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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.
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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
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Costello H, Berry AJ, Reeves S, Weil RS, Joyce EM, Howard R, Roiser JP. Disrupted reward processing in Parkinson's disease and its relationship with dopamine state and neuropsychiatric syndromes: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry 2022; 93:555-562. [PMID: 34930778 PMCID: PMC9016258 DOI: 10.1136/jnnp-2021-327762] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/20/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Neuropsychiatric symptoms are common in Parkinson's disease (PD) and predict poorer outcomes. Reward processing dysfunction is a candidate mechanism for the development of psychiatric symptoms including depression and impulse control disorders (ICDs). We aimed to determine whether reward processing is impaired in PD and its relationship with neuropsychiatric syndromes and dopamine replacement therapy. METHODS The Ovid MEDLINE/PubMed, Embase and PsycInfo databases were searched for articles published up to 5 November 2020. Studies reporting reward processing task performance by patients with PD and healthy controls were included. Summary statistics comparing reward processing between groups were converted to standardised mean difference (SMD) scores and meta-analysed using a random effects model. RESULTS We identified 55 studies containing 2578 participants (1638 PD and 940 healthy controls). Studies assessing three subcomponent categories of reward processing tasks were included: option valuation (n=12), reinforcement learning (n=37) and reward response vigour (n=6). Across all studies, patients with PD on medication exhibited a small-to-medium impairment versus healthy controls (SMD=0.34; 95% CI 0.14 to 0.53), with greater impairments observed off dopaminergic medication in within-subjects designs (SMD=0.43, 95% CI 0.29 to 0.57). Within-subjects subcomponent analysis revealed impaired processing off medication on option valuation (SMD=0.57, 95% CI 0.39 to 0.75) and reward response vigour (SMD=0.36, 95% CI 0.13 to 0.59) tasks. However, the opposite applied for reinforcement learning, which relative to healthy controls was impaired on-medication (SMD=0.45, 95% CI 0.25 to 0.65) but not off-medication (SMD=0.28, 95% CI -0.03 to 0.59). ICD was the only neuropsychiatric syndrome with sufficient studies (n=13) for meta-analysis, but no significant impairment was identified compared tonon-ICD patients (SMD=-0.02, 95% CI -0.43 to 0.39). CONCLUSION Reward processing disruption in PD differs according to subcomponent and dopamine medication state, and warrants further study as a potential treatment target and mechanism underlying associated neuropsychiatric syndromes.
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Affiliation(s)
- Harry Costello
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Alex J Berry
- Division of Psychiatry, University College London, London, UK
| | - Suzanne Reeves
- Division of Psychiatry, University College London, London, UK
| | - Rimona S Weil
- Institute of Neurology, University College London, London, UK
| | - Eileen M Joyce
- Institute of Neurology, University College London, London, UK
| | - Robert Howard
- Division of Psychiatry, University College London, London, UK
| | - Jonathan P Roiser
- Institute of Cognitive Neuroscience, University College London, London, UK
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Simola N, Serra M, Marongiu J, Costa G, Morelli M. Increased emissions of 50-kHz ultrasonic vocalizations in hemiparkinsonian rats repeatedly treated with dopaminomimetic drugs: A potential preclinical model for studying the affective properties of dopamine replacement therapy in Parkinson's disease. Prog Neuropsychopharmacol Biol Psychiatry 2021; 108:110184. [PMID: 33242502 DOI: 10.1016/j.pnpbp.2020.110184] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 11/13/2020] [Accepted: 11/18/2020] [Indexed: 12/19/2022]
Abstract
Dopamine replacement therapy used in Parkinson's disease (PD) may induce alterations in the emotional state that can underlie the manifestation of iatrogenic psychiatric-like disturbances. The preclinical investigation of these disturbances is limited, also because few reliable paradigms are available to study the affective properties of dopaminomimetic drugs in parkinsonian animals. To provide a relevant experimental tool in this respect, we evaluated whether dopaminomimetic drugs modified the emission of 50-kHz ultrasonic vocalizations (USVs), a behavioral marker of positive affect, in rats bearing a unilateral lesion with 6-hydroxydopamine in the medial forebrain bundle. Apomorphine (2 or 4 mg/kg, i.p.), L-3,4-dihydroxyphenilalanine (L-DOPA, 6 or 12 mg/kg, i.p.), or pramipexole (2 or 4 mg/kg, i.p.) were administered in a test cage (× 5 administrations) on alternate days. Seven days after treatment discontinuation, rats were re-exposed to the test cage to measure conditioned calling behavior and thereafter received a drug challenge. Hemiparkinsonian rats treated with either apomorphine or L-DOPA, but not pramipexole, markedly vocalized during repeated treatment and after challenge, and showed conditioned calling behavior. Moreover, apomorphine, L-DOPA and pramipexole elicited different patterns of 50-kHz USV emissions and rotational behavior, indicating that calling behavior in hemiparkinsonian rats treated with dopaminomimetic drugs is not a byproduct of motor activation. Taken together, these results suggest that measuring 50-kHz USV emissions may be a relevant experimental tool for studying how dopaminomimetic drugs modify the affective state in parkinsonian rats, with possible implications for the preclinical investigation of iatrogenic psychiatric-like disturbances in PD.
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Affiliation(s)
- Nicola Simola
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy; National Institute of Neuroscience (INN), University of Cagliari, Cagliari, Italy.
| | - Marcello Serra
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Jacopo Marongiu
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Giulia Costa
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Micaela Morelli
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy; National Institute of Neuroscience (INN), University of Cagliari, Cagliari, Italy; CNR, National Research Council of Italy, Neuroscience Institute, Cagliari, Italy
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Choi JH, Lee JY, Cho JW, Ko SB, Ahn TB, Kim SJ, Cheon SM, Kim JS, Kim YJ, Ma HI, Baik JS, Lee PH, Chung SJ, Kim JM, Song IU, Kim HJ, Sung YH, Kwon DY, Lee JH, Kim JY, Kim JS, Yun JY, Kim HJ, Hong JY, Kim MJ, Youn J, Kim JS, Oh ES, Yang HJ, Yoon WT, You S, Kwon KY, Park HE, Lee SY, Kim Y, Kim HT, Park MY. Validation of the Korean Version of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease Rating Scale. J Clin Neurol 2020; 16:245-253. [PMID: 32319241 PMCID: PMC7174122 DOI: 10.3988/jcn.2020.16.2.245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 10/26/2019] [Accepted: 10/28/2019] [Indexed: 12/28/2022] Open
Abstract
Background and Purpose Impulse-control disorder is an important nonmotor symptom of Parkinson's disease (PD) that can lead to financial and social problems, and be related to a poor quality of life. A nationwide multicenter prospective study was performed with the aim of validating the Korean Version of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease Rating Scale (K-QUIP-RS). Methods The K-QUIP-RS was constructed using forward and backward translation, and pretesting of the prefinal version. PD patients on stable medical condition were recruited from 27 movement-disorder clinics. Participants were assessed using the K-QUIP-RS and evaluated for parkinsonian motor and nonmotor statuses and for PD-related quality of life using a predefined evaluation battery. The test–retest reliability of the K-QUIP-RS was assessed over an interval of 10–14 days, and correlations between the KQUIP-RS and other clinical scales were analyzed. Results This study enrolled 136 patients. The internal consistency of the K-QUIP-RS was indicated by a Cronbach's α coefficient of 0.846, as was the test–retest reliability by a Guttman split-half coefficient of 0.808. The total K-QUIP-RS score was positively correlated with the scores for depression and motivation items on the Unified PD Rating Scale (UPDRS), Montgomery-Asberg Depression Scale, and Rapid-Eye-Movement Sleep-Behavior-Disorders Questionnaire. The total K-QUIP-RS score was also correlated with the scores on part II of the UPDRS and the PD Quality of Life-39 questionnaire, and the dopaminergic medication dose. Conclusions The K-QUIP-RS appears to be a reliable assessment tool for impulse-control and related behavioral disturbances in the Korean PD population.
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Affiliation(s)
- Ji Hyun Choi
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jee Young Lee
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Whan Cho
- Department of Neurology and Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Seong Beom Ko
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Tae Beom Ahn
- Department of Neurology, Kyung Hee University College of Medicine, Seoul, Korea
| | - Sang Jin Kim
- Department of Neurology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Sang Myung Cheon
- Department of Neurology, Dong-A University College of Medicine, Busan, Korea
| | - Joong Seok Kim
- Department of Neurology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Yoon Joong Kim
- Department of Neurology, Hallym University College of Medicine, Anyang, Korea
| | - Hyeo Il Ma
- Department of Neurology, Hallym University College of Medicine, Anyang, Korea
| | - Jong Sam Baik
- Department of Neurology, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Phil Hyu Lee
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sun Ju Chung
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong Min Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - In Uk Song
- Department of Neurology, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea
| | - Han Joon Kim
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Young Hee Sung
- Department of Neurology, Gachon University Gil Hospital, Incheon, Korea
| | - Do Young Kwon
- Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Jae Hyeok Lee
- Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ji Young Kim
- Department of Neurology, Inje University Seoul Paik Hospital, Seoul, Korea
| | - Ji Sun Kim
- Department of Neurology and Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Young Yun
- Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hee Jin Kim
- Department of Neurology, Konkuk University School of Medicine, Seoul, Korea
| | - Jin Yong Hong
- Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Mi Jung Kim
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jinyoung Youn
- Department of Neurology and Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Seon Kim
- Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Korea
| | - Eung Seok Oh
- Department of Neurology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
| | - Hui Jun Yang
- Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Won Tae Yoon
- Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sooyeoun You
- Department of Neurology, Keimyung University School of Medicine, Daegu, Korea
| | - Kyum Yil Kwon
- Department of Neurology, Soonchunhyang University Seoul Hospital, Soonchunhyang University School of Medicine, Seoul, Korea
| | - Hyung Eun Park
- Department of Neurology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Su Yun Lee
- Department of Neurology, Dong-A University College of Medicine, Busan, Korea
| | - Younsoo Kim
- Department of Neurology, Changwon Samsung Hospital, Changwon, Korea
| | - Hee Tae Kim
- Department of Neurology, Hanyang University College of Medicine, Seoul, Korea
| | - Mee Young Park
- Department of Neurology, Yeungnam University College of Medicine, Daegu, Korea.
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Hellberg SN, Russell TI, Robinson MJF. Cued for risk: Evidence for an incentive sensitization framework to explain the interplay between stress and anxiety, substance abuse, and reward uncertainty in disordered gambling behavior. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2019; 19:737-758. [PMID: 30357661 PMCID: PMC6482104 DOI: 10.3758/s13415-018-00662-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Gambling disorder is an impairing condition confounded by psychiatric co-morbidity, particularly with substance use and anxiety disorders. Yet, our knowledge of the mechanisms that cause these disorders to coalesce remains limited. The Incentive Sensitization Theory suggests that sensitization of neural "wanting" pathways, which attribute incentive salience to rewards and their cues, is responsible for the excessive desire for drugs and cue-triggered craving. The resulting hyper-reactivity of the "wanting' system is believed to heavily influence compulsive drug use and relapse. Notably, evidence for sensitization of the mesolimbic dopamine pathway has been seen across gambling and substance use, as well as anxiety and stress-related pathology, with stress playing a major role in relapse. Together, this evidence highlights a phenomenon known as cross-sensitization, whereby sensitization to stress, drugs, or gambling behaviors enhance the sensitivity and dopaminergic response to any of those stimuli. Here, we review the literature on how cue attraction and reward uncertainty may underlie gambling pathology, and examine how this framework may advance our understanding of co-mordidity with substance-use disorders (e.g., alcohol, nicotine) and anxiety disorders. We argue that reward uncertainty, as seen in slot machines and games of chance, increases dopaminergic activity in the mesolimbic pathway and enhances the incentive value of reward cues. We propose that incentive sensitization by reward uncertainty may interact with and predispose individuals to drug abuse and stress, creating a mechanism through which co-mordidity of these disorders may emerge.
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Affiliation(s)
- Samantha N Hellberg
- Psychology Department and the Neuroscience and Behavior Program, Wesleyan University, 207 High Street, Middletown, CT, 06457, USA
- University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | - Trinity I Russell
- Psychology Department and the Neuroscience and Behavior Program, Wesleyan University, 207 High Street, Middletown, CT, 06457, USA
- National Institutes on Drug Abuse, Baltimore, MD, USA
| | - Mike J F Robinson
- Psychology Department and the Neuroscience and Behavior Program, Wesleyan University, 207 High Street, Middletown, CT, 06457, USA.
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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.
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Affiliation(s)
| | | | | | | | | | | | - Demetrio Milardi
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy; AOU, Policlinico G Martino, Messina, Italy
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Vescovelli F, Sarti D, Ruini C. Subjective and psychological well-being in Parkinson's Disease: A systematic review. Acta Neurol Scand 2018; 138:12-23. [PMID: 29696627 DOI: 10.1111/ane.12946] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The aim of this review is to summarize studies investigating subjective and psychological well-being in patients with Parkinson's disease (PD). MATERIALS AND METHODS A systematic and integrative review according to PRISMA criteria was performed with a literature search from inception up to September 2017 in multidisciplinary databases (PubMED, Scopus, Web of Knowledge) by combining together key words related to PD and well-being. Studies were included if: their full-text was available; they involved PD patients; focused on the selected positive dimensions; written in English. Case studies, conference proceedings, abstract, dissertations, book chapters, validation studies and reviews were excluded. Data extracted from the studies included sample characteristics, the positive dimension investigated, type of measure, study aims, design and results. One reviewer extracted details and commented results with other reviewers. The studies' quality was assessed following Kmet, Lee, and Cook. RESULTS Out of 1425 studies extracted, 12 studies (9 quantitative, 2 qualitative, 1 mixed methods) involving 2204 patients with PD were included. Most of the studies had a cross-sectional design and/or evaluated the effect of physical rehabilitation on well-being. Articles documented that the illness could impair well-being for its progressive impact on patients' motor autonomy. Preserving motor and musculoskeletal functioning facilitate patients' experience of well-being, social contribution and the maintenance of their job. CONCLUSIONS Research on positive resources in PD is still scarce compared to other chronic illnesses. The few available investigations suggest the need of preserving motor abilities by proper rehabilitation programs for maintaining and/or promoting patients' well-being and life engagement.
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Affiliation(s)
- F. Vescovelli
- Department of Psychology; University of Bologna; Bologna Italy
| | - D. Sarti
- Riminiterme Center of Rehabilitation; Rimini Italy
| | - C. Ruini
- Department of Psychology; University of Bologna; Bologna Italy
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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.
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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
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Hinkle JT, Perepezko K, Rosenthal LS, Mills KA, Pantelyat A, Mari Z, Tochen L, Bang JY, Gudavalli M, Yoritomo N, Butala A, Bakker CC, Johnson V, Moukheiber E, Dawson TM, Pontone GM. Markers of impaired motor and cognitive volition in Parkinson's disease: Correlates of dopamine dysregulation syndrome, impulse control disorder, and dyskinesias. Parkinsonism Relat Disord 2018; 47:50-56. [PMID: 29198499 PMCID: PMC5803355 DOI: 10.1016/j.parkreldis.2017.11.338] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 10/16/2017] [Accepted: 11/18/2017] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Dopaminergic therapy in Parkinson's disease (PD) can be associated with both motoric (e.g., dyskinesias) and neuropsychiatric adverse effects. Examples of the latter include Dopamine Dysregulation Syndrome (DDS) and impulse control disorder (ICD), which are separate but related behavioral/psychiatric complications of treatment in PD. Dysregulation of volition characterizes both dyskinesias and DDS/ICD; thus, we analyzed potential disease-related correlates in a large PD cohort. METHODS We analyzed cross-sectional data from 654 participants collected through the NINDS Parkinson's Disease Biomarkers Program. DDS/ICD symptoms and dyskinesias were assessed using the Movement Disorders Society (revised) Unified Parkinson's Disease Rating Scale. Potential associated variables were selected from PD-validated or PD-specific scales of neuropsychiatric or motoric status. Multivariable models with DDS/ICD or dyskinesia presence outcomes were produced with backward stepwise regression to identify factors independently associated with DDS/ICD and/or dyskinesias. RESULTS Fifty-three (8.1%) participants endorsed DDS and/or ICD symptoms and 150 (22.9%) were dyskinetic. In multivariable analysis, psychosis was independently associated with both dyskinesias (p = 0.006) and DDS/ICD (p < 0.001). Unpredictable motor fluctuations (p = 0.026) and depression (p = 0.023) were also associated with DDS/ICD; female sex (p = 0.025), low tremor score (p = 0.001) and high akinesia-rigidity score (p < 0.001) were associated with dyskinesias. CONCLUSIONS Our findings suggest that psychosis may be an important marker of impaired volition across motor and cognitive domains. Unpredictable motor fluctuations, psychosis, and depression may together comprise a phenotypic profile of patients at increased risk for DDS/ICD. Similarly, dyskinetic PD patients should be closely monitored for psychotic symptoms and treated appropriately.
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Affiliation(s)
- Jared T Hinkle
- Medical Scientist Training Program, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Dept. of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kate Perepezko
- Dept. of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Liana S Rosenthal
- Morris K. Udall Parkinson's Disease Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Dept. of Neurology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 6-181, Baltimore, MD, United States
| | - Kelly A Mills
- Morris K. Udall Parkinson's Disease Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Dept. of Neurology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 6-181, Baltimore, MD, United States
| | - Alexander Pantelyat
- Morris K. Udall Parkinson's Disease Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Dept. of Neurology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 6-181, Baltimore, MD, United States
| | - Zoltan Mari
- Morris K. Udall Parkinson's Disease Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Dept. of Neurology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 6-181, Baltimore, MD, United States
| | - Laura Tochen
- Dept. of Neurology, Children's National Medical Center, 111 Michigan Avenue, NW, Washington, DC, United States
| | - Jee Yun Bang
- Dept. of Neurology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 6-181, Baltimore, MD, United States
| | - Medha Gudavalli
- Dept. of Neurology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 6-181, Baltimore, MD, United States
| | - Nadine Yoritomo
- Dept. of Neurology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 6-181, Baltimore, MD, United States
| | - Ankur Butala
- Dept. of Neurology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 6-181, Baltimore, MD, United States
| | - Catherine C Bakker
- Morris K. Udall Parkinson's Disease Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Vanessa Johnson
- Dept. of Neurology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 6-181, Baltimore, MD, United States
| | - Emile Moukheiber
- Dept. of Neurology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 6-181, Baltimore, MD, United States
| | - Ted M Dawson
- Morris K. Udall Parkinson's Disease Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Dept. of Neurology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 6-181, Baltimore, MD, United States; Neuroregeneration and Stem Cell Programs, Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Dept. of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Gregory M Pontone
- Dept. of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Morris K. Udall Parkinson's Disease Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Dept. of Neurology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 6-181, Baltimore, MD, United States.
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10
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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: 67] [Impact Index Per Article: 9.6] [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.
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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
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11
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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.
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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
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12
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Delpont B, Lhommée E, Klinger H, Schmitt E, Bichon A, Fraix V, Castrioto A, Quesada JL, Pélissier P, Kistner A, Carnicella S, Lüscher C, Broussolle E, Pollak P, Thobois S, Krack P. Psychostimulant effect of dopaminergic treatment and addictions in Parkinson's disease. Mov Disord 2017; 32:1566-1573. [DOI: 10.1002/mds.27101] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 05/23/2017] [Accepted: 06/04/2017] [Indexed: 01/13/2023] Open
Affiliation(s)
- Benoit Delpont
- Movement Disorders Unit; Neurology Department, CHU Grenoble Alpes and Université Grenoble Alpes; Grenoble France
| | - Eugénie Lhommée
- Movement Disorders Unit; Neurology Department, CHU Grenoble Alpes and Université Grenoble Alpes; Grenoble France
- Grenoble Institut des Neurosciences, Inserm, U1216; Grenoble France
| | - Hélène Klinger
- Service de Neurologie C, Université Lyon I, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer; Lyon France
- CNRS, UMR 5229, Centre de Neurosciences Cognitives; Lyon France
| | - Emmanuelle Schmitt
- Movement Disorders Unit; Neurology Department, CHU Grenoble Alpes and Université Grenoble Alpes; Grenoble France
- Grenoble Institut des Neurosciences, Inserm, U1216; Grenoble France
| | - Amélie Bichon
- Movement Disorders Unit; Neurology Department, CHU Grenoble Alpes and Université Grenoble Alpes; Grenoble France
- Grenoble Institut des Neurosciences, Inserm, U1216; Grenoble France
| | - Valérie Fraix
- Movement Disorders Unit; Neurology Department, CHU Grenoble Alpes and Université Grenoble Alpes; Grenoble France
- Grenoble Institut des Neurosciences, Inserm, U1216; Grenoble France
| | - Anna Castrioto
- Movement Disorders Unit; Neurology Department, CHU Grenoble Alpes and Université Grenoble Alpes; Grenoble France
- Grenoble Institut des Neurosciences, Inserm, U1216; Grenoble France
| | - Jean-Louis Quesada
- Unité Scientifique de la DRCI et Centre d'Investigation Clinique, CHU de Grenoble; Grenoble France
| | - Pierre Pélissier
- Movement Disorders Unit; Neurology Department, CHU Grenoble Alpes and Université Grenoble Alpes; Grenoble France
| | - Andrea Kistner
- Movement Disorders Unit; Neurology Department, CHU Grenoble Alpes and Université Grenoble Alpes; Grenoble France
| | | | - Christian Lüscher
- Department of Basic Neurosciences; Medical Faculty, University of Geneva, Geneva, Switzerland; Clinic of Neurology, Department of Clinical Neurosciences, Geneva University Hospital; Geneva Switzerland
| | - Emmanuel Broussolle
- Service de Neurologie C, Université Lyon I, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer; Lyon France
- CNRS, UMR 5229, Centre de Neurosciences Cognitives; Lyon France
| | - Pierre Pollak
- Department of Basic Neurosciences; Medical Faculty, University of Geneva, Geneva, Switzerland; Clinic of Neurology, Department of Clinical Neurosciences, Geneva University Hospital; Geneva Switzerland
| | - Stéphane Thobois
- Service de Neurologie C, Université Lyon I, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer; Lyon France
- CNRS, UMR 5229, Centre de Neurosciences Cognitives; Lyon France
| | - Paul Krack
- Movement Disorders Unit; Neurology Department, CHU Grenoble Alpes and Université Grenoble Alpes; Grenoble France
- Grenoble Institut des Neurosciences, Inserm, U1216; Grenoble France
- Department of Basic Neurosciences; Medical Faculty, University of Geneva, Geneva, Switzerland; Clinic of Neurology, Department of Clinical Neurosciences, Geneva University Hospital; Geneva Switzerland
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13
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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.
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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
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Houeto JL, Magnard R, Dalley JW, Belin D, Carnicella S. Trait Impulsivity and Anhedonia: Two Gateways for the Development of Impulse Control Disorders in Parkinson's Disease? Front Psychiatry 2016; 7:91. [PMID: 27303314 PMCID: PMC4884740 DOI: 10.3389/fpsyt.2016.00091] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 05/17/2016] [Indexed: 12/03/2022] Open
Abstract
Apathy and impulsivity are two major comorbid syndromes of Parkinson's disease (PD) that may represent two extremes of a behavioral spectrum modulated by dopamine-dependent processes. PD is characterized by a progressive loss of dopaminergic neurons in the substantia nigra pars compacta to which are attributed the cardinal motor symptoms of the disorder. Dopamine replacement therapy (DRT), used widely to treat these motor symptoms, is often associated with deficits in hedonic processing and motivation, including apathy and depression, as well as impulse control disorders (ICDs). ICDs comprise pathological gambling, hypersexuality, compulsive shopping, binge eating, compulsive overuse of dopaminergic medication, and punding. More frequently observed in males with early onset PD, ICDs are associated not only with comorbid affective symptoms, such as depression and anxiety, but also with behavioral traits, such as novelty seeking and impulsivity, as well as with personal or familial history of alcohol use. This constellation of associated risk factors highlights the importance of inter-individual differences in the vulnerability to develop comorbid psychiatric disorders in PD patients. Additionally, withdrawal from DRT in patients with ICDs frequently unmasks a severe apathetic state, suggesting that apathy and ICDs may be caused by overlapping neurobiological mechanisms within the cortico-striato-thalamo-cortical networks. We suggest that altered hedonic and impulse control processes represent distinct prodromal substrates for the development of these psychiatric symptoms, the etiopathogenic mechanisms of which remain unknown. Specifically, we argue that deficits in hedonic and motivational states and impulse control are mediated by overlapping, yet dissociable, neural mechanisms that differentially interact with DRT to promote the emergence of ICDs in vulnerable individuals. Thus, we provide a novel heuristic framework for basic and clinical research to better define and treat comorbid ICDs in PD.
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Affiliation(s)
- Jean-Luc Houeto
- Service de Neurologie, CIC-INSERM 1402, CHU de Poitiers, Université de Poitiers , Poitiers , France
| | - Robin Magnard
- INSERM U1216, Grenoble Institut des Neurosciences (GIN), University Grenoble Alpes , Grenoble , France
| | - Jeffrey W Dalley
- Department of Psychology, University of Cambridge, Cambridge, UK; Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - David Belin
- Department of Pharmacology, University of Cambridge , Cambridge , UK
| | - Sebastien Carnicella
- INSERM U1216, Grenoble Institut des Neurosciences (GIN), University Grenoble Alpes , Grenoble , France
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15
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Bastide MF, Meissner WG, Picconi B, Fasano S, Fernagut PO, Feyder M, Francardo V, Alcacer C, Ding Y, Brambilla R, Fisone G, Jon Stoessl A, Bourdenx M, Engeln M, Navailles S, De Deurwaerdère P, Ko WKD, Simola N, Morelli M, Groc L, Rodriguez MC, Gurevich EV, Quik M, Morari M, Mellone M, Gardoni F, Tronci E, Guehl D, Tison F, Crossman AR, Kang UJ, Steece-Collier K, Fox S, Carta M, Angela Cenci M, Bézard E. Pathophysiology of L-dopa-induced motor and non-motor complications in Parkinson's disease. Prog Neurobiol 2015. [PMID: 26209473 DOI: 10.1016/j.pneurobio.2015.07.002] [Citation(s) in RCA: 334] [Impact Index Per Article: 37.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Involuntary movements, or dyskinesia, represent a debilitating complication of levodopa (L-dopa) therapy for Parkinson's disease (PD). L-dopa-induced dyskinesia (LID) are ultimately experienced by the vast majority of patients. In addition, psychiatric conditions often manifested as compulsive behaviours, are emerging as a serious problem in the management of L-dopa therapy. The present review attempts to provide an overview of our current understanding of dyskinesia and other L-dopa-induced dysfunctions, a field that dramatically evolved in the past twenty years. In view of the extensive literature on LID, there appeared a critical need to re-frame the concepts, to highlight the most suitable models, to review the central nervous system (CNS) circuitry that may be involved, and to propose a pathophysiological framework was timely and necessary. An updated review to clarify our understanding of LID and other L-dopa-related side effects was therefore timely and necessary. This review should help in the development of novel therapeutic strategies aimed at preventing the generation of dyskinetic symptoms.
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Affiliation(s)
- Matthieu F Bastide
- Univ. de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France; CNRS, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France
| | - Wassilios G Meissner
- Univ. de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France; CNRS, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France; Department of Neurology, University Hospital Bordeaux, France
| | - Barbara Picconi
- Laboratory of Neurophysiology, Fondazione Santa Lucia, IRCCS, Rome, Italy
| | - Stefania Fasano
- Division of Neuroscience, Institute of Experimental Neurology, San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Pierre-Olivier Fernagut
- Univ. de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France; CNRS, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France
| | - Michael Feyder
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Veronica Francardo
- Basal Ganglia Pathophysiology Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Cristina Alcacer
- Basal Ganglia Pathophysiology Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Yunmin Ding
- Department of Neurology, Columbia University, New York, USA
| | - Riccardo Brambilla
- Division of Neuroscience, Institute of Experimental Neurology, San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Gilberto Fisone
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - A Jon Stoessl
- Pacific Parkinson's Research Centre and National Parkinson Foundation Centre of Excellence, University of British Columbia, Vancouver, Canada
| | - Mathieu Bourdenx
- Univ. de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France; CNRS, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France
| | - Michel Engeln
- Univ. de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France; CNRS, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France
| | - Sylvia Navailles
- Univ. de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France; CNRS, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France
| | - Philippe De Deurwaerdère
- Univ. de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France; CNRS, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France
| | - Wai Kin D Ko
- Univ. de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France; CNRS, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France
| | - Nicola Simola
- Department of Biomedical Sciences, Section of Neuropsychopharmacology, Cagliari University, 09124 Cagliari, Italy
| | - Micaela Morelli
- Department of Biomedical Sciences, Section of Neuropsychopharmacology, Cagliari University, 09124 Cagliari, Italy
| | - Laurent Groc
- Univ. de Bordeaux, Institut Interdisciplinaire de neurosciences, UMR 5297, 33000 Bordeaux, France; CNRS, Institut Interdisciplinaire de neurosciences, UMR 5297, 33000 Bordeaux, France
| | - Maria-Cruz Rodriguez
- Department of Neurology, Hospital Universitario Donostia and Neuroscience Unit, Bio Donostia Research Institute, San Sebastian, Spain
| | - Eugenia V Gurevich
- Department of Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Maryka Quik
- Center for Health Sciences, SRI International, CA 94025, USA
| | - Michele Morari
- Department of Medical Sciences, Section of Pharmacology, University of Ferrara, Ferrara, Italy
| | - Manuela Mellone
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, 20133 Milano, Italy
| | - Fabrizio Gardoni
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, 20133 Milano, Italy
| | - Elisabetta Tronci
- Department of Biomedical Sciences, Physiology Section, Cagliari University, Cagliari, Italy
| | - Dominique Guehl
- Univ. de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France; CNRS, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France
| | - François Tison
- Univ. de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France; CNRS, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France; Department of Neurology, University Hospital Bordeaux, France
| | | | - Un Jung Kang
- Basal Ganglia Pathophysiology Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Kathy Steece-Collier
- Michigan State University, College of Human Medicine, Department of Translational Science and Molecular Medicine & The Udall Center of Excellence in Parkinson's Disease Research, 333 Bostwick Ave NE, Grand Rapids, MI 49503, USA
| | - Susan Fox
- Morton & Gloria Shulman Movement Disorders Center, Toronto Western Hospital, Toronto, Ontario M4T 2S8, Canada
| | - Manolo Carta
- Department of Biomedical Sciences, Physiology Section, Cagliari University, Cagliari, Italy
| | - M Angela Cenci
- Basal Ganglia Pathophysiology Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Erwan Bézard
- Univ. de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France; CNRS, Institut des Maladies Neurodégénératives, UMR 5293, 33000 Bordeaux, France; Motac Neuroscience Ltd, Manchester, UK.
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Djamshidian A, O'Sullivan SS, Lawrence AD, Foltynie T, Aviles-Olmos I, Magdalinou N, Tomassini A, Warner TT, Lees AJ, Averbeck BB. Perceptual decision-making in patients with Parkinson's disease. J Psychopharmacol 2014; 28:1149-54. [PMID: 25237123 DOI: 10.1177/0269881114548437] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Impulsive choice and poor information sampling have been found to be key behavioural mechanisms linked to impulse control disorders (ICDs) in Parkinson's disease (PD). Perceptual decision-making is intimately related to information sampling. Therefore, we wanted to determine whether dopaminergic medication or ICDs influence perceptual decision-making in PD. All participants performed two tasks. One was a simple reaction time task, where subjects needed to respond as quickly as possible. The second was a perceptual decision-making task, in which participants had to estimate whether a stimulus contained either more red or more blue pixels. We tested three groups of patients, one treated with levodopa monotherapy, one additionally treated with dopamine agonists, and a third group had ICDs. Results were compared to healthy controls. We found that all patients made more errors than controls. Further, patients with ICDs responded fastest on the reaction time task and also in incorrect trials on the perceptual decision-making task. Similarly, patients with dopamine agonists responded faster than those on levodopa monotherapy and controls. Our results demonstrate that all patients have deficits in perceptual decision-making. However, patients treated with dopamine agonists closely resembled patients with ICDs.
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Affiliation(s)
- Atbin Djamshidian
- Reta Lila Weston Institute of Neurological Studies, University of London, London, UK Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | | | | | - Thomas Foltynie
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, London, UK
| | - Iciar Aviles-Olmos
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, London, UK
| | - Nadia Magdalinou
- Reta Lila Weston Institute of Neurological Studies, University of London, London, UK
| | - Alessandro Tomassini
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, London, UK
| | - Thomas T Warner
- Reta Lila Weston Institute of Neurological Studies, University of London, London, UK
| | - Andrew J Lees
- Reta Lila Weston Institute of Neurological Studies, University of London, London, UK
| | - Bruno B Averbeck
- Laboratory of Neuropsychology, National Institutes of Health, Bethesda, MD, USA
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17
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Zhang G, Zhang Z, Liu L, Yang J, Huang J, Xiong N, Wang T. Impulsive and compulsive behaviors in Parkinson's disease. Front Aging Neurosci 2014; 6:318. [PMID: 25452726 PMCID: PMC4231987 DOI: 10.3389/fnagi.2014.00318] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 10/29/2014] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Impulsive and compulsive behaviors (ICBs) are a heterogeneous group of conditions that may be caused by long-term dopaminergic replacement therapy (DRT) of Parkinson's disease (PD). The spectrum of ICBs includes dopamine dysregulation syndrome (DDS), punding, and impulse control disorders (ICDs). CONTENTS We made a detailed review regarding the epidemiology, pathology, clinical characteristics, risk factors, diagnosis as well as treatment of ICBs. RESULTS The prevalence of ICBs in PD patients is approximately 3-4% for DDS, 0.34-4.2% for punding, and 6-14% for ICDs, with higher prevalence in Western populations than in Asian. Those who take high dose of levodopa are more prone to have DDS, whereas, ICDs are markedly associated with dopamine agonists. Different subtypes of ICBs share many risk factors such as male gender, higher levodopa equivalent daily dose, younger age at PD onset, history of alcoholism, impulsive, or novelty-seeking personality. The Questionnaire for Impulsive-Compulsive Disorder in Parkinson's Disease-Rating Scale seems to be a rather efficacious instrument to obtain relevant information from patients and caregivers. Treatment of ICBs is still a great challenge for clinicians. Readjustment of DRT remains the primary method. Atypical antipsychotics, antidepressants, amantadine, and psychosocial interventions are also prescribed in controlling episodes of psychosis caused by compulsive DRT, but attention should be drawn to balance ICBs symptoms and motor disorders. Moreover, deep brain stimulation of the subthalamic nucleus might be a potential method in controlling ICBs. CONCLUSION The exact pathophysiological mechanisms of ICBs in PD remains poorly understood. Further researches are needed not only to study the pathogenesis, prevalence, features, and risk factors of ICBs, but to find efficacious therapy for patients with these devastating consequences.
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Affiliation(s)
- Guoxin Zhang
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Zhentao Zhang
- Department of Neurology, Renmin Hospital of Wuhan University , Wuhan , China
| | - Ling Liu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Jiaolong Yang
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Jinsha Huang
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Nian Xiong
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | - Tao Wang
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
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Cilia R, Siri C, Canesi M, Zecchinelli AL, De Gaspari D, Natuzzi F, Tesei S, Meucci N, Mariani CB, Sacilotto G, Zini M, Ruffmann C, Pezzoli G. Dopamine dysregulation syndrome in Parkinson's disease: from clinical and neuropsychological characterisation to management and long-term outcome. J Neurol Neurosurg Psychiatry 2014; 85:311-8. [PMID: 23591553 DOI: 10.1136/jnnp-2012-303988] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Dopamine dysregulation syndrome (DDS) refers to a compulsive pattern of dopaminergic drug misuse complicating Parkinson's disease (PD). To date, few data are available on DDS risk factors, cognitive profile and long-term outcome. METHODS In this retrospective case-control study, consecutive PD outpatients fulfilling criteria for DDS were assessed over a 6-year period (2005-2011). They were compared with 70 PD cases matched for age at onset, gender and disease duration, and with 1281 subjects with motor fluctuations and dyskinesias. DDS patients and matched controls underwent extensive neuropsychological assessment. Strategies for DDS patients management and the outcome at the last follow-up visit were recorded. RESULTS Thirty-five patients with DDS were identified, reporting history of depression, family history of PD and drug abuse, greater difference between 'Off' versus 'On' motor symptoms compared to age-matched controls. They had younger age at onset (but not any gender difference) compared to general PD population. Cognitive profile of DDS did not show major abnormalities, including executive functions. DDS patients have been followed up for 3.2±2.1 years and remission was recorded in 40% of cases. Negative DDS outcome was significantly associated with poor caregiver supervision. Sustained remission occurred more commonly on clozapine and on duodenal levodopa infusion and subthalamic nucleus deep brain stimulation (STN-DBS) than on apomorphine pump treatment. CONCLUSIONS Clinicians should be aware of risk factors predisposing to DDS. Duodenal levodopa infusion and, less consistently, STN-DBS were more commonly associated with DDS remission. Effective caregiving plays a key role in long-term behavioural outcome.
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Affiliation(s)
- Roberto Cilia
- Parkinson Institute, Istituti Clinici di Perfezionamento, , Milan, Italy
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19
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Evans AH, Kettlewell J, McGregor S, Kotschet K, Griffiths RI, Horne M. A conditioned response as a measure of impulsive-compulsive behaviours in Parkinson's disease. PLoS One 2014; 9:e89319. [PMID: 24586685 PMCID: PMC3933354 DOI: 10.1371/journal.pone.0089319] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Accepted: 01/17/2014] [Indexed: 01/01/2023] Open
Abstract
Objectives Parkinson's Disease patients wore a device on the wrist that gave reminders to take levodopa and also measured bradykinesia and dyskinesia. Consumption of medications was acknowledged by placing the thumb on the device. Some patients performed this acknowledgement repeatedly and unconsciously. This study examines whether this behaviour reflected increased impulsivity. Methods and Results Twenty five participants were selected because they had i) excess acknowledgements described above or ii) Impulsive-Compulsive Behaviours or iii) neither of these. A blinded assessor applied clinical scales to measure Impulsive-Compulsive Behaviours, cognition, depression, anxiety and apathy. A Response Ratio, representing the number of acknowledgements/number of doses (expressed as a percentage) was tightly correlated with ratings of Impulsive-Compulsive Behaviours (r2 = 0.79) in 19/25 subjects. Some of these patients had dyskinesia, which was higher with extraneous responses than with response indicating medication consumption. Six of the 25 subjects had high Impulsive-Compulsive Behaviour Scores, higher apathy scores, low levels of dyskinesia and normal Response Ratios. Patients without ICB (low RR) also had low dyskinesia levels regardless of the relevance of the response. Conclusion An elevated Response Ratio is a specific measure of a type of ICB where increased incentive salience is attributed to cues by the presence of high striatal dopamine levels, manifested by high levels of dyskinesia. This study also points to a second form of ICBs which occur in the absence of dyskinesia, has normal Response Ratios and higher apathy scores, and may represent prefrontal pathology.
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Affiliation(s)
| | - Jade Kettlewell
- Florey Neuroscience Institute, University of Melbourne, Parkville Victoria, Australia
| | | | - Katya Kotschet
- Florey Neuroscience Institute, University of Melbourne, Parkville Victoria, Australia
- St Vincent's Hospital, Fitzroy, Victoria, Australia
| | - Robert I. Griffiths
- Florey Neuroscience Institute, University of Melbourne, Parkville Victoria, Australia
| | - Malcolm Horne
- Florey Neuroscience Institute, University of Melbourne, Parkville Victoria, Australia
- St Vincent's Hospital, Fitzroy, Victoria, Australia
- Department of Medicine, St Vincent's Hospital, Fitzroy, Victoria, Australia
- * E-mail:
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Engeln M, Fasano S, Ahmed SH, Cador M, Baekelandt V, Bezard E, Fernagut PO. Levodopa gains psychostimulant-like properties after nigral dopaminergic loss. Ann Neurol 2013; 74:140-4. [DOI: 10.1002/ana.23881] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 01/29/2013] [Accepted: 03/01/2013] [Indexed: 11/10/2022]
Affiliation(s)
| | - Stefania Fasano
- Institute of Experimental Neurology; Division of Neuroscience; San Raffaele Research Institute; Milan; Italy
| | | | | | - Veerle Baekelandt
- Laboratory for Neurobiology and Gene Therapy; Catholic University; Leuven; Belgium
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21
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Eusebio A, Witjas T, Cohen J, Fluchère F, Jouve E, Régis J, Azulay JP. Subthalamic nucleus stimulation and compulsive use of dopaminergic medication in Parkinson's disease. J Neurol Neurosurg Psychiatry 2013; 84:868-74. [PMID: 23447648 DOI: 10.1136/jnnp-2012-302387] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Behavioural disorders associated with compulsive use of dopaminergic drugs for Parkinson's disease (PD) such as dopamine dysregulation syndrome (DDS) and impulse control disorders (ICDs) may have devastating consequences and are challenging to manage. Whether or not such patients should undergo subthalamic nucleus (STN) deep brain stimulation (DBS) is controversial. A few case reports and small series have reported contrasting effects of STN DBS on dopamine misuse and ICDs, while a recent prospective study found clear beneficial effects of STN DBS on these disorders. METHODS We conducted an observational study on 110 consecutive parkinsonian patients scheduled for STN DBS surgery. Patients were assessed preoperatively through extensive behavioural and psychiatric evaluations and divided into two groups: with or without compulsive dopaminergic medication use. Evaluations were repeated 1 year after surgery in both groups. RESULTS Before surgery 18 patients (16.3%) were compulsive dopamine users of whom 12 (10.9%) fulfilled all criteria for DDS. 90% of these patients also had at least one ICD compared to 20% in the group without compulsive dopamine use. One year after surgery, one patient had persistent compulsive dopamine use, while no new occurrences were reported in the group without the condition before surgery. STN DBS did not provoke any major psychiatric complications and ICDs were reduced in all patients. CONCLUSIONS Our results suggest that STN DBS may reduce compulsive use of dopaminergic medication and its behavioural consequences. Whether this improvement is the result of STN DBS or the consequence of better treatment management remains to be established.
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Affiliation(s)
- Alexandre Eusebio
- Department of Neurology and Movement Disorders, CHU Timone, APHM, 264 rue Saint-Pierre, 13385 Marseille Cedex 05, France.
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22
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Katzenschlager R, Goerlich KS, van Eimeren T. [Repetitive impulse-associated behavioral disorders in Parkinson's disease]. DER NERVENARZT 2012; 83:1582-1589. [PMID: 22878676 DOI: 10.1007/s00115-012-3631-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Parkinson's disease (PD) is associated with a number of behavioral disorders which may cause considerable social, professional or financial problems. Impulse control disorders (ICDs), such as pathological gambling, binge eating, compulsive shopping and hypersexuality occur in approximately 13-14% of PD patients. Further behavioral disorders are the dopamine dysregulation syndrome (DDS), a substance dependence characterized by craving for dopaminergic substances and punding (prolonged repetitive activities which are not goal-oriented).Treatment-related risk factors are dopamine agonists for ICDs and a high total dopaminergic dose for DDS and punding. Shared risk factors are young age at onset, impulsive personality traits, depression and possibly dyskinesia. At the neuronal level these behavioral disorders seem to be associated with changes in the reward system and dysfunction of the orbitofrontal cortex. The evidence level for management strategies is at present insufficient. For ICDs current clinical practice consists of discontinuation or reduction of dopamine agonists.
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23
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Cederfjäll E, Sahin G, Kirik D. Key factors determining the efficacy of gene therapy for continuous DOPA delivery in the Parkinsonian brain. Neurobiol Dis 2012; 48:222-7. [DOI: 10.1016/j.nbd.2011.10.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Accepted: 10/16/2011] [Indexed: 11/25/2022] Open
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24
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Sriram A, Ward HE, Hassan A, Iyer S, Foote KD, Rodriguez RL, McFarland NR, Okun MS. Valproate as a treatment for dopamine dysregulation syndrome (DDS) in Parkinson's disease. J Neurol 2012; 260:521-7. [PMID: 23007193 DOI: 10.1007/s00415-012-6669-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Revised: 08/31/2012] [Accepted: 09/03/2012] [Indexed: 12/17/2022]
Abstract
It has been previously well established that the use of dopaminergic agents in Parkinson's disease may contribute to behavioral disturbances such as dopamine dysregulation syndrome (DDS), impulse control disorders (ICD), and punding. ICD and punding have been most commonly addressed by reducing dose or by discontinuing the use of a dopamine agonist. Treatment of DDS has proven more challenging, and to date there has been no standard approach. In this paper, we review a series of four patients who met criteria for DDS, who were all refractory to medication adjustments. The DDS symptoms responded by the addition of valproic acid in all cases.
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Affiliation(s)
- Ashok Sriram
- Department of Neurology, Center for Movement Disorders and Neurorestoration, Gainesville, FL 32611, USA.
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25
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Witjas T, Eusebio A, Fluchère F, Azulay JP. Addictive behaviors and Parkinson's disease. Rev Neurol (Paris) 2012; 168:624-33. [DOI: 10.1016/j.neurol.2012.06.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Revised: 06/28/2012] [Accepted: 06/28/2012] [Indexed: 10/28/2022]
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26
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Riddle J, Rokosik S, Napier T. Pramipexole- and methamphetamine-induced reward-mediated behavior in a rodent model of Parkinson's disease and controls. Behav Brain Res 2012; 233:15-23. [DOI: 10.1016/j.bbr.2012.04.027] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 03/30/2012] [Accepted: 04/19/2012] [Indexed: 12/15/2022]
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27
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Evans AH, Farrell MJ, Gibson SJ, Helme RD, Lim SY. Dyskinetic patients show rebound worsening of affect after an acute L-dopa challenge. Parkinsonism Relat Disord 2012; 18:514-9. [DOI: 10.1016/j.parkreldis.2012.01.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Revised: 01/05/2012] [Accepted: 01/26/2012] [Indexed: 11/26/2022]
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28
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Nonmotor disorders and their correlation with dopamine: can they be treated by currently available methods? Neurologist 2012; 17:S9-17. [PMID: 22045328 DOI: 10.1097/nrl.0b013e318239669f] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Many of the nonmotor symptoms in Parkinson disease have a dopaminergic basis, whether the result of dopaminergic degeneration or as a result of dopaminergic treatment. In the latter case, the symptoms may be genuine side effects of drugs (hypotension, pathologic gambling, etc.) or they may be secondary either to the pathoplastic effect they have on the natural course of the disease (nonmotor fluctuations) or to the lack of dopamine (apathy, depression, dopamine withdrawal syndrome, etc.). In all these cases, dopaminergic treatment can be helpful. However, many other nonmotor (and motor) symptoms will have no correlation with dopamine; therefore, they require different treatments, very often with little efficacy, as in apathy or cognitive decline.
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29
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Brown RM, Lawrence AJ. Compulsive use of dopamine replacement therapy in Parkinson's disease: insights into the neurobiology of addiction. Addiction 2012; 107:250-1. [PMID: 22248133 DOI: 10.1111/j.1360-0443.2011.03641.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Robyn M Brown
- Florey Neuroscience Institutes, University of Melbourne, Parkville, Victoria, Australia.
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30
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Ambermoon P, Carter A, Hall W, Dissanayaka N, O'Sullivan J. Compulsive use of dopamine replacement therapy: a model for stimulant drug addiction? Addiction 2012; 107:241-7. [PMID: 21793971 DOI: 10.1111/j.1360-0443.2011.03511.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The compulsive use of dopamine replacement therapy (DRT) or dopamine dysregulation syndrome (DDS) is one of the behavioural disturbances reported in some patients with Parkinson's disease (PD) and other disorders who are receiving DRT. We draw this phenomenon to the attention of the addiction field as a topic deserving of more systematic study. We outline: the clinical features, epidemiology and clinical correlates of the disorder; the unresolved issues in its definition and diagnosis; and its potential relevance to neurobiological models of psychostimulant addiction. We argue that compulsive DRT use may provide a useful model for drug addiction, while advancing our understanding of the neurobiology of addiction and improving the management of PD patients with the disorder.
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Affiliation(s)
- Polly Ambermoon
- The University of Queensland, UQ Centre for Clinical Research, Queensland, Australia
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31
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Marzinzik F, Wotka J, Wahl M, Krugel LK, Kordsachia C, Klostermann F. Modulation of habit formation by levodopa in Parkinson's disease. PLoS One 2011; 6:e27695. [PMID: 22110725 PMCID: PMC3218008 DOI: 10.1371/journal.pone.0027695] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Accepted: 10/22/2011] [Indexed: 11/19/2022] Open
Abstract
Dopamine promotes the execution of positively reinforced actions, but its role for the formation of behaviour when feedback is unavailable remains open. To study this issue, the performance of treated/untreated patients with Parkinson's disease and controls was analysed in an implicit learning task, hypothesising dopamine-dependent adherence to hidden task rules. Sixteen patients on/off levodopa and fourteen healthy subjects engaged in a Go/NoGo paradigm comprising four equiprobable stimuli. One of the stimuli was defined as target which was first consistently preceded by one of the three non-target stimuli (conditioning), whereas this coupling was dissolved thereafter (deconditioning). Two task versions were presented: in a 'Go version', only the target cue required the execution of a button press, whereas non-target stimuli were not instructive of a response; in a 'NoGo version', only the target cue demanded the inhibition of the button press which was demanded upon any non-target stimulus. Levodopa influenced in which task version errors grew from conditioning to deconditioning: in unmedicated patients just as controls errors only rose in the NoGo version with an increase of incorrect responses to target cues. Contrarily, in medicated patients errors went up only in the Go version with an increase of response omissions to target cues. The error increases during deconditioning can be understood as a perpetuation of reaction tendencies acquired during conditioning. The levodopa-mediated modulation of this carry-over effect suggests that dopamine supports habit conditioning under the task demand of response execution, but dampens it when inhibition is required. However, other than in reinforcement learning, supporting dopaminergic actions referred to the most frequent, i. e., non-target behaviour. Since this is passive whenever selective actions are executed against an inactive background, dopaminergic treatment could in according scenarios contribute to passive behaviour in patients with Parkinson's disease.
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Affiliation(s)
- Frank Marzinzik
- Department of Neurology, Campus Benjamin Franklin, Charité-University Medicine Berlin, Berlin, Germany
| | - Johann Wotka
- Department of Neurology, Campus Benjamin Franklin, Charité-University Medicine Berlin, Berlin, Germany
| | - Michael Wahl
- Department of Neurology, Campus Benjamin Franklin, Charité-University Medicine Berlin, Berlin, Germany
| | - Lea K. Krugel
- Department of Neurology, Campus Benjamin Franklin, Charité-University Medicine Berlin, Berlin, Germany
| | | | - Fabian Klostermann
- Department of Neurology, Campus Benjamin Franklin, Charité-University Medicine Berlin, Berlin, Germany
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32
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Dopamine dysregulation syndrome and deep brain stimulation of the subthalamic nucleus in Parkinson's disease. Neurol Res Int 2011; 2011:759895. [PMID: 22135744 PMCID: PMC3216377 DOI: 10.1155/2011/759895] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 09/09/2011] [Accepted: 09/15/2011] [Indexed: 11/24/2022] Open
Abstract
Dopamine dysregulation syndrome is a complication of the dopaminergic treatment in Parkinson's disease that may be very disabling due to the negative impact that compulsive medication use may have on patients' social, psychological, and physical functioning. The relationship between subthalamic nucleus deep brain stimulation and dopamine dysregulation syndrome in patients with Parkinson's disease remains unclear. Deep brain stimulation may improve, worsen, or have no effect on preoperative dopamine dysregulation syndrome. Moreover, dopamine dysregulation syndrome may appear for the first time after deep brain stimulation of the subthalamic nucleus. The outcome of postoperative dopamine dysregulation syndrome is poor despite stimulation and medication adjustments. Here we review the phenomenology and neurobiology of this disorder, discuss possible mechanisms that may underlie the diverse outcomes of dopamine dysregulation syndrome after subthalamic nucleus deep brain stimulation, and propose management strategies.
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33
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Katzenschlager R. Dopaminergic dysregulation syndrome in Parkinson's disease. J Neurol Sci 2011; 310:271-5. [DOI: 10.1016/j.jns.2011.07.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Revised: 06/15/2011] [Accepted: 07/11/2011] [Indexed: 01/08/2023]
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De la Casa-Fages B, Grandas F. Dopamine dysregulation syndrome after deep brain stimulation of the subthalamic nucleus in Parkinson's disease. J Neurol Sci 2011; 312:191-3. [PMID: 21872889 DOI: 10.1016/j.jns.2011.08.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Revised: 08/05/2011] [Accepted: 08/08/2011] [Indexed: 11/25/2022]
Abstract
Dopamine dysregulation syndrome is a complication of the dopaminergic treatment for Parkinson's disease, probably related to sensitization of the mesolimbic dopamine system. The relationship between dopamine dysregulation syndrome and deep brain stimulation of the subthalamic nucleus remains unclear. We report three patients with Parkinson's disease who developed de novo dopamine dysregulation syndrome after deep brain stimulation of the subthalamic nucleus. We hypothesized that the combined effect of dopaminergic replacement therapy and deep brain stimulation on the limbic territory of the subthalamic nucleus could have precipitated the dopamine dysregulation syndrome in these patients, by inducing hyperstimulation of the mesolimbic dopamine system. The outcome of postoperative dopamine dysregulation syndrome is poor despite deep brain stimulation adjustments, attempts to reduce the dose of dopaminergic drugs and the addition of quetiapine or antidepressants.
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Affiliation(s)
- Beatriz De la Casa-Fages
- Movement Disorders Research Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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35
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Abstract
Apathy, defined as a primary deficit in motivation and manifested by the simultaneous diminution in the cognitive and emotional concomitants of goal-directed behavior, is a common and debilitating non-motor symptom of Parkinson's disease (PD). Despite the high prevalence and clinical significance of apathy, little is known about its pathophysiology, and in particular how apathy relates to alterations in the neural circuitry underpinning the cognitive and emotional components of goal-directed behavior. Here, we examined the neural coding of reward cues in patients with PD, with or without clinically significant levels of apathy, during performance of a spatial search task during H(2) (15)O PET (positron emission tomography) functional neuroimaging. By manipulating search outcome (money reward vs valueless token), while keeping the actions of the participants constant, we examined the influence of apathy on the neural coding of money reward cues. We found that apathy was associated with a blunted response to money in the ventromedial prefrontal cortex, amygdala, striatum, and midbrain, all part of a distributed neural circuit integral to the representation of the reward value of stimuli and actions, and the influence of reward cues on behavior. Disruption of this circuitry potentially underpins the expression of the various manifestations of apathy in PD, including reduced cognitive, emotional, and behavioral facets of goal-directed behavior.
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36
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Robottom BJ. Efficacy, safety, and patient preference of monoamine oxidase B inhibitors in the treatment of Parkinson's disease. Patient Prefer Adherence 2011; 5:57-64. [PMID: 21423589 PMCID: PMC3058602 DOI: 10.2147/ppa.s11182] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Indexed: 12/14/2022] Open
Abstract
Parkinson's disease (PD) is the second most common neurodegenerative disease and the most treatable. Treatment of PD is symptomatic and generally focuses on the replacement or augmentation of levodopa. A number of options are available for treatment, both in monotherapy of early PD and to treat complications of advanced PD. This review focuses on rasagiline and selegiline, two medications that belong to a class of antiparkinsonian drugs called monoamine oxidase B (MAO-B) inhibitors. Topics covered in the review include mechanism of action, efficacy in early and advanced PD, effects on disability, the controversy regarding disease modification, safety, and patient preference for MAO-B inhibitors.
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Affiliation(s)
- Bradley J Robottom
- Correspondence: Bradley J Robottom, Assistant Professor, Department of Neurology, University of Maryland School of Medicine, 110 S. Paca Street, Rm 3-S-128, Baltimore, MD 21201, USA, Tel +1 410 328 8586, Fax +1 410 328 0167, Email
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Djamshidian A, O'Sullivan SS, Doherty K, Lees AJ, Averbeck BB. Altruistic punishment in patients with Parkinson's disease with and without impulsive behaviour. Neuropsychologia 2010; 49:103-7. [PMID: 20965203 DOI: 10.1016/j.neuropsychologia.2010.10.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Revised: 10/04/2010] [Accepted: 10/05/2010] [Indexed: 11/17/2022]
Abstract
Punishing violators of social norms when there is personal cost is known as altruistic punishment. We tested patients with Parkinson's disease (PD) with and without impulsive-compulsive behaviours (ICBs) and matched control subjects, on and off their regular dopamine replacement therapy on a task, in which the patients decided whether or not to invest a sum of money with a trustee. The sum was then quadrupled and the trustee could decide whether or not to return a portion of the investment. Participants could punish the trustee after they were informed of the trustee's decision. We found that PD patients without ICBs on or off medication punished more often than controls, whereas PD patients with ICBs punished more than controls on medication, but similar to controls off medication. These results suggest a role for dopamine in altruistic punishment decisions in PD patients with impulsive compulsive behaviour.
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Affiliation(s)
- Atbin Djamshidian
- Department of Molecular Neuroscience and Reta Lila Weston Institute for Neurological Studies, University of London, London, United Kingdom
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Thobois S, Broussolle E, Aya Kombo M, Pollak P, Krack P. Reply: Dopamine agonist withdrawal syndrome and non-motor symptoms after Parkinson's disease surgery. Brain 2010. [DOI: 10.1093/brain/awq166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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