unipolar major depression: Systematic review, meta-analysis and meta-regression analyses of double-blind randomised controlled trials. J Psychopharmacol. 2021 Aug;35(8):910- 8. doi: 10.1177/0269881121991827. Epub 2021 Mar 15.Arnone D, Galadari H, Rodgers CJ, et al. Efficacy of onabotulinumtoxinA in the treatment of unipolar major depression: Systematic review, meta-analysis and meta-regression analyses of double-blind randomised controlled trials. J Psychopharmacol. 2021 Aug;35(8):910- 8. doi: 10.1177/0269881121991827. Epub 2021 Mar 15.Crowley JS, Silverstein ML, Reghunathan M, Gosman AA. Glabellar Botulinum Toxin Injection Improves Depression Scores: A Systematic Review and Meta-Analysis. Plast Reconstr Surg. 2022 Jul 1;150(1):211e-220e. doi: 10.1097/PRS.0000000000009240. Epub 2022 May 20.Crowley JS, Silverstein ML, Reghunathan M, Gosman AA. Glabellar Botulinum Toxin Injection Improves Depression Scores: A Systematic Review and Meta-Analysis. Plast Reconstr Surg. 2022 Jul 1;150(1):211e-220e. doi: 10.1097/PRS.0000000000009240. Epub 2022 May 20.Zhu C, Wang K, Yu T, Liu H. Effects of botulinum toxin type a on mood and cognitive function in patients with parkinson's disease and depression. Am J Transl Res. 2021 Apr 15;13(4):2717-23.Zhu C, Wang K, Yu T, Liu H. Effects of botulinum toxin type a on mood and cognitive function in patients with parkinson's disease and depression. Am J Transl Res. 2021 Apr 15;13(4):2717-23.

The authors declare that there are no conflicts of interest present.