1
|
Wang Z, Xia H, Shi J, Fan P, Cao Q, Ding Y, Du X, Yang X. Investigating the Genetic Association of 40 Biochemical Indicators with Parkinson's Disease. J Mol Neurosci 2024; 74:92. [PMID: 39365399 DOI: 10.1007/s12031-024-02273-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Accepted: 09/29/2024] [Indexed: 10/05/2024]
Abstract
The mechanisms of Parkinson's disease (PD) are not fully understood, which hinders the development of effective therapies. Research indicates that lower levels of biochemical indicators like bilirubin, vitamin D, and cholesterol may elevate the risk of PD. However, clinical studies on abnormal levels of biochemical indicators in PD patients' circulation are inconsistent, leading to ongoing debate about their association with PD. Here, we investigate the genetic correlation between 40 biochemical indicators and PD using a bidirectional two-sample Mendelian randomization (MR) approach to uncover potential causal relationships. Data from genome-wide association studies (GWAS) were utilized, with genetic variations from specific lineages serving as instrumental variables (IVs). The methodology followed the STROBE-MR checklist and adhered to the three principal assumptions of MR. Statistical analyses employed methods including inverse variance weighting (IVW), MR-Egger, weighted median, and weighted mode. Biochemical indicators including albumin, C-reactive protein (CRP), and sex hormone-binding globulin (SHBG) showed significant associations with PD risk. Elevated levels of albumin (OR = 1.246, 95% CI 1.006-1.542, P = 0.043) and SHBG (OR = 1.239, 95% CI 1.065-1.439, P = 0.005) were linked to higher PD risk. Conversely, increased CRP levels (OR = 0.663, 95% CI 0.517-0.851; P = 0.001) could potentially lower PD risk. The robustness of the results was confirmed through various MR analysis techniques, including assessments of directional pleiotropy and heterogeneity using MR-Egger intercept and MR-PRESSO methods. This study systematically reveals, for the first time at the genetic level, the relationship between 40 biochemical indicators and PD risk. Our research verifies the role of inflammation in PD and provides new genetic evidence, further advancing the understanding of PD pathogenesis. The study shows a positive correlation between albumin and SHBG with PD risk and a negative correlation between CRP and PD risk. This study identifies for the first time that SHBG may be involved in the onset of PD and potentially worsen disease progression.
Collapse
Affiliation(s)
- Zihao Wang
- Department of Neurology, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Huan Xia
- Department of Neurology, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
- Xinjiang Medical University Affiliated Tumor Hospital, Urumqi, 830011, China
| | - Jianqiao Shi
- Department of Neurology, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Peidong Fan
- Department of Neurology, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Qiannan Cao
- Department of Neurology, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Yunfa Ding
- Jinshazhou Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Xinyu Du
- Department of Neurology, Jiangsu Provincial People's Hospital, Nanjing, 210029, China
| | - Xinling Yang
- Department of Neurology, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China.
| |
Collapse
|
2
|
Ursino M, Pelle S, Nekka F, Robaey P, Schirru M. Valence-dependent dopaminergic modulation during reversal learning in Parkinson's disease: A neurocomputational approach. Neurobiol Learn Mem 2024; 215:107985. [PMID: 39270814 DOI: 10.1016/j.nlm.2024.107985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 08/19/2024] [Accepted: 09/06/2024] [Indexed: 09/15/2024]
Abstract
Reinforcement learning, crucial for behavior in dynamic environments, is driven by rewards and punishments, modulated by dopamine (DA) changes. This study explores the dopaminergic system's influence on learning, particularly in Parkinson's disease (PD), where medication leads to impaired adaptability. Highlighting the role of tonic DA in signaling the valence of actions, this research investigates how DA affects response vigor and decision-making in PD. DA not only influences reward and punishment learning but also indicates the cognitive effort level and risk propensity in actions, which are essential for understanding and managing PD symptoms. In this work, we adapt our existing neurocomputational model of basal ganglia (BG) to simulate two reversal learning tasks proposed by Cools et al. We first optimized a Hebb rule for both probabilistic and deterministic reversal learning, conducted a sensitivity analysis (SA) on parameters related to DA effect, and compared performances between three groups: PD-ON, PD-OFF, and control subjects. In our deterministic task simulation, we explored switch error rates after unexpected task switches and found a U-shaped relationship between tonic DA levels and switch error frequency. Through SA, we classify these three groups. Then, assuming that the valence of the stimulus affects the tonic levels of DA, we were able to reproduce the results by Cools et al. As for the probabilistic task simulation, our results are in line with clinical data, showing similar trends with PD-ON, characterized by higher tonic DA levels that are correlated with increased difficulty in both acquisition and reversal tasks. Our study proposes a new hypothesis: valence, signaled by tonic DA levels, influences learning in PD, confirming the uncorrelation between phasic and tonic DA changes. This hypothesis challenges existing paradigms and opens new avenues for understanding cognitive processes in PD, particularly in reversal learning tasks.
Collapse
Affiliation(s)
- Mauro Ursino
- Department of Electrical, Electronic and Information Engineering Guglielmo Marconi, University of Bologna, Campus of Cesena, I 47521 Cesena, Italy.
| | - Silvana Pelle
- Department of Electrical, Electronic and Information Engineering Guglielmo Marconi, University of Bologna, Campus of Cesena, I 47521 Cesena, Italy.
| | - Fahima Nekka
- Faculté de Pharmacie, Université de Montréal, Montreal, Quebec H3T 1J4, Canada; Centre de recherches mathématiques, Université de Montréal, Montreal, Quebec H3T 1J4, Canada; Centre for Applied Mathematics in Bioscience and Medicine (CAMBAM), McGill University, Montreal, Quebec H3G 1Y6, Canada.
| | - Philippe Robaey
- Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.
| | - Miriam Schirru
- Department of Electrical, Electronic and Information Engineering Guglielmo Marconi, University of Bologna, Campus of Cesena, I 47521 Cesena, Italy; Faculté de Pharmacie, Université de Montréal, Montreal, Quebec H3T 1J4, Canada.
| |
Collapse
|
3
|
Plewnia C, Masini D, Fisone G. Rewarding properties of L-Dopa in experimental parkinsonism are mediated by sensitized dopamine D1 receptors in the dorsal striatum. Mol Psychiatry 2024:10.1038/s41380-024-02721-3. [PMID: 39227434 DOI: 10.1038/s41380-024-02721-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 08/16/2024] [Accepted: 08/22/2024] [Indexed: 09/05/2024]
Abstract
Treatment of Parkinson's disease (PD) is based on the use of dopaminergic drugs, such as L-Dopa and dopamine receptor agonists. These substances counteract motor symptoms, but their administration is accompanied by motor and non-motor complications. Among these latter conditions a neurobehavioral disorder similar to drug abuse, known as dopamine dysregulation syndrome (DDS), is attracting increasing interest because of its profound negative impact on the patients' quality of life. Here we replicate DDS in a PD mouse model based on a bilateral injection of 6-hydroxydopamine (6-OHDA) into the dorsal striatum. Administration of L-Dopa induced locomotor sensitization and conditioned place preference in 6-OHDA lesion, but not in control mice, indicative of the acquisition of addictive-like properties following nigrostriatal dopamine depletion. These behavioral effects were accompanied by abnormal dopamine D1 receptor (D1R) signaling in the medium spiny neurons of the dorsal striatum, leading to hyperactivation of multiple signaling cascades and increased expression of ΔFosB, a stable transcription factor involved in addictive behavior. Systemic administration of the D1R antagonist, SCH23390, abolished these effects and the development of place preference, thereby counteracting the psychostimulant-like effect of L-Dopa. The rewarding properties of L-Dopa were also prevented by chemogenetic inactivation of D1R-expressing neurons in the dorsal striatum. Our results indicate the association between abnormal D1R-mediated transmission and DDS in PD and identify potential approaches for the treatment of this disorder.
Collapse
Affiliation(s)
- Carina Plewnia
- Department of Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden
| | - Débora Masini
- Department of Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden
- Department of Biochemistry and Biophysics, Stockholm University, 10691, Stockholm, Sweden
| | - Gilberto Fisone
- Department of Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden.
| |
Collapse
|
4
|
Debove I, Paschen S, Amstutz D, Cardoso F, Corvol JC, Fung VSC, Lang AE, Martinez Martin P, Rodríguez-Oroz MC, Weintraub D, Krack P, Deuschl G. Management of Impulse Control and Related Disorders in Parkinson's Disease: An Expert Consensus. Mov Disord 2024; 39:235-248. [PMID: 38234035 DOI: 10.1002/mds.29700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/23/2023] [Accepted: 12/13/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Impulse-control and related behavioral disorders (ICBDs) significantly impact the lives of Parkinson's disease (PD) patients and caregivers, with lasting consequences if undiagnosed and untreated. While ICBD pathophysiology and risk factors are well-studied, a standardized severity definition and treatment evidence remain elusive. OBJECTIVE This work aimed to establish international expert consensus on ICBD treatment strategies. To comprehensively address diverse treatment availabilities, experts from various continents were included. METHODS From 2021 to 2023, global movement disorders specialists engaged in a Delphi process. A core expert group initiated surveys, involving a larger panel in three iterations, leading to refined severity definitions and treatment pathways. RESULTS Experts achieved consensus on defining ICBD severity, emphasizing regular PD patient screenings for early detection. General treatment recommendations focused on continuous monitoring, collaboration with significant others, and seeking specialist advice for legal or financial challenges. For mild to severe ICBDs, gradual reduction in dopamine agonists was endorsed, followed by reductions in other PD medications. Second-line treatment strategies included diverse approaches like reversing the last medication change, cognitive behavior therapy, subthalamic nucleus deep brain stimulation, and specific medications like quetiapine, clozapine, and antidepressants. The panel reached consensus on distinct treatment pathways for punding and dopamine dysregulation syndrome, formulating therapy recommendations. Comprehensive discussions addressed management strategies for the exacerbation of either motor or non-motor symptoms following the proposed treatments. CONCLUSION The consensus offers in-depth insights into ICBD management, presenting clear severity criteria and expert consensus treatment recommendations. The study highlights the critical need for further research to enhance ICBD management. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Ines Debove
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Steffen Paschen
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| | - Deborah Amstutz
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Francisco Cardoso
- Movement Disorders Unit, Neurology Service, Internal Medicine Department, The Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Jean-Christophe Corvol
- Department of Neurology, Sorbonne Université, Paris Brain Institute (ICM), Inserm, CNRS, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Victor S C Fung
- Movement Disorders Unit, Department of Neurology, Westmead Hospital and Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Anthony E Lang
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Pablo Martinez Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | | | - Daniel Weintraub
- Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Parkinson's Disease Research, Education and Clinical Center (PADRECC and MIRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Paul Krack
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Günther Deuschl
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| |
Collapse
|
5
|
Liu WM, Yeh CL, Chen PW, Lin CW, Liu AB. Keystroke Biometrics as a Tool for the Early Diagnosis and Clinical Assessment of Parkinson's Disease. Diagnostics (Basel) 2023; 13:3061. [PMID: 37835803 PMCID: PMC10572112 DOI: 10.3390/diagnostics13193061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/22/2023] [Accepted: 09/23/2023] [Indexed: 10/15/2023] Open
Abstract
(1) Background: Parkinson's disease (PD) is the second most common neurodegenerative disease. Early diagnosis and reliable clinical assessments are essential for appropriate therapy and improving patients' quality of life. Keystroke biometrics, which capture unique typing behavior, have shown potential for early PD diagnosis. This study aimed to evaluate keystroke biometric parameters from two datasets to identify indicators that can effectively distinguish de novo PD patients from healthy controls. (2) Methods: Data from natural typing tasks in Physionet were analyzed to estimate keystroke biometric parameters. The parameters investigated included alternating-finger tapping (afTap) and standard deviations of interkey latencies (ILSD) and release latencies (RLSD). Sensitivity rates were calculated to assess the discriminatory ability of these parameters. (3) Results: Significant differences were observed in three parameters, namely afTap, ILSD, and RLSD, between de novo PD patients and healthy controls. The sensitivity rates were high, with values of 83%, 88%, and 96% for afTap, ILSD, and RLSD, respectively. Correlation analysis revealed a significantly negative correlation between typing speed and number of words typed with the standard motor assessment for PD, UPDRS-III, in patients with early PD. (4) Conclusions: Simple algorithms utilizing keystroke biometric parameters can serve as effective screening tests in distinguishing de novo PD patients from healthy controls. Moreover, typing speed and number of words typed were identified as reliable tools for assessing clinical statuses in PD patients. These findings underscore the potential of keystroke biometrics for early PD diagnosis and clinical severity assessment.
Collapse
Affiliation(s)
- Wei-Min Liu
- Department of Computer Science and Information Engineering, Advanced Institute of Manufacturing with High-Tech Innovations, National Chung Cheng University, Chiayi 621301, Taiwan; (W.-M.L.); (C.-L.Y.)
| | - Che-Lun Yeh
- Department of Computer Science and Information Engineering, Advanced Institute of Manufacturing with High-Tech Innovations, National Chung Cheng University, Chiayi 621301, Taiwan; (W.-M.L.); (C.-L.Y.)
| | - Po-Wei Chen
- Department of Physical Medicine and Rehabilitation, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan;
| | - Che-Wei Lin
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan 701401, Taiwan;
| | - An-Bang Liu
- Department of Medicine, School of Medicine, Tzu Chi University, Hualien 970374, Taiwan
- Department of Neurology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 970473, Taiwan
| |
Collapse
|
6
|
Liu K, Song M, Gao S, Yao L, Zhang L, Feng J, Wang L, Gao R, Wang Y. The Dynamics of Dopamine D 2 Receptor-Expressing Striatal Neurons and the Downstream Circuit Underlying L-Dopa-Induced Dyskinesia in Rats. Neurosci Bull 2023; 39:1411-1425. [PMID: 37022638 PMCID: PMC10465438 DOI: 10.1007/s12264-023-01054-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/05/2022] [Indexed: 04/07/2023] Open
Abstract
L-dopa (l-3,4-dihydroxyphenylalanine)-induced dyskinesia (LID) is a debilitating complication of dopamine replacement therapy for Parkinson's disease. The potential contribution of striatal D2 receptor (D2R)-positive neurons and downstream circuits in the pathophysiology of LID remains unclear. In this study, we investigated the role of striatal D2R+ neurons and downstream globus pallidus externa (GPe) neurons in a rat model of LID. Intrastriatal administration of raclopride, a D2R antagonist, significantly inhibited dyskinetic behavior, while intrastriatal administration of pramipexole, a D2-like receptor agonist, yielded aggravation of dyskinesia in LID rats. Fiber photometry revealed the overinhibition of striatal D2R+ neurons and hyperactivity of downstream GPe neurons during the dyskinetic phase of LID rats. In contrast, the striatal D2R+ neurons showed intermittent synchronized overactivity in the decay phase of dyskinesia. Consistent with the above findings, optogenetic activation of striatal D2R+ neurons or their projections in the GPe was adequate to suppress most of the dyskinetic behaviors of LID rats. Our data demonstrate that the aberrant activity of striatal D2R+ neurons and downstream GPe neurons is a decisive mechanism mediating dyskinetic symptoms in LID rats.
Collapse
Affiliation(s)
- Kuncheng Liu
- Department of Physiology and Pathophysiology and Institute of Neuroscience, School of Basic Medical Sciences, Xi'an Jiao Tong University Health Science Center, Xi'an, 710061, China
- Department of Clinical Medicine, Xi'an Jiao Tong University Health Science Center, Xi'an, 710061, China
| | - Miaomiao Song
- Department of Physiology and Pathophysiology and Institute of Neuroscience, School of Basic Medical Sciences, Xi'an Jiao Tong University Health Science Center, Xi'an, 710061, China
| | - Shasha Gao
- Department of Physiology and Pathophysiology and Institute of Neuroscience, School of Basic Medical Sciences, Xi'an Jiao Tong University Health Science Center, Xi'an, 710061, China
| | - Lu Yao
- Department of Physiology and Pathophysiology and Institute of Neuroscience, School of Basic Medical Sciences, Xi'an Jiao Tong University Health Science Center, Xi'an, 710061, China
| | - Li Zhang
- Department of Physiology and Pathophysiology and Institute of Neuroscience, School of Basic Medical Sciences, Xi'an Jiao Tong University Health Science Center, Xi'an, 710061, China
| | - Jie Feng
- Department of Physiology and Pathophysiology and Institute of Neuroscience, School of Basic Medical Sciences, Xi'an Jiao Tong University Health Science Center, Xi'an, 710061, China
| | - Ling Wang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, 710004, China
| | - Rui Gao
- Department of Medical Imaging and Nuclear Medicine, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, 710061, China
| | - Yong Wang
- Department of Physiology and Pathophysiology and Institute of Neuroscience, School of Basic Medical Sciences, Xi'an Jiao Tong University Health Science Center, Xi'an, 710061, China.
| |
Collapse
|
7
|
Tichelaar JG, Sayalı C, Helmich RC, Cools R. Impulse control disorder in Parkinson's disease is associated with abnormal frontal value signalling. Brain 2023; 146:3676-3689. [PMID: 37192341 PMCID: PMC10473575 DOI: 10.1093/brain/awad162] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/18/2023] [Accepted: 04/26/2023] [Indexed: 05/18/2023] Open
Abstract
Dopaminergic medication is well established to boost reward- versus punishment-based learning in Parkinson's disease. However, there is tremendous variability in dopaminergic medication effects across different individuals, with some patients exhibiting much greater cognitive sensitivity to medication than others. We aimed to unravel the mechanisms underlying this individual variability in a large heterogeneous sample of early-stage patients with Parkinson's disease as a function of comorbid neuropsychiatric symptomatology, in particular impulse control disorders and depression. One hundred and ninety-nine patients with Parkinson's disease (138 ON medication and 61 OFF medication) and 59 healthy controls were scanned with functional MRI while they performed an established probabilistic instrumental learning task. Reinforcement learning model-based analyses revealed medication group differences in learning from gains versus losses, but only in patients with impulse control disorders. Furthermore, expected-value related brain signalling in the ventromedial prefrontal cortex was increased in patients with impulse control disorders ON medication compared with those OFF medication, while striatal reward prediction error signalling remained unaltered. These data substantiate the hypothesis that dopamine's effects on reinforcement learning in Parkinson's disease vary with individual differences in comorbid impulse control disorder and suggest they reflect deficient computation of value in medial frontal cortex, rather than deficient reward prediction error signalling in striatum. See Michael Browning (https://doi.org/10.1093/brain/awad248) for a scientific commentary on this article.
Collapse
Affiliation(s)
- Jorryt G Tichelaar
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, 6525EN Nijmegen, The Netherlands
- Radboud University Medical Center, Department of Neurology, Centre of Expertise for Parkinson and Movement Disorders, 6525GA Nijmegen, The Netherlands
| | - Ceyda Sayalı
- The Johns Hopkins University School of Medicine, Center for Psychedelic and Consciousness Research, Baltimore, MD 21224, USA
| | - Rick C Helmich
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, 6525EN Nijmegen, The Netherlands
- Radboud University Medical Center, Department of Neurology, Centre of Expertise for Parkinson and Movement Disorders, 6525GA Nijmegen, The Netherlands
| | - Roshan Cools
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, 6525EN Nijmegen, The Netherlands
- Radboud University Medical Center, Department of Psychiatry, 6525GA Nijmegen, The Netherlands
| |
Collapse
|
8
|
Dawson A, Ortelli P, Carter A, Ferrazzoli D, Dissanayaka NN, Evans A, Chye Y, Lorenzetti V, Frazzitta G, Yücel M. Motivational and myopic mechanisms underlying dopamine medication-induced impulsive-compulsive behaviors in Parkinson's disease. Front Behav Neurosci 2023; 16:949406. [PMID: 36744102 PMCID: PMC9889554 DOI: 10.3389/fnbeh.2022.949406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 12/27/2022] [Indexed: 01/20/2023] Open
Abstract
Introduction Dopaminergic medications can trigger impulsive-compulsive behaviors (ICBs) in pre-disposed patients with Parkinson's disease (PD), but what this implies on a neurocognitive level is unclear. Previous findings highlighted potentially exacerbated incentive motivation (willingness to work for rewards) and choice impulsivity (preferring smaller, immediate rewards over larger, delayed rewards) in PD patients with ICBs (PD + ICBs). Methods To deeply understand this evidence, we studied 24 PD + ICBs and 28 PD patients without ICBs (PD-ICBs). First of all, patients underwent the assessment of impulsivity traits, mood, anxiety, and addiction condition. We further administered robust objective and subjective measures of specific aspects of motivation. Finally, we explored whether these processes might link to any heightened antisocial behavior (aggression and risky driving) in PD + ICBs. Results High levels of positive urgency trait characterized PD + ICBs. They choose to exert more effort for rewards under the conditions of low and medium reward probability and as reward magnitude increases. Findings on choice impulsivity show a great tendency to delay discounting in PD + ICBs, other than a high correlation between delay and probability discounting. In addition, we found what appears to be the first evidence of heightened reactive aggression in PD patients with ICBs. Exacerbated incentive motivation and delay discounting trended toward positively predicting reactive aggression in PD + ICBs. Discussion Our promising results suggest that there might be immense value in future large-scale studies adopting a transdiagnostic neurocognitive endophenotype approach to understanding and predicting the addictive and aggressive behaviors that can arise from dopaminergic medication in PD.
Collapse
Affiliation(s)
- Andrew Dawson
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, VIC, Australia
| | - Paola Ortelli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, Vipiteno-Sterzing, Italy,Department of Movement Disorders and Brain Injury Rehabilitation, “Moriggia-Pelascini” Hospital, Como, Italy,*Correspondence: Paola Ortelli ✉
| | - Adrian Carter
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, VIC, Australia
| | - Davide Ferrazzoli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, Vipiteno-Sterzing, Italy,Department of Movement Disorders and Brain Injury Rehabilitation, “Moriggia-Pelascini” Hospital, Como, Italy
| | - Nadeeka N. Dissanayaka
- Faculty of Medicine, University of Queensland Centre for Clinical Research, The University of Queensland, Herston, QLD, Australia,Department of Neurology, Royal Brisbane and Women's Hospital, Herston, QLD, Australia,School of Psychology, The University of Queensland, St. Lucia, QLD, Australia
| | - Andrew Evans
- Department of Movement Disorders, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Yann Chye
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, VIC, Australia
| | | | | | - Murat Yücel
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, VIC, Australia
| |
Collapse
|
9
|
Kimura I, Revankar GS, Ogawa K, Amano K, Kajiyama Y, Mochizuki H. Neural correlates of impulsive compulsive behaviors in Parkinson's disease: A Japanese retrospective study. Neuroimage Clin 2023; 37:103307. [PMID: 36586362 PMCID: PMC9817029 DOI: 10.1016/j.nicl.2022.103307] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/25/2022] [Accepted: 12/26/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Impulsive compulsive behaviors (ICBs) often disturb patients with Parkinson's Disease (PD), of which impulse control disorder (ICD) and dopamine dysregulation syndrome (DDS) are two major subsets. The nucleus accumbens (NAcc) is involved in ICB; however, it remains unclear how the NAcc affects cortical function and defines the different behavioral characteristics of ICD and DDS. OBJECTIVES To identify the cortico-striatal network primarily involved in ICB and the differences in these networks between patients with ICD and DDS using structural and resting-state functional magnetic resonance imaging. METHODS Patients with PD were recruited using data from a previous cohort study and divided into those with ICB (ICB group) and without ICB (non-ICB group) using the Japanese version of the Questionnaire for Impulsive Compulsive Disorders in Parkinson's Disease (J-QUIP). From these two groups, we extracted 37 pairs matched for age, sex, disease duration, and levodopa equivalent daily dose of dopamine agonists. Patients with ICB were further classified as having ICD or DDS based on the J-QUIP subscore. General linear models were used to compare gray matter volume and functional connectivity (FC) of the NAcc, caudate, and putamen between the ICB and non-ICB groups and between patients with ICD and those with DDS. RESULTS We found no significant differences in gray matter volumebetween the ICB and non-ICB groups or between patients with ICD and those with DDS. Compared with the non-ICB group, the FC of the right NAcc in the ICB group was lower in the bilateral ventromedial prefrontal cortex and higher in the left middle occipital gyrus. Furthermore, patients with DDS showed higher FC between the right putamen and left superior temporal gyrus and higher FC between the left caudate and bilateral middle occipital gyrus than patients with ICD. In contrast, patients with ICD exhibited higher FC between the left NAcc and the right posterior cingulate cortex than patients with DDS. CONCLUSIONS The functionally altered network between the right NAcc and ventromedial prefrontal cortex was associated with ICB in PD. In addition, the surrounding cortico-striatal networks may differentiate the behavioral characteristics of patients with ICD and those with DDS.
Collapse
Affiliation(s)
- Ikko Kimura
- Department of Neurology, Osaka University Graduate School of Medicine, Suita 565-0871, Japan; Graduate School of Frontier Biosciences, Osaka University, Suita 565-0871, Japan
| | - Gajanan S Revankar
- Department of Neurology, Osaka University Graduate School of Medicine, Suita 565-0871, Japan
| | - Kotaro Ogawa
- Department of Neurology, Osaka University Graduate School of Medicine, Suita 565-0871, Japan
| | - Kaoru Amano
- Graduate School of Frontier Biosciences, Osaka University, Suita 565-0871, Japan; Graduate School of Information Science and Technology, The University of Tokyo, Tokyo 113-8656, Japan
| | - Yuta Kajiyama
- Department of Neurology, Osaka University Graduate School of Medicine, Suita 565-0871, Japan.
| | - Hideki Mochizuki
- Department of Neurology, Osaka University Graduate School of Medicine, Suita 565-0871, Japan.
| |
Collapse
|
10
|
Mena-Moreno T, Munguía L, Granero R, Lucas I, Sánchez-Gómez A, Cámara A, Compta Y, Valldeoriola F, Fernandez-Aranda F, Sauvaget A, Menchón JM, Jiménez-Murcia S. Cognitive Behavioral Therapy Plus a Serious Game as a Complementary Tool for a Patient With Parkinson Disease and Impulse Control Disorder: Case Report. JMIR Serious Games 2022; 10:e33858. [PMID: 36083621 PMCID: PMC9508668 DOI: 10.2196/33858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 04/03/2022] [Accepted: 04/22/2022] [Indexed: 11/17/2022] Open
Abstract
Background Impulse control disorders (ICDs) are commonly developed among patients who take dopamine agonist drugs as a treatment for Parkinson disease (PD). Gambling disorder and hypersexuality are more frequent in male patients with PD, with a prevalence over 4% in dopamine agonists users. Although impulsive-compulsive behaviors are related to antiparkinsonian medication, and even though ICD symptomatology, such as hypersexuality, often subsides when the dopaminergic dose is reduced, sometimes ICD persists in spite of drug adjustment. Consequently, a multidisciplinary approach should be considered to address these comorbidities and to explore new forms of complementary interventions, such as serious games or therapies adapted to PD. Objective The aim of this study is to present the case of a patient with ICD (ie, hypersexuality) triggered by dopaminergic medication for PD. A combined intervention was carried out using cognitive behavioral therapy (CBT) for ICD adapted to PD, plus an intervention using a serious game—e-Estesia—whose objective is to improve emotion regulation and impulsivity. The aim of the combination of these interventions was to reduce the harm of the disease. Methods After 20 CBT sessions, the patient received the e-Estesia intervention over 15 sessions. Repeated measures, before and after the combined intervention, were administered to assess emotion regulation, general psychopathology, and emotional distress and impulsivity. Results After the intervention with CBT techniques and e-Estesia, the patient presented fewer difficulties to regulate emotion, less emotional distress, and lower levels of impulsivity in comparison to before the treatment. Moreover, the frequency and severity of the relapses also decreased. Conclusions The combined intervention—CBT and a serious game—showed positive results in terms of treatment outcomes.
Collapse
Affiliation(s)
- Teresa Mena-Moreno
- Department of Psychiatry, Bellvitge University Hospital, Hospitalet de Llobregat, Spain.,Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Investigación Biomédica de Bellvitge, Hospitalet de Llobregat, Spain
| | - Lucero Munguía
- Department of Psychiatry, Bellvitge University Hospital, Hospitalet de Llobregat, Spain.,Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Investigación Biomédica de Bellvitge, Hospitalet de Llobregat, Spain
| | - Rosario Granero
- Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain
| | - Ignacio Lucas
- Department of Psychiatry, Bellvitge University Hospital, Hospitalet de Llobregat, Spain.,Instituto de Investigación Biomédica de Bellvitge, Hospitalet de Llobregat, Spain
| | - Almudena Sánchez-Gómez
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic, Institut D'Investigacions Biomediques August Pi i Sunyer, Institut de Neurociències Universitat de Barcelona (Maria de Maeztu Excellence Center), Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Cámara
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic, Institut D'Investigacions Biomediques August Pi i Sunyer, Institut de Neurociències Universitat de Barcelona (Maria de Maeztu Excellence Center), Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Yaroslau Compta
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic, Institut D'Investigacions Biomediques August Pi i Sunyer, Institut de Neurociències Universitat de Barcelona (Maria de Maeztu Excellence Center), Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Francesc Valldeoriola
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic, Institut D'Investigacions Biomediques August Pi i Sunyer, Institut de Neurociències Universitat de Barcelona (Maria de Maeztu Excellence Center), Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Fernando Fernandez-Aranda
- Department of Psychiatry, Bellvitge University Hospital, Hospitalet de Llobregat, Spain.,Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Investigación Biomédica de Bellvitge, Hospitalet de Llobregat, Spain.,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Anne Sauvaget
- Movement, Interactions, Performance, University of Nantes, Nantes, France
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital, Hospitalet de Llobregat, Spain.,Instituto de Investigación Biomédica de Bellvitge, Hospitalet de Llobregat, Spain.,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital, Hospitalet de Llobregat, Spain.,Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Investigación Biomédica de Bellvitge, Hospitalet de Llobregat, Spain.,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| |
Collapse
|
11
|
De Masi R, Orlando S, Costa MC. Dementia-Associated Compulsive Singing (DACS): Presentation of Unpublished Clinical Cases Miniseries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10844. [PMID: 36078557 PMCID: PMC9517776 DOI: 10.3390/ijerph191710844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/20/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
Dementia-associated compulsive singing (DACS) is a neurotransmettitorial-based behavioral disturbance, characterized by an unabating melodic expression, occurring in patients that suffer from evolved dementia. Previously described only as a "punding" aspect of the dopamine dysregulation syndrome (DDS) in the Parkinson's disease (PD), compulsive singing has now been described, for the first time, in four non-PD patients effectively treated with Haloperidol or Quetiapine. Unlike the DDS-associated conditions, in our cases DACS is not pharmacologically induced, being that all patients were L-dopa-free. We detected a diffuse hyperintensity of the white matter and brain atrophy, with insular shrinkage as well as ventricular system and/or sub-arachnoid space enlargement in our DACS patients. Furthermore, similarly to the other behavioral symptoms of dementia, DACS also seems to be correlated to the degree of cognitive and functional impairment, rather than its subtype. In conclusion, DACS is a non-cognitive, unpublished clinical aspect of evolved dementia, which is interesting due to the involvement of the extra-nigral dopaminergic system, resulting in an unabating altered behavior, but also to the enrichment of our knowledge in the involutional diseases of the central nervous system and their physiopathological manifestations.
Collapse
Affiliation(s)
- Roberto De Masi
- Complex Operative Unit of Neurology, “F. Ferrari” Hospital, Casarano, 73042 Lecce, Italy
- Laboratory of Neuroproteomics, Multiple Sclerosis Centre, “F. Ferrari” Hospital, Casarano, 73042 Lecce, Italy
| | - Stefania Orlando
- Laboratory of Neuroproteomics, Multiple Sclerosis Centre, “F. Ferrari” Hospital, Casarano, 73042 Lecce, Italy
| | - Maria Carmela Costa
- Complex Operative Unit of Ophthalmology, “V. Fazzi” Hospital, 73100 Lecce, Italy
| |
Collapse
|
12
|
Cools R, Tichelaar JG, Helmich RCG, Bloem BR, Esselink RAJ, Smulders K, Timmer MHM. Role of dopamine and clinical heterogeneity in cognitive dysfunction in Parkinson's disease. PROGRESS IN BRAIN RESEARCH 2022; 269:309-343. [PMID: 35248200 DOI: 10.1016/bs.pbr.2022.01.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Parkinson's disease (PD) is commonly treated with dopaminergic medication, which enhances some, while impairing other cognitive functions. It can even contribute to impulse control disorder and addiction. We describe the history of research supporting the dopamine overdose hypothesis, which accounts for the large within-patient variability in dopaminergic medication effects across different tasks by referring to the spatially non-uniform pattern of dopamine depletion in dorsal versus ventral striatum. However, there is tremendous variability in dopaminergic medication effects not just within patients across distinct tasks, but also across different patients. In the second part of this chapter we review recent studies addressing the large individual variability in the negative side effects of dopaminergic medication on functions that implicate dopamine, such as value-based learning and choice. These studies begin to unravel the mechanisms of dopamine overdosing, thus revising the strict version of the overdose hypothesis. For example, the work shows that the canonical boosting of reward-versus punishment-based choice by medication is greater in patients with depression and a non-tremor phenotype, which both implicate, among other pathology, more rather than less severe dysregulation of the mesolimbic dopamine system. Future longitudinal cohort studies are needed to identify how to optimally combine different clinical, personality, cognitive, neural, genetic and molecular predictors of detrimental medication effects in order to account for as much of the relevant variability as possible. This will provide a useful tool for precision neurology, allowing individual and contextual tailoring of (the dose of) dopaminergic medication in order to maximize its cognitive benefits, yet minimize its side effects.
Collapse
Affiliation(s)
- Roshan Cools
- Radboud university medical center, Department of Psychiatry, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
| | - Jorryt G Tichelaar
- Radboud university medical center, Department of Neurology, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Rick C G Helmich
- Radboud university medical center, Department of Neurology, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Bastiaan R Bloem
- Radboud university medical center, Department of Neurology, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Rianne A J Esselink
- Radboud university medical center, Department of Neurology, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Katrijn Smulders
- Radboud university medical center, Department of Neurology, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Monique H M Timmer
- Radboud university medical center, Department of Neurology, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| |
Collapse
|
13
|
De Silva PN. Neurobiological and epigenetic perspectives on hedonism, altruism and conscience. BJPSYCH ADVANCES 2022. [DOI: 10.1192/bja.2022.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
This article examines notions of hedonism, altruism and conscience in relation to the activity of four neurotransmitter pathways: the dopamine reward, noradrenaline fight or flight, serotonin calming and glutamine learning pathways. Associated brain areas that modulate behaviour are highlighted: the prefrontal cortex (activity planning, risk mitigation), the hippocampus (memory retrieval) and the insular cortex (integration of information to decide on action). Putative epigenetic changes influencing adult behaviours after childhood privation are discussed. Pharmacological and psychological means of mitigating harmful behaviours are summarised, alongside the ethics of epigenetic screening to predict future addictive and violent tendencies.
Collapse
|
14
|
de Rus Jacquet A, Ambaw A, Tambe MA, Ma SY, Timmers M, Grace MH, Wu QL, Simon JE, McCabe GP, Lila MA, Shi R, Rochet JC. Neuroprotective mechanisms of red clover and soy isoflavones in Parkinson's disease models. Food Funct 2021; 12:11987-12007. [PMID: 34751296 PMCID: PMC10822195 DOI: 10.1039/d1fo00007a] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder characterized by nigrostriatal degeneration and the spreading of aggregated forms of the presynaptic protein α-synuclein (aSyn) throughout the brain. PD patients are currently only treated with symptomatic therapies, and strategies to slow or stop the progressive neurodegeneration underlying the disease's motor and cognitive symptoms are greatly needed. The time between the first neurobiochemical alterations and the initial presentation of symptoms is thought to span several years, and early neuroprotective dietary interventions could delay the disease onset or slow PD progression. In this study, we characterized the neuroprotective effects of isoflavones, a class of dietary polyphenols found in soy products and in the medicinal plant red clover (Trifolium pratense). We found that isoflavone-rich extracts and individual isoflavones rescued the loss of dopaminergic neurons and the shortening of neurites in primary mesencephalic cultures exposed to two PD-related insults, the environmental toxin rotenone and an adenovirus encoding the A53T aSyn mutant. The extracts and individual isoflavones also activated the Nrf2-mediated antioxidant response in astrocytes via a mechanism involving inhibition of the ubiquitin-proteasome system, and they alleviated deficits in mitochondrial respiration. Furthermore, an isoflavone-enriched soy extract reduced motor dysfunction exhibited by rats lesioned with the PD-related neurotoxin 6-OHDA. These findings suggest that plant-derived isoflavones could serve as dietary supplements to delay PD onset in at-risk individuals and mitigate neurodegeneration in the brains of patients.
Collapse
Affiliation(s)
- Aurélie de Rus Jacquet
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, IN, 47907, USA.
| | - Abeje Ambaw
- Department of Basic Medical Sciences, Purdue University, West Lafayette, IN, 47907, USA
| | - Mitali Arun Tambe
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, IN, 47907, USA.
| | - Sin Ying Ma
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, IN, 47907, USA.
| | - Michael Timmers
- Plants for Human Health Institute, Department of Food Bioprocessing and Nutrition Sciences, North Carolina State University, Kannapolis, NC, 28081, USA
| | - Mary H Grace
- Plants for Human Health Institute, Department of Food Bioprocessing and Nutrition Sciences, North Carolina State University, Kannapolis, NC, 28081, USA
| | - Qing-Li Wu
- Department of Plant Biology, Rutgers University, New Brunswick, NJ, 08901, USA
| | - James E Simon
- Department of Plant Biology, Rutgers University, New Brunswick, NJ, 08901, USA
| | - George P McCabe
- Department of Statistics, Purdue University, West Lafayette, IN 47907, USA
| | - Mary Ann Lila
- Plants for Human Health Institute, Department of Food Bioprocessing and Nutrition Sciences, North Carolina State University, Kannapolis, NC, 28081, USA
| | - Riyi Shi
- Department of Basic Medical Sciences, Purdue University, West Lafayette, IN, 47907, USA
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 47907, USA
- Purdue Institute for Integrative Neuroscience, Purdue University, West Lafayette, IN, 47907, USA
| | - Jean-Christophe Rochet
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, IN, 47907, USA.
- Purdue Institute for Integrative Neuroscience, Purdue University, West Lafayette, IN, 47907, USA
| |
Collapse
|
15
|
Poisson CL, Engel L, Saunders BT. Dopamine Circuit Mechanisms of Addiction-Like Behaviors. Front Neural Circuits 2021; 15:752420. [PMID: 34858143 PMCID: PMC8631198 DOI: 10.3389/fncir.2021.752420] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/08/2021] [Indexed: 12/16/2022] Open
Abstract
Addiction is a complex disease that impacts millions of people around the world. Clinically, addiction is formalized as substance use disorder (SUD), with three primary symptom categories: exaggerated substance use, social or lifestyle impairment, and risky substance use. Considerable efforts have been made to model features of these criteria in non-human animal research subjects, for insight into the underlying neurobiological mechanisms. Here we review evidence from rodent models of SUD-inspired criteria, focusing on the role of the striatal dopamine system. We identify distinct mesostriatal and nigrostriatal dopamine circuit functions in behavioral outcomes that are relevant to addictions and SUDs. This work suggests that striatal dopamine is essential for not only positive symptom features of SUDs, such as elevated intake and craving, but also for impairments in decision making that underlie compulsive behavior, reduced sociality, and risk taking. Understanding the functional heterogeneity of the dopamine system and related networks can offer insight into this complex symptomatology and may lead to more targeted treatments.
Collapse
Affiliation(s)
- Carli L. Poisson
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, United States
- Medical Discovery Team on Addiction, University of Minnesota, Minneapolis, MN, United States
- Graduate Program in Neuroscience, University of Minnesota, Minneapolis, MN, United States
| | - Liv Engel
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, United States
- Medical Discovery Team on Addiction, University of Minnesota, Minneapolis, MN, United States
| | - Benjamin T. Saunders
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, United States
- Medical Discovery Team on Addiction, University of Minnesota, Minneapolis, MN, United States
- Graduate Program in Neuroscience, University of Minnesota, Minneapolis, MN, United States
| |
Collapse
|
16
|
Weiss D, Volkmann J, Fasano A, Kühn A, Krack P, Deuschl G. Changing Gears - DBS For Dopaminergic Desensitization in Parkinson's Disease? Ann Neurol 2021; 90:699-710. [PMID: 34235776 DOI: 10.1002/ana.26164] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 07/06/2021] [Accepted: 07/06/2021] [Indexed: 12/19/2022]
Abstract
In Parkinson's disease, both motor and neuropsychiatric complications unfold as a consequence of both incremental striatal dopaminergic denervation and intensifying long-term dopaminergic treatment. Together, this leads to 'dopaminergic sensitization' steadily increasing motor and behavioral responses to dopaminergic medication that result in the detrimental sequalae of long-term dopaminergic treatment. We review the clinical presentations of 'dopaminergic sensitization', including rebound off and dyskinesia in the motor domain, and neuropsychiatric fluctuations and behavioral addictions with impulse control disorders and dopamine dysregulation syndrome in the neuropsychiatric domain. We summarize state-of-the-art deep brain stimulation, and show that STN-DBS allows dopaminergic medication to be tapered, thus supporting dopaminergic desensitization. In this framework, we develop our integrated debatable viewpoint of "changing gears", that is we suggest rethinking earlier use of subthalamic nucleus deep brain stimulation, when the first clinical signs of dopaminergic motor or neuropsychiatric complications emerge over the steadily progressive disease course. In this sense, subthalamic deep brain stimulation may help reduce longitudinal motor and neuropsychiatric symptom expression - importantly, not by neuroprotection but by supporting dopaminergic desensitization through postoperative medication reduction. Therefore, we suggest considering STN-DBS early enough before patients encounter potentially irreversible psychosocial consequences of dopaminergic complications, but importantly not before a patient shows first clinical signs of dopaminergic complications. We propose to consider neuropsychiatric dopaminergic complications as a new inclusion criterion in addition to established motor criteria, but this concept will require validation in future clinical trials. ANN NEUROL 2021.
Collapse
Affiliation(s)
- Daniel Weiss
- Centre for Neurology, Department for Neurodegenerative Diseases, and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Jens Volkmann
- Department of Neurology, University Hospital and Julius-Maximilian-University, Würzburg, Germany
| | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, ON, Canada.,Division of Neurology, University of Toronto, Toronto, ON, Canada.,Krembil Brain Institute, Toronto, ON, Canada.,Center for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto, ON, Canada
| | - Andrea Kühn
- Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Paul Krack
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Günther Deuschl
- Department of Neurology, University Hospital Schleswig Holstein (UKSH), Christian-Albrechts-University Kiel, Kiel, Germany
| |
Collapse
|
17
|
Gibson AS, Keefe KA, Furlong TM. Accelerated habitual learning resulting from L-dopa exposure in rats is prevented by N-acetylcysteine. Pharmacol Biochem Behav 2020; 198:173033. [PMID: 32888972 DOI: 10.1016/j.pbb.2020.173033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 08/29/2020] [Accepted: 08/31/2020] [Indexed: 10/23/2022]
Abstract
Instrumental actions are initially goal-directed and driven by their associated outcome. However, with repeated experience habitual actions develop which are automated and efficient, as they are instead driven by antecedent stimuli. Dopamine is thought to facilitate the transition from goal-directed to habitual actions. This idea has been largely derived from evidence that psychostimulants accelerate the development of habitual actions. In the current study, we examined the impact of L-dopa (levodopa or L-dihydroxyphenylalanine), which also potentiates dopamine activity, on habitual learning. L-dopa was systemically administered prior to training rats to press a lever for a food outcome. When tested, L-dopa exposed animals were insensitive to changes in the value of the food outcome, and hence demonstrated accelerated habitual behavioral control compared to control animals that remained goal directed. We also showed that when N-acetylcysteine (NAC), an antioxidant and regulator of glutamate activity, was co-administered with L-dopa, it prevented the transition to habitual behavior; an effect demonstrated previously for cocaine. Therefore, this study establishes similarities between L-dopa and psychostimulants in both the development and prevention of habitual actions, and supports the notion that excess dopamine potentiates habitual learning. This finding extends the limited existing knowledge of the impact of L-dopa on learning and behavior, and has implications for neurological disorders where L-dopa is the primary treatment.
Collapse
Affiliation(s)
- Anne S Gibson
- Department of Pharmacology and Toxicology, University of Utah, Salt Lake City, UT, USA; Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA
| | - Kristen A Keefe
- Department of Pharmacology and Toxicology, University of Utah, Salt Lake City, UT, USA; Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA
| | - Teri M Furlong
- Department of Pharmacology and Toxicology, University of Utah, Salt Lake City, UT, USA; Neuroscience Research Australia, 139 Barker Street, Randwick, NSW, Australia; School of Medical Sciences, University of New South Wales, Kensington, NSW, Australia.
| |
Collapse
|
18
|
Kirschner M, Rabinowitz A, Singer N, Dagher A. From apathy to addiction: Insights from neurology and psychiatry. Prog Neuropsychopharmacol Biol Psychiatry 2020; 101:109926. [PMID: 32171904 DOI: 10.1016/j.pnpbp.2020.109926] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 03/11/2020] [Accepted: 03/11/2020] [Indexed: 12/21/2022]
Abstract
The tendency to engage in addictive behaviors has long been tied to the actions of the dopamine system. Early theories were based on the fact that all addictive drugs and behaviors (such as gambling) increase dopamine levels in the striatum, and the evidence that dopamine signaled reward or reward prediction error. However, with a changing emphasis of addiction away from purely pharmacological models that emphasize tolerance and withdrawal, towards one of behavioral dyscontrol, is there still a place for abnormal dopamine signaling in addiction? Here we recast the dopamine theory of addiction based on the idea that tonic dopamine may index a continuous phenotype that goes from apathy to impulsivity and compulsivity. Higher tonic dopamine signaling would make individuals vulnerable to drug reinforcement and cue-induced craving. We relate this to computational models of dopamine signaling, and review clinical and neuroimaging evidence from Parkinson's Disease, schizophrenia and bipolar disorder in support of this model.
Collapse
Affiliation(s)
- Matthias Kirschner
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Canada; Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
| | - Arielle Rabinowitz
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Canada
| | - Neomi Singer
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Canada
| | - Alain Dagher
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Canada.
| |
Collapse
|
19
|
Self-Reported Nonadherence Predicts Changes of Medication after Discharge from Hospital in People with Parkinson's Disease. PARKINSONS DISEASE 2020; 2020:4315489. [PMID: 32714503 PMCID: PMC7355339 DOI: 10.1155/2020/4315489] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/13/2020] [Indexed: 12/26/2022]
Abstract
Background Medication is often changed after hospital discharge in people with Parkinson's disease (PD). Objective This observational study aimed to describe changes in PD medication after discharge and explore their association with self-reported adherence and clinical parameters. Methods During hospitalisation sociodemographic characteristics, the Movement Disorder Society-sponsored revision of the Unified PD Rating Scale for motor function (MDS-UPDRS III), Hoehn and Yahr (H&Y) stage, levodopa equivalent daily dose (LEDD), Beck Depression Inventory II (BDI-II) score, Montreal Cognitive Assessment (MoCA) score, nonmotor symptoms questionnaire (NMSQ), and Stendal Adherence to Medication Score (SAMS) were collected in 125 people with PD. A semistructured interview was conducted 1 month after discharge to determine the extent and reasons for medication changes. Results Thirty-eight patients (30.4%) changed their PD medication after discharge. Most changes (20.8%) were performed by physicians while 9.6% of patients changed their medication by themselves due to side effects, missing effect of the medication, missing knowledge about the indication, running out of medication, or nonspecific reason. This led to decreased doses while changes by physicians resulted in both increase and decrease of doses as well as new drug prescription. Patients without changes, patients with changes performed by them, and patients with changes performed by physicians did not differ in age, disease duration, MDS-UPDRS III, LEDD, NMSQ, MoCA, BDI-II, gender, marital status, or education. However, patients who themselves made the changes were more likely to be nonadherent according to baseline SAMS. Patients who made changes after discharge had higher SAMS modification and forgetting subscores than patients without changes or with changes made by physicians. Conclusion Both intended and unintended nonadherence occur in patients who change medication after discharge. The use of an adherence questionnaire during inpatient treatment may help detect patients with higher risk of changing medication after discharge.
Collapse
|
20
|
O'Sullivan JD. Too much of a good thing: hedonistic homoeostatic dysregulation and other behavioural consequences of excessive dopamine replacement therapy in Parkinson's disease. J Neurol Neurosurg Psychiatry 2020; 91:566-567. [PMID: 32139655 DOI: 10.1136/jnnp-2019-322378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 02/03/2020] [Indexed: 01/26/2023]
Affiliation(s)
- John D O'Sullivan
- Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia .,Neurology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| |
Collapse
|
21
|
Ng JH, See AAQ, Xu Z, King NKK. Longitudinal medication profile and cost savings in Parkinson's disease patients after bilateral subthalamic nucleus deep brain stimulation. J Neurol 2020; 267:2443-2454. [PMID: 32367298 DOI: 10.1007/s00415-020-09741-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 01/30/2020] [Accepted: 01/31/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Deep brain stimulation of the subthalamic nucleus (STN DBS) has been shown to reduce antiparkinsonian medication in Parkinson's disease. We aimed to investigate the changes in long-term medication profile with STN DBS. METHODS Antiparkinsonian medication data for 56 patients were collected from as early as 3 years before STN DBS up to 10 years after. Cost spending on medication changes was analyzed. Mean levodopa equivalent daily dose (LEDD) was projected 10 years into the future based on preoperative data to create a comparator group wherein the patients did not undergo STN DBS. Use of neuroleptics and antidepressants was also recorded. RESULTS LEDD requirement was significantly reduced by a mean of 31 ± 2% over 10 years after DBS, from 1049 ± 381 mg at pre-DBS baseline, to 713 ± 392 mg at 1 year post-DBS, and 712 ± 385 mg at 10 years post-DBS. This was associated with a mean reduction of 35 ± 3% in medicine cost. Modeled LEDD requirements for not having STN DBS were in the range of 1489 mg to 2721 mg at 10 years post-DBS (109-282% higher than the observed mean LEDD in DBS cohort). The proportion of patients increased from 5% before STN DBS to 14% at 10 year post-DBS for neuroleptics, and 11-23% for antidepressants. CONCLUSION STN DBS led to LEDD reduction and antiparkinsonian medication cost savings in our South-East Asian cohort. Medication reduction with STN DBS in our cohort over the 10-year period was comparable to those reported in Western populations.
Collapse
Affiliation(s)
- Jing Han Ng
- Yong Loo Lin School of Medicine, National University of Singapore, 21 Lower Kent Ridge Rd, Singapore, 119077, Singapore
| | - Angela An Qi See
- Department of Neurosurgery, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore
- Department of Neurosurgery, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Zheyu Xu
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Nicolas Kon Kam King
- Department of Neurosurgery, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore.
- Department of Neurosurgery, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
| |
Collapse
|
22
|
Wang TR, Moosa S, Dallapiazza RF, Elias WJ, Lynch WJ. Deep brain stimulation for the treatment of drug addiction. Neurosurg Focus 2019; 45:E11. [PMID: 30064320 DOI: 10.3171/2018.5.focus18163] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Drug addiction represents a significant public health concern that has high rates of relapse despite optimal medical therapy and rehabilitation support. New therapies are needed, and deep brain stimulation (DBS) may be an effective treatment. The past 15 years have seen numerous animal DBS studies for addiction to various drugs of abuse, with most reporting decreases in drug-seeking behavior with stimulation. The most common target for stimulation has been the nucleus accumbens, a key structure in the mesolimbic reward pathway. In addiction, the mesolimbic reward pathway undergoes a series of neuroplastic changes. Chief among them is a relative hypofunctioning of the prefrontal cortex, which is thought to lead to the diminished impulse control that is characteristic of drug addiction. The prefrontal cortex, as well as other targets involved in drug addiction such as the lateral habenula, hypothalamus, insula, and subthalamic nucleus have also been stimulated in animals, with encouraging results. Although animal studies have largely shown promising results, current DBS studies for drug addiction primarily use stimulation during active drug use. More data are needed on the effect of DBS during withdrawal in preventing future relapse. The published human experience for DBS for drug addiction is currently limited to several promising case series or case reports that are not controlled. Further animal and human work is needed to determine what role DBS can play in the treatment of drug addiction.
Collapse
Affiliation(s)
- Tony R Wang
- 1Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia
| | - Shayan Moosa
- 1Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia
| | - Robert F Dallapiazza
- 2Division of Neurosurgery, Toronto Western Hospital University Health Network, Toronto, Ontario, Canada; and
| | - W Jeffrey Elias
- 1Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia
| | - Wendy J Lynch
- 3Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia
| |
Collapse
|
23
|
Cartoon J, Ramalingam J. Dopamine dysregulation syndrome in non-Parkinson's disease patients: a systematic review. Australas Psychiatry 2019; 27:456-461. [PMID: 31032624 DOI: 10.1177/1039856219839476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To explore the presence of dopamine dysregulation syndrome in non-Parkinson's disease patients receiving dopamine replacement therapy. METHODS Electronic searches were conducted of Medline, Embase, PsycINFO and PreMedline to capture articles related to dopamine misuse or factitious disorder combined with the presence of dopamine replacement therapy or a non-Parkinson's disease population. In total, 430 articles were reviewed and studies that addressed dopamine dysregulation syndrome in non-Parkinson's disease patients were included. RESULTS Nine case reports were identified. CONCLUSIONS The pathophysiology underlying dopamine dysregulation syndrome has been thoroughly explored with numerous mechanisms posited. What remains unclear is whether dopamine dysregulation syndrome is a phenomenon specific to Parkinson's disease, as indicated in the proposed diagnostic criteria. A more useful predictor of susceptibility to dopamine dysregulation syndrome may be temperamental traits such as novelty seeking and impulsivity, which overlap with predisposing factors for an addiction disorder.
Collapse
Affiliation(s)
- Jodi Cartoon
- Psychiatry Registrar, Consultation Liaison Psychiatry Department, Gosford Hospital, Gosford, NSW, Australia
| | - Jothi Ramalingam
- Consultant Psychiatrist, Consultation Liaison Psychiatry Department, Gosford Hospital, Gosford, NSW, Australia
| |
Collapse
|
24
|
Affiliation(s)
- Jordan Dubow
- Avadel Pharmaceuticals PLC, Chesterfield, MO, USA
| | - C. Warren Olanow
- Department of Neurology and Neuroscience, Mount Sinai Health System, New York City, NY, USA
| |
Collapse
|
25
|
Carlino E, Piedimonte A, Romagnolo A, Guerra G, Frisaldi E, Vighetti S, Lopiano L, Benedetti F. Verbal communication about drug dosage balances drug reduction in Parkinson's disease: Behavioral and electrophysiological evidences. Parkinsonism Relat Disord 2019; 65:184-189. [PMID: 31277983 DOI: 10.1016/j.parkreldis.2019.06.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 04/23/2019] [Accepted: 06/19/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Changing drug dosage is common in clinical practice. Recent evidence showed that psychological factors may affect the therapeutic outcome. The aim of this study is to test whether verbal communication about drug dosage changes motor performance and fatigue in Parkinson's Disease (PD) patients. METHODS We performed clinical (Unified PD Rating Scale), motor (number of finger flexions and perceived fatigue), and electrophysiological measurements (readiness potential, RP) in PD patients during medication-off and medication-on conditions in three groups. The first group got a full dose of l-dopa and was told it was a full dose. The second group got half dose and was told it was half dose. The third group got half dose, but it was told it was a full standard dose. RESULTS We found that overt half dose was less effective than the full dose for clinical improvement, motor performance, and readiness potential. However, if half dose was given along with verbal instructions that it was a full dose, clinical improvement, motor performance and readiness potential were not significantly different from the full dose. CONCLUSIONS Our findings indicate that verbal communication about dose reduction is as effective as the 50% dose reduction itself, demonstrating that deceptive information about the dose may have an important impact on the therapeutic outcome. Moreover, the supplementary motor area, source of the RP, seems to be involved in this psychological effect.
Collapse
Affiliation(s)
- Elisa Carlino
- Dept of Neuroscience, University of Turin Medical School, Turin, Italy.
| | | | - Alberto Romagnolo
- Dept of Neuroscience, University of Turin Medical School, Turin, Italy
| | - Giulia Guerra
- Dept of Neuroscience, University of Turin Medical School, Turin, Italy
| | - Elisa Frisaldi
- Dept of Neuroscience, University of Turin Medical School, Turin, Italy
| | - Sergio Vighetti
- Dept of Neuroscience, University of Turin Medical School, Turin, Italy; Medicine & Physiology of Hypoxia, Plateau Rosà, Italy
| | - Leonardo Lopiano
- Dept of Neuroscience, University of Turin Medical School, Turin, Italy
| | - Fabrizio Benedetti
- Dept of Neuroscience, University of Turin Medical School, Turin, Italy; Medicine & Physiology of Hypoxia, Plateau Rosà, Italy
| |
Collapse
|
26
|
Orsini CA, Hernandez CM, Bizon JL, Setlow B. Deconstructing value-based decision making via temporally selective manipulation of neural activity: Insights from rodent models. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2019; 19:459-476. [PMID: 30341621 PMCID: PMC6472996 DOI: 10.3758/s13415-018-00649-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The ability to choose among options that differ in their rewards and costs (value-based decision making) has long been a topic of interest for neuroscientists, psychologists, and economists alike. This is likely because this is a cognitive process in which all animals (including humans) engage on a daily basis, be it routine (which road to take to work) or consequential (which graduate school to attend). Studies of value-based decision making (particularly at the preclinical level) often treat it as a uniform process. The results of such studies have been invaluable for our understanding of the brain substrates and neurochemical systems that contribute to decision making involving a range of different rewards and costs. Value-based decision making is not a unitary process, however, but is instead composed of distinct cognitive operations that function in concert to guide choice behavior. Within this conceptual framework, it is therefore important to consider that the known neural substrates supporting decision making may contribute to temporally distinct and dissociable components of the decision process. This review will describe this approach for investigating decision making, drawing from published studies that have used techniques that allow temporal dissection of the decision process, with an emphasis on the literature in animal models. The review will conclude with a discussion of the implications of this work for understanding pathological conditions that are characterized by impaired decision making.
Collapse
Affiliation(s)
- Caitlin A Orsini
- Department of Psychiatry, University of Florida College of Medicine, P.O. Box 100256, Gainesville, FL, 32610-0256, USA.
- Center for Addiction Research and Education, University of Florida, Gainesville, FL, 32610, USA.
| | - Caesar M Hernandez
- Department of Neuroscience, University of Florida, Gainesville, FL, 32610, USA
| | - Jennifer L Bizon
- Department of Psychiatry, University of Florida College of Medicine, P.O. Box 100256, Gainesville, FL, 32610-0256, USA
- Center for Addiction Research and Education, University of Florida, Gainesville, FL, 32610, USA
- Department of Neuroscience, University of Florida, Gainesville, FL, 32610, USA
| | - Barry Setlow
- Department of Psychiatry, University of Florida College of Medicine, P.O. Box 100256, Gainesville, FL, 32610-0256, USA
- Center for Addiction Research and Education, University of Florida, Gainesville, FL, 32610, USA
- Department of Neuroscience, University of Florida, Gainesville, FL, 32610, USA
- Department of Psychology, University of Florida, Gainesville, FL, 32610, USA
| |
Collapse
|
27
|
Evans AH, Okai D, Weintraub D, Lim SY, O'Sullivan SS, Voon V, Krack P, Sampaio C, Post B, Leentjens AFG, Martinez-Martin P, Stebbins GT, Goetz CG, Schrag A. Scales to assess impulsive and compulsive behaviors in Parkinson's disease: Critique and recommendations. Mov Disord 2019; 34:791-798. [PMID: 31136681 DOI: 10.1002/mds.27689] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 09/11/2018] [Accepted: 10/10/2018] [Indexed: 11/10/2022] Open
Abstract
Impulse control disorders (ICDs) and related impulsive and compulsive behaviors (together called ICBs) have been increasingly recognized in the context of Parkinson's disease (PD) and treatment. The International Parkinson's and Movement Disorder Society commissioned a task force to assess available clinical screening instruments and rating scales, including their clinimetric properties, make recommendations regarding their utility, and suggest future directions in scale development and validation. The literature was systematically searched for scales measuring a range of reported ICBs in PD. A scale was designated "recommended" if the scale had been employed in PD studies, been used beyond the group that developed it, and had adequate clinimetric data published for PD. Numerous diagnostic screening tools and severity rating scales were identified for a range of ICBs, including compulsive medication use, punding/hobbyism, walkabout, pathological gambling, hypersexuality, compulsive or binge eating, compulsive buying, reckless driving, compulsive exercise, pyromania, trichotillomania, hoarding, kleptomania, intermittent explosive disorder, and internet addiction. For screening across the range of ICBs (except compulsive medication use), the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's disease (QUIP) and QUIP-Rating Scale (QUIP-RS) are recommended, and for severity rating across the range of ICBs the QUIP-RS and the Ardouin Scale of Behavior in Parkinson's Disease are recommended. The Scale for Outcomes in Parkinson's Disease-Psychiatric Complications is recommended for rating of hypersexuality and the compulsive behaviors gambling/shopping. Further testing of established scales against gold standard diagnostic criteria is urgently required for all other individual ICBs in PD. © 2019 International Parkinson and Movement Disorder Society © 2019 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Andrew H Evans
- Department of Neurology, the Royal Melbourne Hospital, Parkville, Australia
| | - David Okai
- Kings College London, Institute of Psychiatry, Section of Cognitive Neuropsychiatry, London, UK
| | - Daniel Weintraub
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Parkinson's Disease and Mental Illness Research, Education and Clinical Centers (Philadelphia Parkinson's Disease Research, Education and Clinical Center (PADRECC) and Mental Illness Research Education Clinical, Centers of Excellence (MIRECC)), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Shen-Yang Lim
- Division of Neurology, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sean S O'Sullivan
- Division of Neurology, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Neurology, Bon Secours Hospital, Cork, Ireland
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Paul Krack
- Movement Disorders Center, Department of Neurology, University Hospital (Inselspital) and University of Bern, Bern Switzerland
| | - Cristina Sampaio
- Cure Huntington's Disease InitiativeEl (CHDI) Management/CHDI Foundation, Princeton, New Jersey, USA
| | - Bart Post
- Department of Neurology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Albert F G Leentjens
- Department of Psychiatry, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Pablo Martinez-Martin
- National Center of Epidemiology and Centro de Investigacion Biomedica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Glenn T Stebbins
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Christopher G Goetz
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Anette Schrag
- Department of Clinical Neurosciences, Institute of Neurology, University College London, London, UK
| | | |
Collapse
|
28
|
Béreau M, Krack P, Brüggemann N, Münte TF. Neurobiology and clinical features of impulse control failure in Parkinson's disease. Neurol Res Pract 2019; 1:9. [PMID: 33324875 PMCID: PMC7650064 DOI: 10.1186/s42466-019-0013-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 02/12/2019] [Indexed: 12/02/2022] Open
Abstract
Impulse control disorders (ICDs) and other impulsive-compulsive related behaviours are frequent and still under recognized non-motor complications of Parkinson's disease (PD). They result from sensitization of the mesocorticolimbic pathway that arose in predisposed PD patients concomitantly with spreading of PD pathology, non-physiological dopaminergic and pulsatile administration of dopamine replacement therapy (DRT). Neuropsychiatric fluctuations (NPF) reflect the psychotropic effects of dopaminergic drugs and play a crucial role in the emergence of ICDs and behavioral addictions. Dopamine agonists (DA) which selectively target D2 and D3 receptors mostly expressed within the mesocorticolimbic pathway, are the main risk factor to develop ICDs. Neuroimaging studies suggest that dopamine agonists lead to a blunted response of the brain's reward system both during reward delivery and anticipation. Genetic predispositions are crucial for the responsiveness of the mesolimbic system and the development of ICDs with several genes having been identified. Early screening for neuropsychiatric fluctuations, reduction of DA, fractionating levodopa dosage, education of patients and their relatives, are the key strategies for diagnosis and management of ICDs and related disorders.
Collapse
Affiliation(s)
- Matthieu Béreau
- Department of Neurology, University Hospital of Besançon, 25030 Besançon, Cedex France
| | - Paul Krack
- Department of Neurology, Inselspital, University of Bern, CH-3010 Bern, Switzerland
| | | | - Thomas F. Münte
- Department of Neurology, University of Lübeck, 23562 Lübeck, Germany
- Institute of Psychology II, University of Lübeck, 23562 Lübeck, Germany
| |
Collapse
|
29
|
Abstract
OBJECTIVES Bipolar disorder (BD) is associated with impairments in facial emotion and emotional prosody perception during both mood episodes and periods of remission. To expand on previous research, the current study investigated cross-modal emotion perception, that is, matching of facial emotion and emotional prosody in remitted BD patients. METHODS Fifty-nine outpatients with BD and 45 healthy volunteers were included into a cross-sectional study. Cross-modal emotion perception was investigated by using two subtests out of the Comprehensive Affective Testing System (CATS). RESULTS Compared to control subjects patients were impaired in matching sad (p < .001) and angry emotional prosody (p = .034) to one of five emotional faces exhibiting the corresponding emotion and significantly more frequently matched sad emotional prosody to happy faces (p < .001) and angry emotional prosody to neutral faces (p = .017). In addition, patients were impaired in matching neutral emotional faces to the emotional prosody of one of three sentences (p = .006) and significantly more often matched neutral faces to sad emotional prosody (p = .014). CONCLUSIONS These findings demonstrate that, even during periods of symptomatic remission, patients suffering from BD are impaired in matching facial emotion and emotional prosody. As this type of emotion processing is relevant in everyday life, our results point to the necessity to provide specific training programs to improve psychosocial outcomes. (JINS, 2019, 25, 336-342).
Collapse
|
30
|
Latella D, Maggio MG, Maresca G, Saporoso AF, Le Cause M, Manuli A, Milardi D, Bramanti P, De Luca R, Calabrò RS. Impulse control disorders in Parkinson's disease: A systematic review on risk factors and pathophysiology. J Neurol Sci 2019; 398:101-106. [PMID: 30690412 DOI: 10.1016/j.jns.2019.01.034] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 12/29/2018] [Accepted: 01/21/2019] [Indexed: 02/06/2023]
Abstract
AIM Purpose of this review is to evaluate the potential risk factors that may predispose to the development of Impulse control disorders (ICDs) in Parkinson's Disease (PD) patients, including the effects of dopaminergic therapy. METHODS This descriptive review was conducted to identificate risk factors that could cause impulsive control disorders in PD. Studies were found on PubMed (2010-2018), Web Of Science (January 2010-July 2018) and Cochrane (2010-2018) databases. RESULTS The data suggest that intrinsic and extrinsic factors may be involved in the development of behavioral complications. To date, the link between PD and the development of ICDs is not very clear, but studies highlight the existence of a predisposition to ICDs in the presence of risk factors. CONCLUSIONS A better assessment of the behavioral disorders of PD may be useful in the rehabilitative intervention for increasing the quality of life.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Demetrio Milardi
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy; AOU, Policlinico G Martino, Messina, Italy
| | | | | | | |
Collapse
|
31
|
Solinas M, Belujon P, Fernagut PO, Jaber M, Thiriet N. Dopamine and addiction: what have we learned from 40 years of research. J Neural Transm (Vienna) 2018; 126:481-516. [PMID: 30569209 DOI: 10.1007/s00702-018-1957-2] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 11/17/2018] [Indexed: 12/22/2022]
Abstract
Among the neurotransmitters involved in addiction, dopamine (DA) is clearly the best known. The critical role of DA in addiction is supported by converging evidence that has been accumulated in the last 40 years. In the present review, first we describe the dopaminergic system in terms of connectivity, functioning and involvement in reward processes. Second, we describe the functional, structural, and molecular changes induced by drugs within the DA system in terms of neuronal activity, synaptic plasticity and transcriptional and molecular adaptations. Third, we describe how genetic mouse models have helped characterizing the role of DA in addiction. Fourth, we describe the involvement of the DA system in the vulnerability to addiction and the interesting case of addiction DA replacement therapy in Parkinson's disease. Finally, we describe how the DA system has been targeted to treat patients suffering from addiction and the result obtained in clinical settings and we discuss how these different lines of evidence have been instrumental in shaping our understanding of the physiopathology of drug addiction.
Collapse
Affiliation(s)
- Marcello Solinas
- Université de Poitiers, INSERM, U-1084, Laboratoire de Neurosciences Expérimentales et Cliniques, Poitiers, France.
| | - Pauline Belujon
- Université de Poitiers, INSERM, U-1084, Laboratoire de Neurosciences Expérimentales et Cliniques, Poitiers, France
| | - Pierre Olivier Fernagut
- Université de Poitiers, INSERM, U-1084, Laboratoire de Neurosciences Expérimentales et Cliniques, Poitiers, France
| | - Mohamed Jaber
- Université de Poitiers, INSERM, U-1084, Laboratoire de Neurosciences Expérimentales et Cliniques, Poitiers, France
- CHU de Poitiers, Poitiers, France
| | - Nathalie Thiriet
- Université de Poitiers, INSERM, U-1084, Laboratoire de Neurosciences Expérimentales et Cliniques, Poitiers, France
| |
Collapse
|
32
|
Béreau M, Fleury V, Bouthour W, Castrioto A, Lhommée E, Krack P. Hyperdopaminergic behavioral spectrum in Parkinson's disease: A review. Rev Neurol (Paris) 2018; 174:653-663. [DOI: 10.1016/j.neurol.2018.07.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 07/22/2018] [Accepted: 07/24/2018] [Indexed: 02/08/2023]
|
33
|
Napier TC, Persons AL. Pharmacological insights into impulsive-compulsive spectrum disorders associated with dopaminergic therapy. Eur J Neurosci 2018; 50:2492-2502. [PMID: 30269390 DOI: 10.1111/ejn.14177] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 09/13/2018] [Accepted: 09/14/2018] [Indexed: 12/31/2022]
Abstract
Impulsive-compulsive spectrum disorders are associated with dopamine agonist therapy in some patients. These untoward outcomes occur with direct-acting, full and partial agonists at D2 dopamine family receptors. The disorders typically emerge during chronic treatment, and exhibit common features that are independent of the neurological or psychiatric pathology for which the initial therapy was indicated. It is well-documented that the brain is 'plastic', changing in response to alterations to internal factors (e.g., disease processes), as well as external factors (e.g., therapies). The complexities of these clinical scenarios have eluded a clear depiction of the neurobiology for impulsive-compulsive spectrum disorders and engendered considerable debate regarding the mechanistic underpinnings of the disorders. In this opinion, we use pharmacological concepts related to homeostatic compensation subsequent to chronic receptor activation to provide a unifying construct. This construct helps explain the occurrence of impulsive-compulsive spectrum disorders across disease states, and during therapy with full and partial agonists.
Collapse
Affiliation(s)
- T Celeste Napier
- Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA.,Center for Compulsive Behavior and Addiction, Rush University Medical Center, Chicago, IL, USA
| | - Amanda L Persons
- Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA.,Center for Compulsive Behavior and Addiction, Rush University Medical Center, Chicago, IL, USA.,Department of Physician Assistant Studies, Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
34
|
Straka I, Minár M, Gažová A, Valkovič P, Kyselovič J. Clinical aspects of adherence to pharmacotherapy in Parkinson disease: A PRISMA-compliant systematic review. Medicine (Baltimore) 2018; 97:e10962. [PMID: 29879046 PMCID: PMC5999496 DOI: 10.1097/md.0000000000010962] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Parkinson disease (PD) is the second most common neurodegenerative disease with various motor and nonmotor symptoms. Progressive course of PD requires frequent medication adjustments. Various combinations of drugs and dose regimens could be used to control symptoms. Thus, not surprisingly, adherence to pharmacotherapy is frequently suboptimal in these patients having negative effect on motor control and patient's quality of life. METHODS In this article, we offer up-to-date review of adherence in PD compared with other chronic conditions. In addition, we summarize factors influencing level of adherence, ways of measuring, and methods of adherence optimization. For the review of adherence in PD, a literature search was undertaken using PubMed database and relevant search terms. Articles were screened for suitability and data relevance. RESULTS PubMed and Scopus databases were systematically searched in 2016 and data extraction was a multistep process based on the PRISMA Guidelines. CONCLUSION According to the recent data, sufficient control of motor symptoms and adequate quality of life are primary goals in the treatment of PD. Adherence to pharmacotherapy play a key role in this process, thus the medication should be tailored for each patient. In order to improve level of suboptimal adherence, these patients should have got recommended various dosing devices or alarms. Good communication with the patients and their relatives or caregivers is also essential.
Collapse
Affiliation(s)
- Igor Straka
- Second Department of Neurology, Faculty of Medicine Comenius University and University Hospital Bratislava
| | - Michal Minár
- Second Department of Neurology, Faculty of Medicine Comenius University and University Hospital Bratislava
| | - Andrea Gažová
- Institute of Pharmacology and Clinical Pharmacology, Faculty of Medicine Comenius University
| | - Peter Valkovič
- Second Department of Neurology, Faculty of Medicine Comenius University and University Hospital Bratislava
- Institute of Normal and Pathological Sciences, Slovak Academy of Sciences
| | - Ján Kyselovič
- Department of Internal Medicine, Faculty of Medicine in Bratislava, Comenius University, Slovakia
| |
Collapse
|
35
|
Dawson A, Dissanayaka NN, Evans A, Verdejo-Garcia A, Chong TTJ, Frazzitta G, Ferrazzoli D, Ortelli P, Yücel M, Carter A. Neurocognitive correlates of medication-induced addictive behaviours in Parkinson's disease: A systematic review. Eur Neuropsychopharmacol 2018; 28:561-578. [PMID: 29653742 DOI: 10.1016/j.euroneuro.2018.03.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 03/06/2018] [Accepted: 03/22/2018] [Indexed: 12/28/2022]
Abstract
Dopaminergic medication can induce severe addictive behaviours (e.g., pathological gambling) in susceptible Parkinson's disease (PD) patients. It is still unknown which particular neurocognitive processes become exacerbated or dysfunctional in PD patients with addictive behaviours. We sought to systematically review the relevant literature to identity potential neurocognitive correlates of medication-induced addictive behaviours in PD. We framed our review around neurocognitive processes central to four dominant accounts of substance addiction: 'aberrant learning', 'incentive sensitization', 'impulsivity to compulsivity' and 'impaired response inhibition and salience attribution'. Searches of the PubMed and Scopus databases were completed on June 23, 2017. To be included, studies were required to involve: (a) medicated PD patients, without a history of deep brain stimulation, with and without addictive behaviours; (b) a reward-related or decision-making task; and (c) statistical comparison of addictive and non-addictive groups' 'on' medication performance on the task(s). Studies were summarised qualitatively with statistically significant (p<.05) group differences and effect sizes (Cohen's d) highlighted. 35 studies were included. Findings showed that the extant literature is highly heterogeneous. The domains of reward and punishment learning, reflection impulsivity and disadvantageous decision-making exemplify this. More homogeneity exists in domains in which (a) neurocognitive dysfunction is not apparent (motor control, cognitive/attentional flexibility and cognitive control) or (b) typical neurocognitive processes appear exacerbated by medication (reward motivation and choice impulsivity). Future large-scale neurocognitive studies are still required to develop our scientific understanding of addictive behaviours in PD and aid their clinical treatment and prediction.
Collapse
Affiliation(s)
- Andrew Dawson
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria 3800, Australia
| | - Nadeeka N Dissanayaka
- University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Queensland 4029, Australia; Department of Neurology, Royal Brisbane & Women's Hospital, Herston, Queensland 4029, Australia; School of Psychology, The University of Queensland, St. Lucia, Queensland 4029, Australia
| | - Andrew Evans
- The Royal Melbourne Hospital, Parkville, Victoria 3050, Australia
| | - Antonio Verdejo-Garcia
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria 3800, Australia
| | - Trevor T J Chong
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria 3800, Australia
| | - Giuseppe Frazzitta
- Movement Disorders and Brain Injury Rehabilitation, 'Moriggia-Pelascini' Hospital, Gravedona ed Uniti, Como 22015, Italy
| | - Davide Ferrazzoli
- Movement Disorders and Brain Injury Rehabilitation, 'Moriggia-Pelascini' Hospital, Gravedona ed Uniti, Como 22015, Italy
| | - Paola Ortelli
- Movement Disorders and Brain Injury Rehabilitation, 'Moriggia-Pelascini' Hospital, Gravedona ed Uniti, Como 22015, Italy
| | - Murat Yücel
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria 3800, Australia
| | - Adrian Carter
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria 3800, Australia; University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Queensland 4029, Australia
| |
Collapse
|
36
|
Omarova SM, Fedorova NV, Tomskiy AA, Gamaleya AA, Bril' EV, Gubareva NN, Poddubskaya AA. [Syndrome dopamine dysregulation and deep brain stimulation of the subthalamic nucleus in Parkinson's disease]. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 117:27-32. [PMID: 29376980 DOI: 10.17116/jnevro201711712127-32] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM Dopamine dysregulation syndrome (DDS) is a complication of the dopaminergic therapy in Parkinson's disease (PD); it is manifested as a compulsive medication use and may have negative impact on patients' social, psychological, and physical functioning. An effect of deep brain stimulation in the subthalamic nucleus (DBS STN) on DDS is not fully understood. Therefore, the degree of DDS during DBS STN in PD patients was evaluated in the study. MATERIAL AND METHODS The main group included 15 patients with DDS symptoms in the preoperative period. The comparison group consisted of 15 patients without DDS symptoms and the control group consisted of 15 patients who did not undergo surgery. RESULTS AND CONCLUSION The severity of motor disturbances in the surgery groups has decreased significantly (by 45%). Motor complications during DBS STN in patients with DDS have decreased by 50%; a decrease in the reduction of doses of dopaminergic preparations was noted as well.
Collapse
Affiliation(s)
- S M Omarova
- Russian Medical Academy of Continuing Postgraduate Education, Moscow, Russia
| | - N V Fedorova
- Russian Medical Academy of Continuing Postgraduate Education, Moscow, Russia
| | - A A Tomskiy
- Burdenko National Research Centre of Neurosurgery, Moscow, Russia
| | - A A Gamaleya
- Burdenko National Research Centre of Neurosurgery, Moscow, Russia
| | - E V Bril'
- Russian Medical Academy of Continuing Postgraduate Education, Moscow, Russia
| | - N N Gubareva
- Russian Medical Academy of Continuing Postgraduate Education, Moscow, Russia
| | - A A Poddubskaya
- Burdenko National Research Centre of Neurosurgery, Moscow, Russia
| |
Collapse
|
37
|
Warren N, O'Gorman C, Lehn A, Siskind D. Dopamine dysregulation syndrome in Parkinson's disease: a systematic review of published cases. J Neurol Neurosurg Psychiatry 2017; 88:1060-1064. [PMID: 29018160 DOI: 10.1136/jnnp-2017-315985] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 06/13/2017] [Accepted: 08/01/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Dopamine dysregulation syndrome (DDS) is an uncommon complication of the treatment of Parkinson's disease, characterised by addictive behaviour and excessive use of dopaminergic medication. DDS may frequently go unrecognised or misdiagnosed. We aimed to clarify current understanding of presentation, risk factors, comorbidities and management of DDS. METHODS Case reports were identified through a systematic search of databases (PubMed, Embase) with the following terms: dopaminergic dysregulation syndrome, hedonistic homeostatic dysregulation, dopamine/levodopa addiction. RESULTS We reviewed 390 articles, identifying 98 cases of DDS. Early-onset Parkinson's disease (67%) and male gender (83%) were common. DDS presented with significant physical and social impairment, actions to enable or prevent detection of overuse, as well as mood, anxiety and motor fluctuations. All DDS cases met DSM-V (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) substance use disorder criteria. Past substance and psychiatric history was present in 15.3% and 10.2% of cases. Comorbid impulse control disorders (61%), psychosis (32%) and panic attacks (14%) were common. A large variety of management strategies were used; only 56% of cases resolving. Sodium valproate was successful in 5/5 cases. The response to deep brain stimulation varied. CONCLUSIONS Given the functional impairment, medical and psychiatric consequences and the difficulties of treatment, early identification of DDS should be a priority.
Collapse
Affiliation(s)
- Nicola Warren
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia
- Department of Psychiatry, Metro South Addiction and Mental Health Services, Brisbane, Queensland, Australia
| | - Cullen O'Gorman
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia
- Department of Neurology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Alexander Lehn
- Department of Neurology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Dan Siskind
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia
- Department of Psychiatry, Metro South Addiction and Mental Health Services, Brisbane, Queensland, Australia
| |
Collapse
|
38
|
Loiodice S, McGhan P, Gryshkova V, Fleurance R, Dardou D, Hafidi A, Nogueira da Costa A, Durif F. Striatal changes underlie MPEP-mediated suppression of the acquisition and expression of pramipexole-induced place preference in an alpha-synuclein rat model of Parkinson's disease. J Psychopharmacol 2017. [PMID: 28631520 DOI: 10.1177/0269881117714051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Impulsive-compulsive disorders in Parkinson's disease patients have been described as behavioural or substance addictions including pathological gambling or compulsive medication use of dopamine replacement therapy. A substantial gap remains in the understanding of these disorders. We previously demonstrated that the rewarding effect of the D2/D3 agonist pramipexole was enhanced after repeated exposure to L-dopa and alpha-synuclein mediated dopaminergic nigral loss with specific transcriptional signatures suggesting a key involvement of the glutamatergic pathway. Here, we further investigate the therapeutic potential of metabotropic glutamate receptor 5 antagonism in Parkinson's disease/dopamine replacement therapy related bias of reward-mediated associative learning. We identified protein changes underlying the striatal remodelling associated with the pramipexole-induced conditioned place preference. Acquisition and expression of the pramipexole-induced conditioned place preference were abolished by the metabotropic glutamate receptor 5 antagonist 2-methyl-6-phenylethynyl (pyridine) (conditioned place preference scores obtained with pramipexole conditioning were reduced by 12.5% and 125.8% when 2-methyl-6-phenylethynyl (pyridine) was co-administrated with pramipexole or after the pramipexole conditioning, respectively). Up-regulation of the metabotropic glutamate receptor 5 was found in the dorsomedial-striatum and nucleus accumbens core. Activation of these two brain sub-regions was also highlighted through FosB immunohistochemistry. Convergent molecular and pharmacological data further suggests metabotropic glutamate receptor 5 as a promising therapeutic target for the management of Parkinson's disease/dopamine replacement therapy related reward bias.
Collapse
Affiliation(s)
- Simon Loiodice
- 1 EA7280 Neuropsychopharmacology of sub-cortical dopaminergic pathways, Université d'Auvergne, Clermont-Ferrand, France.,2 Department of Non-Clinical Development, UCB Biopharma SPRL, Braine-l'Alleud, Belgium
| | - Portia McGhan
- 2 Department of Non-Clinical Development, UCB Biopharma SPRL, Braine-l'Alleud, Belgium
| | - Vitalina Gryshkova
- 2 Department of Non-Clinical Development, UCB Biopharma SPRL, Braine-l'Alleud, Belgium
| | - Renaud Fleurance
- 2 Department of Non-Clinical Development, UCB Biopharma SPRL, Braine-l'Alleud, Belgium
| | - David Dardou
- 1 EA7280 Neuropsychopharmacology of sub-cortical dopaminergic pathways, Université d'Auvergne, Clermont-Ferrand, France
| | - Aziz Hafidi
- 1 EA7280 Neuropsychopharmacology of sub-cortical dopaminergic pathways, Université d'Auvergne, Clermont-Ferrand, France
| | | | - Franck Durif
- 1 EA7280 Neuropsychopharmacology of sub-cortical dopaminergic pathways, Université d'Auvergne, Clermont-Ferrand, France.,3 Neurology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| |
Collapse
|
39
|
Adams WK, Vonder Haar C, Tremblay M, Cocker PJ, Silveira MM, Kaur S, Baunez C, Winstanley CA. Deep-Brain Stimulation of the Subthalamic Nucleus Selectively Decreases Risky Choice in Risk-Preferring Rats. eNeuro 2017; 4:ENEURO.0094-17.2017. [PMID: 28791332 PMCID: PMC5547195 DOI: 10.1523/eneuro.0094-17.2017] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 06/15/2017] [Accepted: 07/03/2017] [Indexed: 11/21/2022] Open
Abstract
Deep brain stimulation of the subthalamic nucleus (STN-DBS) can improve the motor symptoms of Parkinson's disease (PD) and negate the problematic side effects of dopamine replacement therapy. Although there is concern that STN-DBS may enhance the development of gambling disorder and other impulse control disorders in this patient group, recent data suggest that STN-DBS may actually reduce iatrogenic impulse control disorders, and alleviate obsessive-compulsive disorder (OCD). Here, we sought to determine whether STN-DBS was beneficial or detrimental to performance of the rat gambling task (rGT), a rodent analogue of the Iowa Gambling Task (IGT) used to assess risky decision making clinically. Rats chose between four options associated with different amounts and probabilities of sugar pellet rewards versus timeout punishments. As in the IGT, the optimal approach was to favor options associated with smaller per-trial gains but lower timeout penalties. Once a stable behavioral baseline was established, electrodes were implanted bilaterally into the STN, and the effects of STN-DBS assessed on-task over 10 consecutive sessions using an A-B-A design. STN-DBS did not affect choice in optimal decision makers that correctly favored options associated with smaller per-trial gains but also lower penalties. However, a minority (∼25%) preferred the maladaptive "high-risk, high-reward" options at baseline. STN-DBS significantly and progressively improved choice in these risk-preferring rats. These data support the hypothesis that STN-DBS may be beneficial in ameliorating maladaptive decision making associated with compulsive and addiction disorders.
Collapse
Affiliation(s)
- Wendy K. Adams
- Department of Psychology, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver V6T 1Z3, Canada
| | - Cole Vonder Haar
- Department of Psychology, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver V6T 1Z3, Canada
| | - Melanie Tremblay
- Department of Psychology, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver V6T 1Z3, Canada
| | - Paul J. Cocker
- Department of Psychology, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver V6T 1Z3, Canada
| | - Mason M. Silveira
- Department of Psychology, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver V6T 1Z3, Canada
| | - Sukhbir Kaur
- Department of Psychology, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver V6T 1Z3, Canada
| | - Christelle Baunez
- Institut de Neurosciences de la Timone, UMR7289 Centre National de la Recherche Scientifique and Aix-Marseille Université, 13005, Marseille, France
| | - Catharine A. Winstanley
- Department of Psychology, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver V6T 1Z3, Canada
| |
Collapse
|
40
|
Yasuhara T, Date I. Intracerebral Transplantation of Genetically Engineered Cells for Parkinson's Disease: Toward Clinical Application. Cell Transplant 2017. [DOI: 10.3727/000000007783464632] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Over the last decade, molecular biology has progressively developed, leading to new technology with subsequent clinical application for various cerebral diseases including Parkinson's disease (PD), one of the most investigated neurodegenerative disorders. The therapy for PD is mainly composed of medication, including drug replacement therapy, surgical treatment, and cell transplantation. Cell therapy for PD has been explored by using fetal nigral cells as an allo- or xenograft, autologous sympathetic ganglion, adrenal medulla, and carotid body in clinical settings. In addition, neurotrophic factors, including glial cell line-derived neurotrophic factor (GDNF), have a strong potency to rescue degenerating dopaminergic cells. Protein and/or gene therapy also might be a therapeutic option for PD. In this review, genetically engineered cell transplantation for animal models of PD, including catecholamine/neurotrophic factor-secreting cell transplantation with or without encapsulation, as performed in our laboratories, and their potential future as clinical applications are described with recent clinical studies in this field.
Collapse
Affiliation(s)
- Takao Yasuhara
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700–8558, Japan
- Department of Neurology, Medical College of Georgia, Augusta, GA 30912, USA
| | - Isao Date
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700–8558, Japan
| |
Collapse
|
41
|
Sharma JC, Lewis A. Weight in Parkinson's Disease: Phenotypical Significance. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 134:891-919. [PMID: 28805588 DOI: 10.1016/bs.irn.2017.04.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Body weight in Parkinson's disease (PD) is a significant nonmotor feature. Weight homeostasis is a complex physiological process and gets deranged in PD patients leading to changes in weight. While both the low and high body weight have been reported as risk factors for PD, the majority of PD patients have a lower weight and a subset of patients lose weight during the course of the disease, while a small proportion gain weight. A number of clinical parameters such as older age, impaired cognition, severity of disease, and an imbalance of food intake determined by satiety and hunger hormones have been reported to be associated with but not the cause of weight change. Low body weight and weight loss have a negative impact on disease severity, dyskinesia quality of life, and mortality indicative of disease progression. An early assessment of olfactory impairment seems to identify patients at risk of weight loss, the patients with more severe olfactory loss-anosmic group, lose weight as compared to the patients with some preservation of olfaction, the hyposmic group. Higher levodopa dose per kilogram body weight increases the risk of dyskinesia, higher body weight seems to be protective against this complication. The identification of PD patients according to the nonmotor phenotype of "Park-olfaction-weight-phenotype" and the "olfaction-weight-dyskinesia" triad should help to develop strategies to prevent weight reduction and improve general health and complications of PD patients. The phenotype seems to reflect a differential prodromal pathology and influence clinical disease. Higher body weight patients would benefit from life style changes to achieve a healthy profile. Weight monitoring and weight orientated approach to management of PD patients should help to improve their outcome. Body weight change might be a surrogate to disease progression and may be used to investigate neuroprotection strategies.
Collapse
Affiliation(s)
- Jagdish C Sharma
- Geriatric Medicine (Movement Disorders), Lincoln County Hospital, Lincoln, United Kingdom; University of Lincoln, Lincoln, United Kingdom.
| | - Anna Lewis
- Geriatric Medicine (Movement Disorders), Lincoln County Hospital, Lincoln, United Kingdom; University of Lincoln, Lincoln, United Kingdom
| |
Collapse
|
42
|
|
43
|
Bilderbeck AC, Atkinson LZ, Geddes JR, Goodwin GM, Harmer CJ. The effects of medication and current mood upon facial emotion recognition: findings from a large bipolar disorder cohort study. J Psychopharmacol 2017; 31:320-326. [PMID: 27678089 DOI: 10.1177/0269881116668594] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Emotional processing abnormalities have been implicated in bipolar disorder (BD) but studies are typically small and uncontrolled. Here, facial expression recognition was explored in a large and naturalistically recruited cohort of BD patients. METHODS 271 patients with BD completed the facial expression recognition task. The effects of current medication together with the influence of current mood state and diagnostic subtype were assessed whilst controlling for the effects of demographic variables. RESULTS Patients who were currently receiving treatment with lithium demonstrated significantly poorer accuracy in recognising angry faces, an effect that held in a monotherapy sub-analysis comparing those participants on lithium only and those who were medication-free. Accuracy in recognising angry faces was also lower amongst participants currently taking dopamine antagonists (antipsychotics). Higher levels of current depressive symptoms were linked to poorer accuracy at identifying happy faces. CONCLUSION Use of lithium and possibly dopamine antagonists may be associated with reduced processing of anger cues in BD. Findings support the existence of mood-congruent negative biases associated with depressive symptoms in BD. Observational cohort studies provide opportunities to explore the substantial effects of demographic, psychometric and clinical variables on cognitive performance and emotional processing.
Collapse
Affiliation(s)
| | | | - John R Geddes
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Guy M Goodwin
- Department of Psychiatry, University of Oxford, Oxford, UK
| | | |
Collapse
|
44
|
Stievenard A, Méquinion M, Andrews ZB, Destée A, Chartier-Harlin MC, Viltart O, Vanbesien-Mailliot CC. Is there a role for ghrelin in central dopaminergic systems? Focus on nigrostriatal and mesocorticolimbic pathways. Neurosci Biobehav Rev 2017; 73:255-275. [DOI: 10.1016/j.neubiorev.2016.11.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 11/23/2016] [Accepted: 11/25/2016] [Indexed: 12/21/2022]
|
45
|
Sexual Dysfunctions in Parkinson's Disease: An Underrated Problem in a Much Discussed Disorder. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 134:859-876. [DOI: 10.1016/bs.irn.2017.05.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
46
|
Pramipexole induced place preference after L-dopa therapy and nigral dopaminergic loss: linking behavior to transcriptional modifications. Psychopharmacology (Berl) 2017; 234:15-27. [PMID: 27614895 DOI: 10.1007/s00213-016-4430-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 09/04/2016] [Indexed: 01/25/2023]
Abstract
RATIONALE Impulsive-compulsive disorders (ICD) in patients with Parkinson's disease (PD) have been described as behavioral or substance addictions including hypersexuality, gambling, or compulsive medication use of the dopamine replacement therapy (DRT). OBJECTIVES A remaining challenge is to understand the neuroadaptations leading to reward bias in PD patients under DRT. METHODS To this end, the appetitive effect of the D2/D3 agonist pramipexole was assessed after chronic exposure to L-dopa in an alpha-synuclein PD rat model. RESULTS Association of progressive nigral loss and chronic L-dopa was required to observe a pramipexole-induced place preference. This behavioral outcome was inhibited by metabotropic glutamate receptor 5 (mGluR5) antagonism while transcriptional profiling highlighted regulations potentially related to the context of psychostimulant addiction. CONCLUSION This study provides evidences strongly suggesting that PD-like lesion and L-dopa therapy were concomitant factors involved in striatal remodeling underlying the pramipexole-induced place preference. Molecular and pharmacological data suggest a key involvement of the glutamatergic pathway in this behavioral outcome.
Collapse
|
47
|
Sierra M, Carnicella S, Strafella AP, Bichon A, Lhommée E, Castrioto A, Chabardes S, Thobois S, Krack P. Apathy and Impulse Control Disorders: Yin & Yang of Dopamine Dependent Behaviors. JOURNAL OF PARKINSONS DISEASE 2016; 5:625-36. [PMID: 25870025 DOI: 10.3233/jpd-150535] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Neuropsychiatric symptoms are common non-motor symptoms in Parkinson's disease (PD). Apathy and impulse control disorders (ICD) are two opposite motivational expressions of a continuous behavioural spectrum involving hypo- and hyperdopaminergia. Both syndromes share pathological (decreased vs increased) dopamine receptor stimulation states. Apathy belongs to the spectrum of hypodopaminergic symptoms together with anhedonia, anxiety and depression. Apathy is a key symptom of PD which worsens with disease progression. Animal models, imaging and pharmacological studies concur in pointing out dopaminergic denervation in the aetiology of parkinsonian apathy with a cardinal role of decreased tonic D2/D3 receptor stimulation. ICDs are part of the hyperdopaminergic behavioural spectrum, which also includes punding, and dopamine dysregulation syndrome (DDS), which are all related to non-physiological dopaminergic stimulation induced by antiparkinsonian drugs. According to clinical data tonic D2/D3 receptor stimulation can be sufficient to induce ICDs. Clinical observations in drug addiction and PD as well as data from studies in dopamine depleted rodents provide hints allowing to argue that both pulsatile D1 and D2 receptor stimulation and the severity of dopaminergic denervation are risk factors to develop punding behavior and DDS. Imaging studies have shown that the brain structures involved in drug addiction are also involved in hyperdopaminergic behaviours with increase of bottom-up appetitive drive and decrease in prefrontal top down behavioural control.
Collapse
Affiliation(s)
- María Sierra
- Service of Neurology, University Hospital "Marqués de Valdecilla (IFIMAV)", University of Cantabria and "Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED)", Santander, Spain
| | | | - Antonio P Strafella
- Morton and Gloria Shulman Movement Disorder Unit - E.J. Safra Parkinson Disease Program, Toronto Western Hospital and Research Institute, UHN & Research Imaging Centre, Campbell Family Mental Health Research Institute, CAMH, University of Toronto, Ontario, Canada
| | - Amélie Bichon
- Movement Disorder Unit, Department of Psychiatry and Neurology, CHU de Grenoble, Joseph Fourier University, Grenoble Universités, France; and INSERM, Unit 836, Grenoble Institut des Neurosciences, Grenoble, France
| | - Eugénie Lhommée
- Movement Disorder Unit, Department of Psychiatry and Neurology, CHU de Grenoble, Joseph Fourier University, Grenoble Universités, France; and INSERM, Unit 836, Grenoble Institut des Neurosciences, Grenoble, France
| | - Anna Castrioto
- Movement Disorder Unit, Department of Psychiatry and Neurology, CHU de Grenoble, Joseph Fourier University, Grenoble Universités, France; and INSERM, Unit 836, Grenoble Institut des Neurosciences, Grenoble, France
| | - Stephan Chabardes
- Department of Neurosurgery CHU de Grenoble, Joseph Fourier University, Grenoble, France and INSERM, Unité 836, Grenoble Institut des Neurosciences, Grenoble, France
| | - Stéphane Thobois
- Université de Lyon, F-69622, Lyon, France; Université Lyon 1, Villeurbanne, France; CNRS, UMR5229, Centre de Neuroscience Cognitive, Bron, France; Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France
| | - Paul Krack
- Movement Disorder Unit, Department of Psychiatry and Neurology, CHU de Grenoble, Joseph Fourier University, Grenoble Universités, France; and INSERM, Unit 836, Grenoble Institut des Neurosciences, Grenoble, France
| |
Collapse
|
48
|
Martínez-Fernández R, Schmitt E, Martinez-Martin P, Krack P. The hidden sister of motor fluctuations in Parkinson's disease: A review on nonmotor fluctuations. Mov Disord 2016; 31:1080-94. [PMID: 27431515 DOI: 10.1002/mds.26731] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 06/13/2016] [Accepted: 06/19/2016] [Indexed: 12/29/2022] Open
Abstract
Only a few years after the introduction of levodopa, the first descriptions of motor fluctuations and dyskinesia related to dopaminergic therapy appeared. In PD, attention turned to their management, that had dampened the euphoria of the "levodopa miracle." It soon became clear that neuropsychiatric, autonomic, and sensory features also tend to develop fluctuations after chronic exposure to l-dopa. The diversity of fluctuating nonmotor symptoms, their largely subjective nature, coupled with a frequent lack of insight led to difficulties in identification and quantification. This may explain why, despite the high impact of nonmotor symptoms on patient autonomy and quality of life, evaluation of nonmotor fluctuations is not part of clinical routine. In view of the lack of specific validated assessment tools, detailed anamnesis should ideally be coupled with an evaluation in both ON and OFF drug conditions. The mechanisms of nonmotor fluctuations are not well understood. It is thought that they share dopaminergic presynaptic pharmacokinetic and postsynaptic pharmacodynamic mechanisms with the classical motor complications, but involve different neural pathways. Although symptoms fluctuate with dopaminergic treatment, serotonine and norepinephrine denervation, as well as interactions between neurotransmitter systems, probably contribute to their diversity. The lack of validated tools for assessment of these phenomena explains the almost complete absence of treatment studies. Management, largely resulting from expert opinion, includes psychiatric follow-up, nondopaminergic drugs, and advanced dopaminergic treatment, including drug delivery pumps and DBS. This review aims to provide a starting point for the understanding, diagnosis, and management of nonmotor fluctuations. © 2016 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
| | - Emmanuelle Schmitt
- Movement Disorders Unit, Department of Psychiatry and Neurology, CHU de Grenoble, Université de Grenoble Alpes and Grenoble Institut des Neurosciences, INSERM U386, Grenoble, France
| | - Pablo Martinez-Martin
- National Center of Epidemiology, Carlos III Institute of Health and CIBERNED, Madrid, Spain
| | - Paul Krack
- Neurology Division, Department of Clinical Neurosciences, University Hospital of Geneva, Geneva, Switzerland
| |
Collapse
|
49
|
Zhao Y, Heida T, van Wegen EEH, Bloem BR, van Wezel RJA. E-health Support in People with Parkinson's Disease with Smart Glasses: A Survey of User Requirements and Expectations in the Netherlands. JOURNAL OF PARKINSONS DISEASE 2016; 5:369-78. [PMID: 25855044 DOI: 10.3233/jpd-150568] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Recent advances in smart glasses, wearable computers in the form of glasses, bring new therapeutic and monitoring possibilities for people with Parkinson's disease (PD). For example, it can provide visual and auditory cues during activities of daily living that have long been used to improve gait disturbances. Furthermore, smart glasses can personalize therapies based on the state of the user and/or the user environment in real-time using object recognition and motion tracking. To provide guidelines for developers in creating new PD applications for smart glasses, a self-reported questionnaire was designed to survey the requirements, constraints, and attitudes of people with PD with respect to this new technology. The survey was advertised online over an 11 month period on the website of the Parkinson Vereninging. The results were derived from 62 participants (54.8% men and 45.2% women, average age of 65.7 ± 9.1), representing a response rate of 79.5% . The participants were overall very enthusiastic about smart glasses as an assistive technology to facilitate daily living activities, especially its potential to self-manage motor problems and provide navigational guidance, thereby restoring their confidence and independence. The reported level of usage of mobile technologies like tablets and smartphones suggests that smart glasses could be adopted relatively easily, especially by younger people with PD. However, the respondents were concerned about the cost, appearance, efficacy, and potential side effects of smart glasses. To accommodate a wide range of symptoms, personal preferences, and comfort level with technology, smart glasses should be designed to allow simple operation and personalization.
Collapse
Affiliation(s)
- Yan Zhao
- Biomedical Signal and Systems, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Tjitske Heida
- Biomedical Signal and Systems, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Erwin E H van Wegen
- Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Bastiaan R Bloem
- Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Richard J A van Wezel
- Biomedical Signal and Systems, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.,Biophysics, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| |
Collapse
|
50
|
Ferrazzoli D, Carter A, Ustun FS, Palamara G, Ortelli P, Maestri R, Yücel M, Frazzitta G. Dopamine Replacement Therapy, Learning and Reward Prediction in Parkinson's Disease: Implications for Rehabilitation. Front Behav Neurosci 2016; 10:121. [PMID: 27378872 PMCID: PMC4906006 DOI: 10.3389/fnbeh.2016.00121] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 05/30/2016] [Indexed: 12/21/2022] Open
Abstract
The principal feature of Parkinson’s disease (PD) is the impaired ability to acquire and express habitual-automatic actions due to the loss of dopamine in the dorsolateral striatum, the region of the basal ganglia associated with the control of habitual behavior. Dopamine replacement therapy (DRT) compensates for the lack of dopamine, representing the standard treatment for different motor symptoms of PD (such as rigidity, bradykinesia and resting tremor). On the other hand, rehabilitation treatments, exploiting the use of cognitive strategies, feedbacks and external cues, permit to “learn to bypass” the defective basal ganglia (using the dorsolateral area of the prefrontal cortex) allowing the patients to perform correct movements under executive-volitional control. Therefore, DRT and rehabilitation seem to be two complementary and synergistic approaches. Learning and reward are central in rehabilitation: both of these mechanisms are the basis for the success of any rehabilitative treatment. Anyway, it is known that “learning resources” and reward could be negatively influenced from dopaminergic drugs. Furthermore, DRT causes different well-known complications: among these, dyskinesias, motor fluctuations, and dopamine dysregulation syndrome (DDS) are intimately linked with the alteration in the learning and reward mechanisms and could impact seriously on the rehabilitative outcomes. These considerations highlight the need for careful titration of DRT to produce the desired improvement in motor symptoms while minimizing the associated detrimental effects. This is important in order to maximize the motor re-learning based on repetition, reward and practice during rehabilitation. In this scenario, we review the knowledge concerning the interactions between DRT, learning and reward, examine the most impactful DRT side effects and provide suggestions for optimizing rehabilitation in PD.
Collapse
Affiliation(s)
- Davide Ferrazzoli
- Department of Parkinson's disease, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital Gravedona ed Uniti (Como), Italy
| | - Adrian Carter
- UQ Centre for Clinical Research, The University of QueenslandBrisbane, QLD, Australia; School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash UniversityMelbourne, VIC, Australia
| | - Fatma S Ustun
- Neuroscience Graduate Program and National Magnetic Resonance Research Center (UMRAM), Bilkent University Ankara, Turkey
| | - Grazia Palamara
- Department of Parkinson's disease, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital Gravedona ed Uniti (Como), Italy
| | - Paola Ortelli
- Department of Parkinson's disease, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital Gravedona ed Uniti (Como), Italy
| | - Roberto Maestri
- Department of Biomedical Engineering, Scientific Institute of Montescano, S. Maugeri Foundation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Montescano (Pavia), Italy
| | - Murat Yücel
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University Melbourne, VIC, Australia
| | - Giuseppe Frazzitta
- Department of Parkinson's disease, Movement Disorders and Brain Injury Rehabilitation, "Moriggia-Pelascini" Hospital Gravedona ed Uniti (Como), Italy
| |
Collapse
|