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Carbone F, Djamshidian A. Impulse Control Disorders in Parkinson's Disease: An Overview of Risk Factors, Pathogenesis and Pharmacological Management. CNS Drugs 2024; 38:443-457. [PMID: 38613665 PMCID: PMC11098885 DOI: 10.1007/s40263-024-01087-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2024] [Indexed: 04/15/2024]
Abstract
Impulse control disorders in Parkinson's disease are relatively common drug-induced addictive behaviours that are usually triggered by the dopamine agonists pramipexole, ropinirole and rotigotine. This narrative review aimed to provide a comprehensive overview of the current knowledge of impulse control disorders in Parkinson's disease. We summarised the prevalence, clinical features, risk factors and potential underlying mechanisms of impulse control disorders in Parkinson's disease. Moreover, recent advances in behavioural and imaging characteristics and management strategies are discussed. Early detection as well as a tailored multidisciplinary approach, which typically includes careful adjustment of the dopaminergic therapy and the treatment of associated neuropsychiatric symptoms, are necessary. In some cases, a continuous delivery of levodopa via a pump or the dopamine D1 receptor agonist, apomorphine, can be considered. In selected patients without cognitive or speech impairment, deep brain stimulation of the subthalamic nucleus can also improve addictions. Finding the right balance of tapering dopaminergic dose (usually dopamine agonists) without worsening motor symptoms is essential for a beneficial long-term outcome.
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Affiliation(s)
- Federico Carbone
- Department of Neurology, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Atbin Djamshidian
- Department of Neurology, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.
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2
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Liang K, Li X, Ma J, Yang H, Shi X, Fan Y, Yang D, Guo D, Liu C, Dong L, Chang Q, Gu Q, Chen S, Li D. Predictors of dopamine dysregulation syndrome in patients with early Parkinson's disease. Neurol Sci 2023; 44:4333-4342. [PMID: 37452260 PMCID: PMC10641065 DOI: 10.1007/s10072-023-06956-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Dopamine dysregulation syndrome (DDS) is a complication of Parkinson's disease (PD) that seriously affects the quality of life of PD patients. Currently, the risk factors for DDS are poorly known, and it is critical to identify them in the early stages of PD. OBJECTIVE To explore the incidence of and risk factors for DDS in patients with early PD. METHODS A retrospective cohort study was conducted on the general data, clinical features, and imaging data of patients with early PD in the PPMI database. Multivariate Cox regression analysis was performed to analyze the risk factors for the development of DDS in patients with early PD, and Kaplan‒Meier curves examined the frequency and predictors of incident DDS symptoms. RESULTS At baseline, 2.2% (n = 6) of patients with early PD developed DDS, and the cumulative incidence rates of DDS during the 5-year follow-up period were 2.8%, 6.4%, 10.8%, 15.5%, and 18.7%, respectively. In the multivariate Cox regression model controlling for age, sex, and drug use, hypersexuality (HR = 3.088; 95% CI: 1.416~6.732; P = 0.005), compulsive eating (HR = 3.299; 95% CI: 1.665~6.534; P = 0.001), compulsive shopping (HR = 3.899; 95% CI: 1.769~8.593; P = 0.001), anxiety (HR = 4.018; 95% CI: 2.136~7.599; P < 0.01), and lower Hoehn-Yahr (H-Y) stage (HR = 0.278; 95% CI: 0.152~0.509; P < 0.01) were independent risk factors for DDS in patients with early PD. PD patients with DDS had lower DAT uptake values than those patients without DDS. CONCLUSION Early PD patients with hypersexuality, compulsive eating, compulsive shopping, anxiety, and lower H-Y stage were at increased risk for DDS. The occurrence of DDS may be related to the decrease in the average DAT uptake of the caudate and putamen.
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Affiliation(s)
- Keke Liang
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Xiaohuan Li
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Jianjun Ma
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China.
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China.
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China.
| | - Hongqi Yang
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China.
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China.
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China.
| | - Xiaoxue Shi
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Yongyan Fan
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Dawei Yang
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Dashuai Guo
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Chuanze Liu
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Linrui Dong
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Qingqing Chang
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Qi Gu
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Siyuan Chen
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Dongsheng Li
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
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Green MA, Crawford JL, Kuhnen CM, Samanez-Larkin GR, Seaman KL. Multivariate associations between dopamine receptor availability and risky investment decision-making across adulthood. Cereb Cortex Commun 2023; 4:tgad008. [PMID: 37255569 PMCID: PMC10225308 DOI: 10.1093/texcom/tgad008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 06/01/2023] Open
Abstract
Enhancing dopamine increases financial risk taking across adulthood but it is unclear whether baseline individual differences in dopamine function are related to risky financial decisions. Here, thirty-five healthy adults completed an incentive-compatible risky investment decision task and a PET scan at rest using [11C]FLB457 to assess dopamine D2-like receptor availability. Participants made choices between a safe asset (bond) and a risky asset (stock) with either an expected value less than the bond ("bad stock") or expected value greater than the bond ("good stock"). Five measures of behavior (choice inflexibility, risk seeking, suboptimal investment) and beliefs (absolute error, optimism) were computed and D2-like binding potential was extracted from four brain regions of interest (midbrain, amygdala, anterior cingulate, insula). We used canonical correlation analysis to evaluate multivariate associations between decision-making and dopamine function controlling for age. Decomposition of the first dimension (r = 0.76) revealed that the strongest associations were between measures of choice inflexibility, incorrect choice, optimism, amygdala binding potential, and age. Follow-up univariate analyses revealed that amygdala binding potential and age were both independently associated with choice inflexibility. The findings suggest that individual differences in dopamine function may be associated with financial risk taking in healthy adults.
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Affiliation(s)
- Mikella A Green
- Department of Psychology & Neuroscience, 417 Chapel Dr, Durham, NC 27708, Center for Cognitive Neuroscience, Duke University, 308 Research Drive, Durham, NC 27708
| | - Jennifer L Crawford
- Department of Psychology, Brandeis University, 415 South Street, Waltham, MA 02453
| | - Camelia M Kuhnen
- UNC Kenan-Flagler Business School, 300 Kenan Center Drive, Chapel Hill, NC 27599, National Bureau of Economic Research, 1050 Massachusetts Avenue, Cambridge, MA 02138
| | - Gregory R Samanez-Larkin
- Department of Psychology & Neuroscience, 417 Chapel Dr, Durham, NC 27708, Center for Cognitive Neuroscience, Duke University, 308 Research Drive, Durham, NC 27708
| | - Kendra L Seaman
- Department of Psychology, University of Texas at Dallas, 800 W Campbell Road, Richardson, TX 75080-3021, Center for Vital Longevity, University of Texas at Dallas, 1600 Viceroy Drive, Suite 800, Dallas, TX 75235
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4
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Hall A, Weightman M, Jenkinson N, MacDonald HJ. Performance on the balloon analogue risk task and anticipatory response inhibition task is associated with severity of impulse control behaviours in people with Parkinson's disease. Exp Brain Res 2023; 241:1159-1172. [PMID: 36894682 PMCID: PMC10082127 DOI: 10.1007/s00221-023-06584-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 02/24/2023] [Indexed: 03/11/2023]
Abstract
Dopamine agonist medication is one of the largest risk factors for development of problematic impulse control behaviours (ICBs) in people with Parkinson's disease. The present study investigated the potential of dopamine gene profiling and individual performance on impulse control tasks to explain ICB severity. Clinical, genetic and task performance data were entered into a mixed-effects linear regression model for people with Parkinson's disease taking (n = 50) or not taking (n = 25) dopamine agonist medication. Severity of ICBs was captured via the Questionnaire for Impulsive-compulsive disorders in Parkinson's disease Rating Scale. A cumulative dopamine genetic risk score (DGRS) was calculated for each participant from variance in five dopamine-regulating genes. Objective measures of impulsive action and impulsive choice were measured on the Anticipatory Response Inhibition Task and Balloon Analogue Risk Task, respectively. For participants on dopamine agonist medication, task performance reflecting greater impulsive choice (p = 0.014), and to a trend level greater impulsive action (p = 0.056), as well as a longer history of DA medication (p < 0.001) all predicted increased ICB severity. DGRS however, did not predict ICB severity (p = 0.708). No variables could explain ICB severity in the non-agonist group. Our task-derived measures of impulse control have the potential to predict ICB severity in people with Parkinson's and warrant further investigation to determine whether they can be used to monitor ICB changes over time. The DGRS appears better suited to predicting the incidence, rather than severity, of ICBs on agonist medication.
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Affiliation(s)
- Alison Hall
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.,Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Matthew Weightman
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.,Centre for Human Brain Health, University of Birmingham, Birmingham, UK.,Wellcome Centre for Integrative Neuroimaging, Department of Clinical Neurosciences, FMRIB, Nuffield, University of Oxford, Oxford, UK
| | - Ned Jenkinson
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.,Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Hayley J MacDonald
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK. .,Centre for Human Brain Health, University of Birmingham, Birmingham, UK. .,Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.
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5
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Du S, Huang Y, Ma Y, Qin Y, Cui J, Bai W, Han H, Zhang R, Yu H. The mediating effects of depression, anxiety, and rapid eye movement sleep behavior disorder on the association between dopaminergic replacement therapy and impulse control disorders in Parkinson's disease. Neurol Sci 2023; 44:557-564. [PMID: 36221041 DOI: 10.1007/s10072-022-06443-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 10/03/2022] [Indexed: 01/17/2023]
Abstract
OBJECTIVES This study aims to longitudinally explore whether and how rapid eye movement sleep behavior disorder (RBD), depression, and anxiety mediate the association between dopaminergic replacement therapy (DRT) and impulse control disorders (ICDs) in patients with Parkinson's disease (PD). METHODS Subjects were selected from the Parkinson's Progression Markers Initiative. After excluding missing data, 268, 223, 218, 238, and 219 patients with PD diagnosed at 12, 24, 36, 48, and 60 months prior, respectively, were included. We used the Questionnaire for Impulsive-Compulsive Disorders, RBD Screening Questionnaire, Geriatric Depression Scale, and State-Trait-Anxiety Inventory to assess ICBs, RBD, depression, and anxiety, respectively. We constructed three causal mediation analysis models to infer potential contingent pathways from DRT to ICD mediated by depression, anxiety, and RBD separately. RESULTS DRT was associated with an increased risk of PD incidence. Aggravation of ICDs was partly explained by improvements in depression (the average causal mediation effect accounted for 8.0% of the total effect) and RBD (the average causal mediation effect of RBD accounted for 16.4% of the total effect). This suggested that anxiety (the average causal mediation effect accounted for 12.7% of the total effect) plays a mediating role. CONCLUSIONS Focusing on changes in RBD, depression, and anxiety associated with hyperdopaminergic status should be an essential part of strategies to prevent ICDs in patients with Parkinson's disease.
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Affiliation(s)
- Sidan Du
- Department of Health Statistics, School of Public Health, Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment, Shanxi Medical University, 56 South XinJian Road, Taiyuan, 030001, China
| | - Ying Huang
- Department of Health Statistics, School of Public Health, Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment, Shanxi Medical University, 56 South XinJian Road, Taiyuan, 030001, China
| | - Yifei Ma
- Department of Health Statistics, School of Public Health, Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment, Shanxi Medical University, 56 South XinJian Road, Taiyuan, 030001, China
| | - Yao Qin
- Department of Health Statistics, School of Public Health, Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment, Shanxi Medical University, 56 South XinJian Road, Taiyuan, 030001, China
| | - Jing Cui
- Department of Health Statistics, School of Public Health, Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment, Shanxi Medical University, 56 South XinJian Road, Taiyuan, 030001, China
| | - Wenlin Bai
- Department of Health Statistics, School of Public Health, Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment, Shanxi Medical University, 56 South XinJian Road, Taiyuan, 030001, China
| | - Hongjuan Han
- Department of Health Statistics, School of Public Health, Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment, Shanxi Medical University, 56 South XinJian Road, Taiyuan, 030001, China
| | - Rong Zhang
- Department of Health Statistics, School of Public Health, Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment, Shanxi Medical University, 56 South XinJian Road, Taiyuan, 030001, China
| | - Hongmei Yu
- Department of Health Statistics, School of Public Health, Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment, Shanxi Medical University, 56 South XinJian Road, Taiyuan, 030001, China.
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6
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Baagil H, Hohenfeld C, Habel U, Eickhoff SB, Gur RE, Reetz K, Dogan I. Neural correlates of impulse control behaviors in Parkinson's disease: Analysis of multimodal imaging data. Neuroimage Clin 2023; 37:103315. [PMID: 36610308 PMCID: PMC9850204 DOI: 10.1016/j.nicl.2023.103315] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 11/22/2022] [Accepted: 01/02/2023] [Indexed: 01/06/2023]
Abstract
BACKGROUND Impulse control behaviors (ICB) are frequently observed in patients with Parkinson's disease (PD) and are characterized by compulsive and repetitive behavior resulting from the inability to resist internal drives. OBJECTIVES In this study, we aimed to provide a better understanding of structural and functional brain alterations and clinical parameters related to ICB in PD patients. METHODS We utilized a dataset from the Parkinson's Progression Markers Initiative including 36 patients with ICB (PDICB+) compared to 76 without ICB (PDICB-) and 61 healthy controls (HC). Using multimodal MRI data we assessed gray matter brain volume, white matter integrity, and graph topological properties at rest. RESULTS Compared with HC, PDICB+ showed reduced gray matter volume in the bilateral superior and middle temporal gyrus and in the right middle occipital gyrus. Compared with PDICB-, PDICB+ showed volume reduction in the left anterior insula. Depression and anxiety were more prevalent in PDICB+ than in PDICB- and HC. In PDICB+, lower gray matter volume in the precentral gyrus and medial frontal cortex, and higher axial diffusivity in the superior corona radiata were related to higher depression score. Both PD groups showed disrupted functional topological network pattern within the cingulate cortex compared with HC. PDICB+ vs PDICB- displayed reduced topological network pattern in the anterior cingulate cortex, insula, and nucleus accumbens. CONCLUSIONS Our results suggest that structural alterations in the insula and abnormal topological connectivity pattern in the salience network and the nucleus accumbens may lead to impaired decision making and hypersensitivity towards reward in PDICB+. Moreover, PDICB+ are more prone to suffer from depression and anxiety.
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Affiliation(s)
- Hamzah Baagil
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Research Center Jülich and RWTH Aachen University, Germany
| | - Christian Hohenfeld
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Research Center Jülich and RWTH Aachen University, Germany
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA‑BRAIN, Jülich‑Aachen Research Alliance, Institute of Brain Structure-Function Relationships, Aachen, Germany
| | - Simon B Eickhoff
- Institute for Systems Neuroscience, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany; Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Center Jülich, Germany
| | - Raquel E Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Research Center Jülich and RWTH Aachen University, Germany.
| | - Imis Dogan
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Research Center Jülich and RWTH Aachen University, Germany
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Wolfschlag M, Håkansson A. Drug-Induced Gambling Disorder: Epidemiology, Neurobiology, and Management. Pharmaceut Med 2023; 37:37-52. [PMID: 36611111 PMCID: PMC9825131 DOI: 10.1007/s40290-022-00453-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2022] [Indexed: 01/09/2023]
Abstract
Problematic gambling has been suggested to be a possible consequence of dopaminergic medications used mainly in neurological conditions, i.e. pramipexole and ropinirole, and possibly by one antipsychotic compound, aripiprazole. Patients with Parkinson's disease, restless legs syndrome and other conditions potentially treated with dopamine agonists, as well as patients treated for psychotic disorders, are vulnerable patient groups with theoretically increased risk of developing gambling disorder (GD), for example due to higher rates of mental ill-health in these groups. The aim of the present paper is to review the epidemiological, clinical, and neurobiological evidence of the association between dopaminergic medications and GD, and to describe risk groups and treatment options. The neurobiology of GD involves the reward and reinforcement system, based mainly on mesocorticolimbic dopamine projections, with the nucleus accumbens being a crucial area for developing addictions to substances and behaviors. The addictive properties of gambling can perhaps be explained by the reward uncertainty that activates dopamine signaling in a pathological manner. Since reward-related learning is mediated by dopamine, it can be altered by dopaminergic medications, possibly leading to increased gambling behavior and a decreased impulse control. A causal relationship between the medications and GD seems likely, but the molecular mechanisms behind this association have not been fully described yet. More research is needed in order to fully outline the clinical picture of GD developing in patient groups with dopaminergic medications, and data are needed on the differentiation of risk in different compounds. In addition, very few interventional studies are available on the management of GD induced by dopaminergic medications. While GD overall can be treated, there is need for treatment studies testing the effectiveness of tapering of the medication or other gambling-specific treatment modalities in these patient groups.
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Affiliation(s)
- Mirjam Wolfschlag
- Malmö-Trelleborg Addiction Center, Competence Center Addiction, Region Skåne, Södra Förstadsgatan 35, plan 4, S-205 02 Malmö, Sweden ,Faculty of Medicine, Dept of Clinical Sciences Lund, Lund University, Psychiatry, Lund, Sweden
| | - Anders Håkansson
- Malmö-Trelleborg Addiction Center, Competence Center Addiction, Region Skåne, Södra Förstadsgatan 35, plan 4, S-205 02, Malmö, Sweden. .,Faculty of Medicine, Dept of Clinical Sciences Lund, Lund University, Psychiatry, Lund, Sweden.
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8
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Mata-Marín D, Pineda-Pardo JÁ, Michiels M, Pagge C, Ammann C, Martínez-Fernández R, Molina JA, Vela-Desojo L, Alonso-Frech F, Obeso I. A circuit-based approach to modulate hypersexuality in Parkinson's disease. Psychiatry Clin Neurosci 2022; 77:223-232. [PMID: 36579893 DOI: 10.1111/pcn.13523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 12/30/2022]
Abstract
AIM Impulse-control disorder is a common neuropsychiatric complication in Parkinson's disease (PD) under dopamine replacement therapy. Prior studies tested the balance between enhanced desire towards reward and cognitive control deficits, hypothesized to be biased towards the former in impulse control disorders. We provide evidence for this hypothesis by measuring behavioral and neural patterns behind the influence of sexual desire over response inhibition and tools towards functional restoration using repetitive transcranial stimulation in patients with hypersexuality as predominant impulsive disorder. METHODS The effect of sexual cues on inhibition was measured with a novel erotic stop-signal task under on and off dopaminergic medication. Task-related functional and anatomical connectivity models were estimated in 16 hypersexual and 17 nonhypersexual patients with PD as well as in 17 healthy controls. Additionally, excitatory neuromodulation using intermittent theta-burst stimulation (sham-controlled) was applied over the pre-supplementary motor area in 20 additional hypersexual patients with PD aiming to improve response inhibition. RESULTS Compared with their nonhypersexual peers, patients with hypersexuality recruited caudate, pre-supplementary motor area, ventral tegmental area, and anterior cingulate cortex while on medication. Reduced connectivity was found between pre-supplementary motor area and caudate nucleus in hypersexual compared with nonhypersexual patients (while medicated), a result paralleled by compensatory enhanced anatomical connectivity. Furthermore, stimulation over the pre-supplementary motor area improved response inhibition in hypersexual patients with PD when exposed to sexual cues. CONCLUSION This study, therefore, has identified a specific fronto-striatal and mesolimbic circuitry underlying uncontrolled sexual responses in medicated patients with PD where cortical neuromodulation halts its expression.
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Affiliation(s)
- David Mata-Marín
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain.,PhD program in Neuroscience, Autonoma University of Madrid, Madrid, Spain
| | - José Ángel Pineda-Pardo
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
| | - Mario Michiels
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain.,PhD program in Neuroscience, Autonoma University of Madrid, Madrid, Spain
| | - Cristina Pagge
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,PhD program in Neuroscience, Autonoma University of Madrid, Madrid, Spain
| | - Claudia Ammann
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain
| | - Raúl Martínez-Fernández
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
| | | | | | | | - Ignacio Obeso
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain.,Department of Psychobiology & Methods for the Behavioral Sciences Department, Complutense University of Madrid, Madrid, Spain
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9
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Song AK, Hay KR, Trujillo P, Aumann M, Stark AJ, Yan Y, Kang H, Donahue MJ, Zald DH, Claassen DO. Amphetamine-induced dopamine release and impulsivity in Parkinson's disease. Brain 2022; 145:3488-3499. [PMID: 34951464 DOI: 10.1093/brain/awab487] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/23/2021] [Accepted: 11/30/2021] [Indexed: 11/12/2022] Open
Abstract
Impulsive-compulsive behaviours manifest in a substantial proportion of subjects with Parkinson's disease. Reduced ventral striatum dopamine receptor availability, and increased dopamine release is noted in patients with these symptoms. Prior studies of impulsivity suggest that midbrain D2 autoreceptors regulate striatal dopamine release in a feedback inhibitory manner, and in healthy populations, greater impulsivity is linked to poor proficiency of this inhibition. This has not been assessed in a Parkinson's disease population. Here, we applied 18F-fallypride PET studies to assess striatal and extrastriatal D2-like receptor uptake in a placebo-controlled oral dextroamphetamine sequence. We hypothesized that Parkinson's disease patients with impulsive-compulsive behaviours would have greater ventral striatal dopaminergic response to dextroamphetamine, and that an inability to attenuate ventral striatal dopamine release via midbrain D2 autoreceptors would underlie this response. Twenty patients with Parkinson's disease (mean age = 64.1 ± 5.8 years) both with (n = 10) and without (n = 10) impulsive-compulsive behaviours, participated in a single-blind dextroamphetamine challenge (oral; 0.43 mg/kg) in an OFF dopamine state. All completed PET imaging with 18F-fallypride, a high-affinity D2-like receptor ligand, in the placebo and dextroamphetamine state. Both voxelwise and region of interest analyses revealed dextroamphetamine-induced endogenous dopamine release localized to the ventral striatum, and the caudal-medial orbitofrontal cortex. The endogenous dopamine release observed in the ventral striatum correlated positively with patient-reported participation in reward-based behaviours, as quantified by the self-reported Questionnaire for Impulsivity in Parkinson's disease Rating Scale. In participants without impulsive-compulsive behaviours, baseline midbrain D2 receptor availability negatively correlated with ventral striatal dopamine release; however, this relationship was absent in those with impulsive-compulsive behaviours. These findings emphasize that reward-based behaviours in Parkinson's disease are regulated by ventral striatal dopamine release, and suggest that loss of inhibitory feedback from midbrain autoreceptors may underlie the manifestation of impulsive-compulsive behaviours.
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Affiliation(s)
- Alexander K Song
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Kaitlyn R Hay
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Paula Trujillo
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Megan Aumann
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA.,Vanderbilt Brain Institute, Department of Psychology, Vanderbilt University, Nashville, TN 37232, USA
| | - Adam J Stark
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Yan Yan
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Hakmook Kang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37232, USA.,Center for Quantitative Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Manus J Donahue
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - David H Zald
- Department of Psychology, Vanderbilt University, Nashville, TN 37240, USA.,Department of Psychiatry, Rutgers University, Piscataway, NJ 08854, USA
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
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10
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Marín‐Lahoz J, Martinez‐Horta S, Pagonabarraga J, Horta‐Barba A, Aracil‐Bolaños I, Bejr‐kasem H, Sampedro F, Campolongo A, Kulisevsky J. Predicting Impulse Control Disorders in Parkinson’s disease through incentive biomarkers. Ann Neurol 2022; 92:974-984. [DOI: 10.1002/ana.26486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Juan Marín‐Lahoz
- Neurology Department Miguel Servet University Hospital Zaragoza Spain
- Instituto de Investigación Sanitaria de Aragón Zaragoza Spain
- Universitat Autònoma de Barcelona (U.A.B.), Medicine Department Barcelona Spain
| | - Saül Martinez‐Horta
- Universitat Autònoma de Barcelona (U.A.B.), Medicine Department Barcelona Spain
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital Barcelona Spain
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
| | - Javier Pagonabarraga
- Universitat Autònoma de Barcelona (U.A.B.), Medicine Department Barcelona Spain
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital Barcelona Spain
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
| | - Andrea Horta‐Barba
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital Barcelona Spain
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
| | - Ignacio Aracil‐Bolaños
- Universitat Autònoma de Barcelona (U.A.B.), Medicine Department Barcelona Spain
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital Barcelona Spain
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
| | - Helena Bejr‐kasem
- Universitat Autònoma de Barcelona (U.A.B.), Medicine Department Barcelona Spain
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital Barcelona Spain
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
| | - Frederic Sampedro
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
| | - Antonia Campolongo
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital Barcelona Spain
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
| | - Jaime Kulisevsky
- Universitat Autònoma de Barcelona (U.A.B.), Medicine Department Barcelona Spain
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital Barcelona Spain
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
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11
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Hinkle JT, Mills KA, Perepezko K, Pontone GM. Bidirectional Correlations Between Dopaminergic Function and Motivation in Parkinson's Disease. J Geriatr Psychiatry Neurol 2022; 35:353-362. [PMID: 33622073 PMCID: PMC8382801 DOI: 10.1177/0891988721996802] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To test the hypothesis that striatal dopamine function influences motivational alterations in Parkinson disease (PD), we compared vesicular monoamine transporter 2 (VMAT2) and dopamine transporter (DaT) imaging data in PD patients with impulse control disorders (ICDs), apathy, or neither. METHODS We extracted striatal binding ratios (SBR) from VMAT2 PET imaging (18F-AV133) and DaTscans from the Parkinson's Progression Markers Initiative (PPMI) multicenter observational study. Apathy and ICDs were assessed using the Movement Disorders Society-revised Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP), respectively. We used analysis of variance (ANOVA) and log-linear mixed-effects (LME) regression to model SBRs with neurobehavioral metrics. RESULTS Among 23 participants (mean age 62.7 years, mean disease duration 1.8 years) with VMAT2 imaging data, 5 had apathy, 5 had an ICD, and 13 had neither. ANOVA indicated strong groupwise differences in VMAT2 binding in right anterior putamen [F(2,20) = 16.2, p < 0.0001), right posterior putamen [F(2,20) = 16.9, p < 0.0001), and right caudate [F(2,20) = 6.8, p = 0.006)]. Post-hoc tests and repeated-measures analysis with LME regression also supported right striatal VMAT2 elevation in the ICD group and reduction in the apathy group relative to the group with neither ICD nor apathy. DaT did not exhibit similar correlations, but normalizing VMAT2 with DaT SBR strengthened bidirectional correlations with ICD (high VMAT2/DaT) and apathy (low VMAT2/DaT) in all striatal regions bilaterally. CONCLUSIONS Our findings constitute preliminary evidence that striatal presynaptic dopaminergic function helps describe the neurobiological basis of motivational dysregulation in PD, from high in ICDs to low in apathy.
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Affiliation(s)
- Jared T Hinkle
- Medical Scientist Training Program, 1500Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kelly A Mills
- Department of Neurology, 1500Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kate Perepezko
- Department of Mental Health, 25802Johns Hopkins Bloomberg School of Public Health, Dept. of Mental Health, Baltimore, MD, USA
| | - Gregory M Pontone
- Department of Psychiatry, 1500Johns Hopkins University School of Medicine, Baltimore, MD, USA
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12
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Ueda N, Higashiyama Y, Saito A, Kimura K, Nakae Y, Endo M, Joki H, Kugimoto C, Kishida H, Doi H, Takeuchi H, Koyano S, Tanaka F. Relationship between motor learning and gambling propensity in Parkinson's disease. J Clin Exp Neuropsychol 2022; 44:50-61. [PMID: 35658796 DOI: 10.1080/13803395.2022.2083083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The basal ganglia and related dopaminergic cortical areas are important neural systems underlying motor learning and are also implicated in impulse control disorders (ICDs). Motor learning impairments and ICDs are frequently observed in Parkinson's disease (PD). Nevertheless, the relationship between motor learning ability and ICDs has not been elucidated. METHODS We examined the relationship between motor learning ability and gambling propensity, a possible symptom for prodromal ICDs, in PD patients. Fifty-nine PD patients without clinical ICDs and 43 normal controls (NC) were administered a visuomotor rotation perturbation task and the Iowa Gambling Task (IGT) to evaluate motor learning ability and gambling propensity, respectively. Participants also performed additional cognitive assessments and underwent brain perfusion SPECT imaging. RESULTS Better motor learning ability was significantly correlated with lower IGT scores, i.e., higher gambling propensity, in PD patients but not in NC. The higher scores on assessments reflecting prefrontal lobe function and well-preserved blood perfusion in prefrontal areas were correlated with lower IGT scores along with better motor learning ability. CONCLUSIONS Our findings suggest that better motor learning ability and higher gambling propensity are based on better prefrontal functions, which are in accordance with the theory that the prefrontal cortex is one of the common essential regions for both motor learning and ICDs.
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Affiliation(s)
- Naohisa Ueda
- Department of Neurology, Yokohama City University Medical Center, Kanagawa, Japan.,Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Yuichi Higashiyama
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Asami Saito
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Katsuo Kimura
- Department of Neurology, Yokohama City University Medical Center, Kanagawa, Japan
| | - Yoshiharu Nakae
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Masanao Endo
- Department of Neurology, Yokohama City University Medical Center, Kanagawa, Japan
| | - Hideto Joki
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Chiharu Kugimoto
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Hitaru Kishida
- Department of Neurology, Yokohama City University Medical Center, Kanagawa, Japan
| | - Hiroshi Doi
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Hideyuki Takeuchi
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Shigeru Koyano
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Fumiaki Tanaka
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
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13
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Unlucky punches: the vulnerability-stress model for the development of impulse control disorders in Parkinson's disease. NPJ Parkinsons Dis 2021; 7:112. [PMID: 34880241 PMCID: PMC8654901 DOI: 10.1038/s41531-021-00253-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 11/04/2021] [Indexed: 01/09/2023] Open
Abstract
Impulse-control disorders are commonly observed during dopamine-replacement therapy in Parkinson’s disease, but the majority of patients seems “immune” to this side effect. Epidemiological evidence suggests that a major risk factor may be a specific difference in the layout of the dopaminergic-reinforcement system, of which the ventral striatum is a central player. A series of imaging studies of the dopaminergic system point toward a presynaptic reduction of dopamine-reuptake transporter density and dopamine synthesis capacity. Here, we review current evidence for a vulnerability-stress model in which a relative reduction of dopaminergic projections to the ventral striatum and concomitant sensitization of postsynaptic neurons represent a predisposing (hypodopaminergic) vulnerability. Stress (hyperdopaminergic) is delivered when dopamine replacement therapy leads to a relative overdosing of the already-sensitized ventral striatum. These alterations are consistent with consecutive changes in reinforcement mechanisms, which stimulate learning from reward and impede learning from punishment, thereby fostering the development of impulse-control disorders. This vulnerability-stress model might also provide important insights into the development of addictions in the non-Parkinsonian population.
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14
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Martín-Bastida A, Delgado-Alvarado M, Navalpotro-Gómez I, Rodríguez-Oroz MC. Imaging Cognitive Impairment and Impulse Control Disorders in Parkinson's Disease. Front Neurol 2021; 12:733570. [PMID: 34803882 PMCID: PMC8602579 DOI: 10.3389/fneur.2021.733570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/28/2021] [Indexed: 12/04/2022] Open
Abstract
Dementia and mild forms of cognitive impairment as well as neuropsychiatric symptoms (i. e., impulse control disorders) are frequent and disabling non-motor symptoms of Parkinson's disease (PD). The identification of changes in neuroimaging studies for the early diagnosis and monitoring of the cognitive and neuropsychiatric symptoms associated with Parkinson's disease, as well as their pathophysiological understanding, are critical for the development of an optimal therapeutic approach. In the current literature review, we present an update on the latest structural and functional neuroimaging findings, including high magnetic field resonance and radionuclide imaging, assessing cognitive dysfunction and impulse control disorders in PD.
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Affiliation(s)
- Antonio Martín-Bastida
- Department of Neurology, Clínica Universidad de Navarra, Pamplona, Spain.,CIMA, Center of Applied Medical Research, Universidad de Navarra, Neurosciences Program, Pamplona, Spain
| | | | - Irene Navalpotro-Gómez
- Cognitive Impairment and Movement Disorders Unit, Neurology Department, Hospital del Mar, Barcelona, Spain.,Clinical and Biological Research in Neurodegenerative Diseases, Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital del Mar Research Institute (IMIM), Barcelona, Spain.,Barcelonabeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - María Cruz Rodríguez-Oroz
- Department of Neurology, Clínica Universidad de Navarra, Pamplona, Spain.,CIMA, Center of Applied Medical Research, Universidad de Navarra, Neurosciences Program, Pamplona, Spain.,IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
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15
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Hall A, Weaver SR, Compton LJ, Byblow WD, Jenkinson N, MacDonald HJ. Dopamine genetic risk score predicts impulse control behaviors in Parkinson's disease. Clin Park Relat Disord 2021; 5:100113. [PMID: 34765965 PMCID: PMC8569744 DOI: 10.1016/j.prdoa.2021.100113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/09/2021] [Accepted: 10/20/2021] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION Up to 40% of Parkinson's disease patients taking dopamine agonist medication develop impulse control behaviors which can have severe negative consequences. The current study aimed to utilize dopamine genetics to identify patients most at risk of developing these behaviors. METHODS Demographic, clinical, and genetic data were obtained from the Parkinson's Progression Markers Initiative for de novo patients (n = 327), patients taking dopamine agonists (n = 146), and healthy controls (n = 160). Impulsive behaviors were identified using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease. A dopamine genetic risk score was calculated for each patient according to polymorphisms in genes coding for dopamine D1, D2 and D3 receptors, and catechol-O-methyltransferase. A higher score reflected higher central dopamine neurotransmission. RESULTS Patients on agonists with a low dopamine genetic risk score were over 18 times more likely to have an impulsive behavior compared to higher scores (p = 0.04). The 38% of patients taking agonists who had at least one impulsive behavior were more likely to be male and report higher Unified Parkinson's Disease Rating Scale I&II scores. With increasing time on dopamine agonists (range 92-2283 days, mean 798 ± 565 standard deviation), only patients with a high dopamine genetic risk score showed an increase in number of impulsive behaviors (p = 0.033). Predictive effects of the gene score were not present in de novo or healthy control. CONCLUSIONS A dopamine genetic risk score can identify patients most at risk of developing impulsive behaviors on dopamine agonist medication and predict how these behaviors may worsen over time.
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Affiliation(s)
- Alison Hall
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Samuel R. Weaver
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | | | - Winston D. Byblow
- Department of Exercise Sciences, University of Auckland, Auckland, New Zealand
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Ned Jenkinson
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Hayley J. MacDonald
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
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16
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Simoni S, Paoletti FP, Eusebi P, Cappelletti G, Filidei M, Brahimi E, Nigro P, Santangelo V, Parnetti L, Calabresi P, Tambasco N. Impulse Control Disorders and Levodopa-Induced Dyskinesias in Parkinson's Disease: Pulsatile versus Continuous Dopaminergic Stimulation. JOURNAL OF PARKINSONS DISEASE 2021; 10:927-934. [PMID: 32280105 DOI: 10.3233/jpd-191833] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Dopaminergic medications in Parkinson's disease (PD) are usually associated with the development of both levodopa-induced dyskinesias (LID) and impulse control and repetitive behavior disorders (ICRB). OBJECTIVE To assess the prevalence and the severity of ICRB in a cohort of moderate and advanced PD patients and to investigate the potential interplay between ICRB, LID and dopaminergic therapies. METHODS 117 PD patients were consecutively recruited. LID were assessed by using the Rush Dyskinesia Rating Scale (RDRS). ICRB were tested by means of Questionnaire for Impulsive Compulsive Disorders in Parkinson's Disease Rating Scale (QUIP-RS). RESULTS 55 patients were affected by LID. Among them, 37 were treated only by oral therapy, OT (LID/OT), while 18 were on treatment with jejunal levodopa infusion, JLI (LID/JLI). 62 patients were not affected by LID (NLID) and all of them were on therapy only with oral drugs. The overall prevalence of clinically significant ICRB was 34% (95% CI = 26% to 43%) and the mean value (±SD) of QUIP-RS total score was 5.4±8.5. Prevalence of clinically significant ICRB, as well as severity of ICRB, was higher in patients with LID compared to NLID patients (p = 0.016 and p < 0.001, respectively). When considering LID/JLI, LID/OT and NLID groups, QUIP-RS total score was significantly higher in LID/OT patients compared to LID/JLI (10.4±11.8 vs. 4.9±6.0, p = 0.019) and NLID (10.4±11.8 vs. 2.5±4.8, p < 0.001) groups. CONCLUSION PD patients with LID show ICRB more frequently and more severely than patients without LID. Among LID patients, those treated by JLI showed a lower severity of ICRB than those on OT, suggesting a potential protective effect of JLI on ICRB.
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Affiliation(s)
- Simone Simoni
- Movement Disorders Center, Neurology Department, Perugia General Hospital and University of Perugia, Perugia, Italy
| | - Federico Paolini Paoletti
- Movement Disorders Center, Neurology Department, Perugia General Hospital and University of Perugia, Perugia, Italy.,Neurology Department, Perugia General Hospital and University of Perugia, Perugia, Italy
| | - Paolo Eusebi
- Neurology Department, Perugia General Hospital and University of Perugia, Perugia, Italy
| | - Giulia Cappelletti
- Neurology Department, Perugia General Hospital and University of Perugia, Perugia, Italy
| | - Marta Filidei
- Neurology Department, Perugia General Hospital and University of Perugia, Perugia, Italy
| | - Elona Brahimi
- Neurology Department, Regina Montis Regalis Hospital, Cuneo, Italy
| | - Pasquale Nigro
- Movement Disorders Center, Neurology Department, Perugia General Hospital and University of Perugia, Perugia, Italy
| | - Valerio Santangelo
- Department of Philosophy, Social Sciences & Education, University of Perugia, Perugia, Italy.,Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Lucilla Parnetti
- Neurology Department, Perugia General Hospital and University of Perugia, Perugia, Italy.,Section of Neurology Department, Center for Memory Disturbances, Laboratory of Clinical Neurochemistry, Perugia General Hospital and University of Perugia, Perugia, Italy
| | - Paolo Calabresi
- Neurologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Nicola Tambasco
- Movement Disorders Center, Neurology Department, Perugia General Hospital and University of Perugia, Perugia, Italy.,Neurology Department, Perugia General Hospital and University of Perugia, Perugia, Italy
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17
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Impulse control disorders are associated with lower ventral striatum dopamine D3 receptor availability in Parkinson's disease: A [ 11C]-PHNO PET study. Parkinsonism Relat Disord 2021; 90:52-56. [PMID: 34385007 DOI: 10.1016/j.parkreldis.2021.06.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/12/2021] [Accepted: 06/28/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Reduced postsynaptic D3 dopaminergic receptor availability has been reported in the ventral striatum of pathological gamblers without Parkinson's disease (PD) and in patients with PD and impulse control disorders (ICD). However, a direct relationship between ventral striatum D3 dopaminergic receptors and the severity of ICD in PD patients has not yet been proven using a validated tool for ICD in PD, such as the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's disease-Rating Scale (QUIP-RS). In this pilot study, we investigated the relationship between ventral striatum D3 dopamine receptor availability and severity of impulse control disorder (ICD) in Parkinson's disease (PD). METHODS Twelve patients were assessed with PET and the high affinity dopamine D3 receptor radioligand [11C]-PHNO. Severity of ICD was assessed with the QUIP-RS. RESULTS We found that lower ventral striatum D3 receptor availability measured with [11C]-PHNO PET was associated with greater severity of ICD, as measured by the QUIP-RS score (rho = -0.625, p = 0.03). CONCLUSION These findings suggest that the occurrence and severity of ICD in Parkinson's disease may be linked to reductions in ventral striatum dopamine D3 receptor availability. Further studies in larger cohort of patients need to be performed in order to confirm our findings and clarify whether lower ventral striatum D3 receptor may reflect a pharmacological downregulation to higher dopamine release in ventral striatum of patients with ICD or a patients' predisposition to ICD.
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18
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Augustine A, Winstanley CA, Krishnan V. Impulse Control Disorders in Parkinson's Disease: From Bench to Bedside. Front Neurosci 2021; 15:654238. [PMID: 33790738 PMCID: PMC8006437 DOI: 10.3389/fnins.2021.654238] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 02/22/2021] [Indexed: 12/16/2022] Open
Abstract
Parkinson’s disease (PD) is a neurodegenerative disorder that is characterized by symptoms that impact both motor and non-motor domains. Outside of motor impairments, PD patients are at risk for impulse control disorders (ICDs), which include excessively disabling impulsive and compulsive behaviors. ICD symptoms in PD (PD + ICD) can be broadly conceptualized as a synergistic interaction between dopamine agonist therapy and the many molecular and circuit-level changes intrinsic to PD. Aside from discontinuing dopamine agonist treatment, there remains a lack of consensus on how to best address ICD symptoms in PD. In this review, we explore recent advances in the molecular and neuroanatomical mechanisms underlying ICD symptoms in PD by summarizing a rapidly accumulating body of clinical and preclinical studies, with a special focus on the utility of rodent models in gaining new insights into the neurochemical basis of PD + ICD. We also discuss the relevance of these findings to the broader problem of impulsive and compulsive behaviors that impact a range of neuropsychiatric syndromes.
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Affiliation(s)
- Andrea Augustine
- Department of BioSciences, Rice University, Houston, TX, United States
| | - Catharine A Winstanley
- Department of Psychology, Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, BC, Canada
| | - Vaishnav Krishnan
- Departments of Neurology, Neuroscience and Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
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19
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The role of dopamine pharmacotherapy and addiction-like behaviors in Parkinson's disease. Prog Neuropsychopharmacol Biol Psychiatry 2020; 102:109942. [PMID: 32272129 DOI: 10.1016/j.pnpbp.2020.109942] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 03/29/2020] [Accepted: 03/31/2020] [Indexed: 12/19/2022]
Abstract
Addictions involve a spectrum of behaviors that encompass features of impulsivity and compulsivity, herein referred to as impulsive-compulsive spectrum disorders (ICSDs). The etiology of ICSDs likely involves a complex interplay among neurobiological, psychological and social risk factors. Neurobiological risk factors include the status of the neuroanatomical circuits that govern ICSDs. These circuits can be altered by disease, as well as exogenous influences such as centrally-acting pharmacologics. The 'poster child' for this scenario is Parkinson's disease (PD) medically managed by pharmacological treatments. PD is a progressive neurodegenerative disease that involves a gradual loss of dopaminergic neurons largely within nigrostriatal projections. Replacement therapy includes dopamine receptor agonists that directly activate postsynaptic dopamine receptors (bypassing the requirement for functioning presynaptic terminals). Some clinically useful dopamine agonists, e.g., pramipexole and ropinirole, exhibit high affinity for the D2/D3 receptor subtypes. These agonists provide excellent relief from PD motor symptoms, but some patients exhibit debilitating ICSD. Teasing out the neuropsychiatric contribution of PD-associated pathology from the drugs used to treat PD motor symptoms is challenging. In this review, we posit that modern clinical and preclinical research converge on the conclusion that dopamine replacement therapy can mediate addictions in PD and other neurological disorders. We provide five categories of evidences that align with this position: (i) ICSD prevalence is greater with D2/D3 receptor agonist therapy vs PD alone. (ii) Capacity of dopamine replacement therapy to produce addiction-like behaviors is independent of disease for which the therapy is being provided. (iii) ICSD-like behaviors are recapitulated in laboratory rats with and without PD-like pathology. (iv) Behavioral pathology co-varies with drug exposure. (v) ICSD Features of ICSDs are consistent with agonist pharmacology and neuroanatomical substrates of addictions. Considering the underpinnings of ICSDs in PD should not only help therapeutic decision-making in neurological disorders, but also apprise ICSDs in general.
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20
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Jiménez-Urbieta H, Gago B, Quiroga-Varela A, Rodríguez-Chinchilla T, Merino-Galán L, Delgado-Alvarado M, Navalpotro-Gómez I, Belloso-Iguerategui A, Marin C, Rodríguez-Oroz MC. Motor impulsivity and delay intolerance are elicited in a dose-dependent manner with a dopaminergic agonist in parkinsonian rats. Psychopharmacology (Berl) 2020; 237:2419-2431. [PMID: 32440779 DOI: 10.1007/s00213-020-05544-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 04/30/2020] [Indexed: 10/24/2022]
Abstract
RATIONALE Impulse control disorders (ICD) and other impulsive-compulsive behaviours are frequently found in Parkinson's disease (PD) patients treated with dopaminergic agonists. To date, there are no available animal models to investigate their pathophysiology and determine whether they can be elicited by varying doses of dopaminergic drugs. In addition, there is some controversy regarding the predispositional pattern of striatal dopaminergic depletion. OBJECTIVES To study the effect of two doses of pramipexole (PPX) on motor impulsivity, delay intolerance and compulsive-like behaviour. METHODS Male rats with mild dopaminergic denervation in the dorsolateral striatum (bilateral injections of 6-hydroxidopamine (6-OHDA)) treated with two doses of PPX (0.25 mg/kg and 3 mg/kg) and tested in the variable delay-to-signal paradigm. RESULTS Partial (50%) dopaminergic depletion did not induce significant changes in motor impulsivity or delay intolerance. However, 0.25 mg/kg of PPX increased motor impulsivity, while 3 mg/kg of PPX increased both motor impulsivity and delay intolerance. These effects were independent of the drug's antiparkinsonian effects. Importantly, impulsivity scores before and after dopaminergic lesion were positively associated with the impulsivity observed after administering 3 mg/kg of PPX. No compulsive-like behaviour was induced by PPX administration. CONCLUSIONS We described a rat model, with a moderate dorsolateral dopaminergic lesion resembling that suffered by patients with early PD, that develops different types of impulsivity in a dose-dependent manner dissociated from motor benefits when treated with PPX. This model recapitulates key features of abnormal impulsivity in PD and may be useful for deepening our understanding of the pathophysiology of ICD.
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Affiliation(s)
| | - Belén Gago
- Instituto de Investigación Biomédica de Málaga, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
| | - Ana Quiroga-Varela
- Centro de Investigación Médica Aplicada (CIMA), Universidad de Navarra, Pamplona, Spain
| | | | - Leyre Merino-Galán
- Centro de Investigación Médica Aplicada (CIMA), Universidad de Navarra, Pamplona, Spain.,University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Manuel Delgado-Alvarado
- Neurology Department, Sierrallana Hospital, Torrelavega, Spain.,Psychiatry Research Area, IDIVAL, University Hospital Marqués de Valdecilla, Santander, Spain.,Biomedical Research Networking Center for Mental Health (CIBERSAM), Madrid, Spain
| | | | | | - Concepció Marin
- IRCE, Institut d' investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - María C Rodríguez-Oroz
- Centro de Investigación Médica Aplicada (CIMA), Universidad de Navarra, Pamplona, Spain. .,Ikerbasque Foundation, Bilbao, Spain. .,Basque Center on Cognition, Brain and Language (BCBL), San Sebastián, Spain. .,Servicio de Neurología, Clínica Universidad de Navarra, Pamplona, Spain.
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21
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Kirschner M, Rabinowitz A, Singer N, Dagher A. From apathy to addiction: Insights from neurology and psychiatry. Prog Neuropsychopharmacol Biol Psychiatry 2020; 101:109926. [PMID: 32171904 DOI: 10.1016/j.pnpbp.2020.109926] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 03/11/2020] [Accepted: 03/11/2020] [Indexed: 12/21/2022]
Abstract
The tendency to engage in addictive behaviors has long been tied to the actions of the dopamine system. Early theories were based on the fact that all addictive drugs and behaviors (such as gambling) increase dopamine levels in the striatum, and the evidence that dopamine signaled reward or reward prediction error. However, with a changing emphasis of addiction away from purely pharmacological models that emphasize tolerance and withdrawal, towards one of behavioral dyscontrol, is there still a place for abnormal dopamine signaling in addiction? Here we recast the dopamine theory of addiction based on the idea that tonic dopamine may index a continuous phenotype that goes from apathy to impulsivity and compulsivity. Higher tonic dopamine signaling would make individuals vulnerable to drug reinforcement and cue-induced craving. We relate this to computational models of dopamine signaling, and review clinical and neuroimaging evidence from Parkinson's Disease, schizophrenia and bipolar disorder in support of this model.
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Affiliation(s)
- Matthias Kirschner
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Canada; Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
| | - Arielle Rabinowitz
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Canada
| | - Neomi Singer
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Canada
| | - Alain Dagher
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Canada.
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22
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van Deursen DN, van den Heuvel OA, Booij J, Berendse HW, Vriend C. Autonomic failure in Parkinson's disease is associated with striatal dopamine deficiencies. J Neurol 2020; 267:1922-1930. [PMID: 32162062 PMCID: PMC7320937 DOI: 10.1007/s00415-020-09785-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/03/2020] [Accepted: 03/05/2020] [Indexed: 12/11/2022]
Abstract
Autonomic dysfunction is a common non-motor symptom in Parkinson's disease (PD). Dopamine and serotonin are known to play a role in autonomic regulation, and, therefore, PD-related degeneration of serotonergic and dopaminergic neurons in these regions may be associated with autonomic dysfunction. We sought to clarify the association between extrastriatal serotonergic and striatal dopaminergic degeneration and the severity of autonomic symptoms, including gastrointestinal, pupillomotor, thermoregulatory, cardiovascular, and urinary dysfunction. We performed hierarchical multiple regression analyses to determine the relationships between (extra)striatal serotonergic and dopaminergic degeneration and autonomic dysfunction in 310 patients with PD. We used [123I]FP-CIT SPECT binding to presynaptic serotonin (SERT) and dopamine (DAT) transporters as a measure of the integrity of these neurotransmitter systems, and the SCOPA-AUT (Scales for Outcomes in Parkinson's Disease-Autonomic) questionnaire to evaluate the perceived severity of autonomic dysfunction. Motor symptom severity, medication status, and sex were added to the model as covariates. Additional analyses were also performed using five subdomains of the SCOPA-AUT: cardiovascular, gastrointestinal, urinary, thermoregulatory, and pupillomotor symptoms. We found that autonomic symptoms were most significantly related to lower [123I]FP-CIT binding ratios in the right caudate nucleus and were mainly driven by gastrointestinal and cardiovascular dysfunction. These results provide a first look into the modest role of dopaminergic projections towards the caudate nucleus in the pathophysiology of autonomic dysfunction in PD, but the underlying mechanism warrants further investigation.
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Affiliation(s)
- Dagmar N van Deursen
- Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Odile A van den Heuvel
- Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Jan Booij
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam UMC, Academic Medical Center, Meibergdreef 9, Amsterdam, The Netherlands
| | - Henk W Berendse
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Chris Vriend
- Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
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23
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Kelly MJ, Baig F, Hu MTM, Okai D. Spectrum of impulse control behaviours in Parkinson's disease: pathophysiology and management. J Neurol Neurosurg Psychiatry 2020; 91:703-711. [PMID: 32354771 DOI: 10.1136/jnnp-2019-322453] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 12/27/2022]
Abstract
Impulse control behaviours (ICBs) are a range of behaviours linked by their reward-based, repetitive natures. They can be precipitated in Parkinson's disease (PD) by dopamine replacement therapy, often with detrimental consequences for patients and caregivers. While now a well-recognised non-motor feature of treated PD, much remains unknown about the influence of risk factors, pathophysiological mechanisms, vulnerability factors for specific types of behaviour and the optimal management strategies. Imaging studies have identified structural and functional changes in striatal and prefrontal brain regions, among others. Gene association studies indicate a role for genetic predisposition to PD-ICB. Clinical observational studies have identified potential modifiable and non-modifiable risk factors. Psychological studies shed light on the neurocognitive domains implicated in PD-ICBs and identify psychosocial determinants that may perpetuate the cycle of impulsive and harm-avoidance behaviours. Based on these results, a range of pharmacological and non-pharmacological management strategies have been trialled in PD-ICBs with varying success. The purpose of this review is to update clinicians on the evidence around the pathophysiology of PD-ICB. We aim to translate our findings into an interpretable biopsychosocial model that can be applied to the clinical assessment and management of individual cases of PD-ICB.
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Affiliation(s)
- Mark John Kelly
- School of Medicine, Trinity Centre for Health Sciences, Tallaght University Hospital, Trinity College, Dublin, Ireland .,Oxford Parkinson's Disease Centre, Division of Neurology, Nuffield Department of Clinical Neurosciences, Oxford, Oxfordshire, UK
| | - Fahd Baig
- Molecular and Clinical Sciences Research Centre, London, UK, University of London Saint George's, London, London, UK
| | - Michele Tao-Ming Hu
- Oxford Parkinson's Disease Centre, Division of Neurology, Nuffield Department of Clinical Neurosciences, Oxford, Oxfordshire, UK
| | - David Okai
- Neuropsychiatry Department, South London and Maudsley NHS Foundation Trust, London, London, UK.,Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, London, UK
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24
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Abstract
Parkinson disease has historically been conceptualized as a movement disorder. In recent decades, nonmotor and neuropsychiatric symptoms have become increasingly recognized as being of paramount importance for patients with Parkinson disease. Neuropsychiatric phenomena dominate the course of the other major Lewy body disease, dementia with Lewy bodies. In this review, we survey the clinical relevance of nonmotor and neuropsychiatric symptoms to the heterogeneous presentations of Lewy body disease and their significance to ongoing research in this area. We consider how the nature of Lewy body neuropathology may help explicate the basis of nonmotor and neuropsychiatric symptoms in these two disorders.
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Affiliation(s)
- Jared T Hinkle
- Medical Scientist Training Program, Johns Hopkins School of Medicine, 1830 E Monument St, Baltimore, MD 21205, USA; Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 600 North Wolfe Street, Phipps 300, Baltimore, MD 21287, USA
| | - Gregory M Pontone
- Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 600 North Wolfe Street, Phipps 300, Baltimore, MD 21287, USA; Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
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25
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Barbosa P, Hapuarachchi B, Djamshidian A, Strand K, Lees AJ, de Silva R, Holton JL, Warner TT. Lower nucleus accumbens α-synuclein load and D3 receptor levels in Parkinson's disease with impulsive compulsive behaviours. Brain 2020; 142:3580-3591. [PMID: 31603207 DOI: 10.1093/brain/awz298] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/08/2019] [Accepted: 08/05/2019] [Indexed: 12/28/2022] Open
Abstract
Impulsive compulsive behaviours in Parkinson's disease have been linked to increased dopaminergic release in the ventral striatum and excessive stimulation of dopamine D3 receptors. Thirty-one patients with impulsive compulsive behaviours and Parkinson's disease who donated their brains to the Queen Square Brain Bank for Neurological Disorders were assessed for α-synuclein neuropathological load and tyrosine hydroxylase levels in the nucleus accumbens, dorsal putamen and caudate using immunohistochemistry. Dopamine D2 and dopamine D3 receptors protein levels in the nucleus accumbens, frontal cortex and putamen were determined using western blotting. Results were compared to 29 Parkinson's disease cases without impulsive compulsive behaviours matched by age, sex, disease duration, age at Parkinson's disease onset and disease duration. The majority of patients with impulsive compulsive behaviours had dopamine dysregulation syndrome. Patients with Parkinson's disease and impulsive compulsive behaviours had lower α-synuclein load and dopamine D3 receptor levels in the nucleus accumbens. No differences were seen between groups in the other brain areas and in the analysis of tyrosine hydroxylase and dopamine D2 receptor levels. Lower α-synuclein load in the nucleus accumbens of individuals with Parkinson's disease and impulsive compulsive behaviours was confirmed on western blotting. Downregulation of the dopamine D3 receptor levels may have occurred either as a consequence of the degenerative process or of a pre-morbid trait. The lower levels of α-synuclein may have contributed to an excessive stimulation of the ventral striatum resulting in impulsive compulsive behaviours.
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Affiliation(s)
- Pedro Barbosa
- Reta Lila Weston Institute of Neurological Studies, Department of Clinical Movement Disorder and Neuroscience, UCL Queen Square Institute of Neurology, 1 Wakefield Street, London, UK.,Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of Neurology, 1 Wakefield Street, London, UK
| | - Bimali Hapuarachchi
- Reta Lila Weston Institute of Neurological Studies, Department of Clinical Movement Disorder and Neuroscience, UCL Queen Square Institute of Neurology, 1 Wakefield Street, London, UK
| | - Atbin Djamshidian
- Reta Lila Weston Institute of Neurological Studies, Department of Clinical Movement Disorder and Neuroscience, UCL Queen Square Institute of Neurology, 1 Wakefield Street, London, UK.,Department of Neurology, Innsbruck Medical University, Innsbruck, Anichstrasse 35, Innsbruck, Austria
| | - Kate Strand
- Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of Neurology, 1 Wakefield Street, London, UK
| | - Andrew J Lees
- Reta Lila Weston Institute of Neurological Studies, Department of Clinical Movement Disorder and Neuroscience, UCL Queen Square Institute of Neurology, 1 Wakefield Street, London, UK.,Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of Neurology, 1 Wakefield Street, London, UK
| | - Rohan de Silva
- Reta Lila Weston Institute of Neurological Studies, Department of Clinical Movement Disorder and Neuroscience, UCL Queen Square Institute of Neurology, 1 Wakefield Street, London, UK
| | - Janice L Holton
- Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of Neurology, 1 Wakefield Street, London, UK
| | - Thomas T Warner
- Reta Lila Weston Institute of Neurological Studies, Department of Clinical Movement Disorder and Neuroscience, UCL Queen Square Institute of Neurology, 1 Wakefield Street, London, UK.,Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of Neurology, 1 Wakefield Street, London, UK
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26
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Vriend C, van Balkom TD, van Druningen C, Klein M, van der Werf YD, Berendse HW, van den Heuvel OA. Processing speed is related to striatal dopamine transporter availability in Parkinson's disease. Neuroimage Clin 2020; 26:102257. [PMID: 32344372 PMCID: PMC7186552 DOI: 10.1016/j.nicl.2020.102257] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 03/27/2020] [Accepted: 04/02/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Parkinson's disease (PD) affects the integrity of the dopamine and serotonin system, and is characterized by a plethora of different symptoms, including cognitive impairments of which the pathophysiology is not yet fully elucidated. OBJECTIVES Investigate the role of the integrity of the dopaminergic and serotonergic system in cognitive functioning in early-stage PD using Single Photon Emission Computed Tomography (SPECT) combined with the radiotracer 123I-N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropane (123I-FP-CIT). METHODS We studied the association between cognitive functions and dopamine transporter (DAT) availability in the caudate nucleus and putamen - as a proxy for striatal dopaminergic integrity - and serotonin transporter (SERT) availability as a proxy for serotonergic integrity in the thalamus and hippocampus using bootstrapped multiple regression. One-hundred-and-twenty-nine (129) PD patients underwent a 123I-FP-CIT SPECT scan and a neuropsychological assessment. RESULTS We showed a positive association between DAT availability in the head of the caudate nucleus and the Stroop Color Word Task - card I (reading words; β = 0.32, P = 0.001) and a positive association between DAT availability in the anterior putamen and the Trail Making Test part A (connecting consecutively numbered circles; β = 0.25, P = 0.02). These associations remained after adjusting for motor symptom severity or volume of the region-of-interest and were most pronounced in medication-naïve PD patients. There were no associations between cognitive performance and SERT availability in the thalamus or hippocampus. CONCLUSIONS We interpret these results as a role for striatal dopamine - and its PD-related decline - in aspects of processing speed.
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Affiliation(s)
- Chris Vriend
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Anatomy and Neurosciences, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam 1007 MB, the Netherlands.
| | - Tim D van Balkom
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Corné van Druningen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Martin Klein
- Amsterdam UMC, Vrije Universiteit Amsterdam, Medical Psychology, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Ysbrand D van der Werf
- Amsterdam UMC, Vrije Universiteit Amsterdam, Anatomy and Neurosciences, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam 1007 MB, the Netherlands
| | - Henk W Berendse
- Amsterdam UMC, Vrije Universiteit Amsterdam, Neurology, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Odile A van den Heuvel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Anatomy and Neurosciences, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam 1007 MB, the Netherlands
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27
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Phillipps C, Longato N, Béreau M, Carrière N, Lagha-Boukbiza O, Mengin AC, Monga B, Defebvre L, Ory-Magne F, Castrioto A, Lhommée E, Rascol O, Krack P, Tranchant C, Corvol JC, Anheim M. Is Motor Side Onset of Parkinson's Disease a Risk Factor for Developing Impulsive-Compulsive Behavior? A Cross-Sectional Study. Mov Disord 2020; 35:1080-1081. [PMID: 32311121 DOI: 10.1002/mds.28053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 03/06/2020] [Indexed: 01/30/2023] Open
Affiliation(s)
- Clélie Phillipps
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch, France.,Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - Nadine Longato
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch, France.,Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - Matthieu Béreau
- Department of neurology, university hospital of Besançon, Besançon, France
| | - Nicolas Carrière
- U1171, INSERM, Lille University, Lille, France; Neurology Department, Lille University Hospital, Lille, France
| | - Ouhaid Lagha-Boukbiza
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch, France.,Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - Amaury C Mengin
- Hôpitaux Universitaires de Strasbourg, Pôle de Psychiatrie, Santé Mentale et Addictologie, 1, place de l'Hôpital, Strasbourg, France; Université de Strasbourg, Faculté de Médecine, Strasbourg, France
| | - Ben Monga
- Faculté de Médecine et Ecole de Santé Publique, Université de Lubumbashi, Lubumbashi, République Démocratique du, Congo
| | - Luc Defebvre
- U1171, INSERM, Lille University, Lille, France; Neurology Department, Lille University Hospital, Lille, France
| | - Fabienne Ory-Magne
- University of Toulouse 3, Centre Hospitalo-Universitaire de Toulouse and INSERM; Centre d'Investigation Clinique CIC1436, Départements de Neurosciences et de Pharmacologie Clinique, NeuroToul COEN center, Toulouse, France
| | - Anna Castrioto
- Movement Disorders Center, Neurology, CHU Grenoble Alpes, Grenoble, France; Université Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
| | - Eugénie Lhommée
- Movement Disorders Center, Neurology, CHU Grenoble Alpes, Grenoble, France; Université Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
| | - Olivier Rascol
- Services de Neurologie et de Pharmacologie Clinique, Centre de Reference AMS, Centre d'Investigation Clinique, Réseau NS-Park/FCRIN et Centre of Excellence for Neurodegenerative Disorders (COEN) de Toulouse, CHU de Toulouse, Toulouse 3 University, Toulouse, France
| | - Paul Krack
- Department of Neurology, Division of Movement Disorders, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christine Tranchant
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch, France.,Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - Jean-Christophe Corvol
- Sorbonne Université, Assistance Publique Hôpitaux de Paris, Inserm, CNRS, ICM, Department of Neurology, Clinical Investigation Center for Neurosciences, Pitié-Salpêtrière Hospital, Paris, France
| | - Mathieu Anheim
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch, France.,Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
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28
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Kamps S, van den Heuvel OA, van der Werf YD, Berendse HW, Weintraub D, Vriend C. Smaller subcortical volume in Parkinson patients with rapid eye movement sleep behavior disorder. Brain Imaging Behav 2020; 13:1352-1360. [PMID: 30155787 PMCID: PMC6395547 DOI: 10.1007/s11682-018-9939-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Parkinson disease (PD) patients with rapid eye movement (REM) sleep behavior disorder (RBD) have worse motor symptoms and non-motor symptoms than patients without RBD. The aim of this study was to examine underlying differences in brain structure from a network perspective. Baseline data were obtained from Parkinson's Progression Markers Initiative (PPMI) participants. We divided PD patients and healthy controls (HC) into RBD positive and RBD negative using a cutoff score of ≥5 on the RBD screening questionnaire. HC with probable RBD were excluded. We first carried out a region-of-interest analysis of structural MRIs using voxel-based morphometry to study volumetric differences for the putamen, thalamus and hippocampus in a cross-sectional design. Additionally, an exploratory whole-brain analysis was performed. To study group differences from a network perspective, we then performed a 'seed-based' analysis of structural covariance, using the bilateral dorsal-caudal putamen, mediodorsal thalamus and anterior hippocampus as seed regions. The volume of the right putamen was smaller in PD patients with RBD. RBD symptom severity correlated negatively with volume of the right putamen, left hippocampus and left thalamus. We did not find any differences in structural covariance between PD patients with and without RBD. Presence of RBD and severity of RBD symptoms in PD are associated with smaller volumes of the putamen, thalamus and hippocampus.
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Affiliation(s)
- Sanne Kamps
- Department of Psychiatry, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Odile A van den Heuvel
- Department of Psychiatry, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Anatomy and Neurosciences, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ysbrand D van der Werf
- Department of Anatomy and Neurosciences, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Henk W Berendse
- Department of Neurology, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Daniel Weintraub
- Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,Parkinson's Disease and Mental Illness Research, Education and Clinical Centers (PADRECC and MIRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - Chris Vriend
- Department of Psychiatry, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. .,Department of Anatomy and Neurosciences, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. .,Department of Anatomy and Neurosciences, Amsterdam UMC, VU University Medical Center, De Boelelaan 1108, P.O. Box 705, 1007 MB, Amsterdam, The Netherlands.
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29
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Hammes J, Theis H, Giehl K, Hoenig MC, Greuel A, Tittgemeyer M, Timmermann L, Fink GR, Drzezga A, Eggers C, van Eimeren T. Dopamine metabolism of the nucleus accumbens and fronto-striatal connectivity modulate impulse control. Brain 2020; 142:733-743. [PMID: 30753324 DOI: 10.1093/brain/awz007] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/23/2018] [Accepted: 11/28/2018] [Indexed: 12/14/2022] Open
Abstract
Impulsive-compulsive behaviours like pathological gambling or hypersexuality are a frequent side effect of dopamine replacement therapy in patients with Parkinson's disease. Multiple imaging studies suggest a significant reduction of presynaptic dopamine transporters in the nucleus accumbens to be a predisposing factor, reflecting either a reduction of mesolimbic projections or, alternatively, a lower presynaptic dopamine transporter expression per se. Here, we aimed to test the hypothesis of fewer mesolimbic projections as a risk factor by using dopamine synthesis capacity as a proxy of dopaminergic terminal density. Furthermore, previous studies have demonstrated a reduction of fronto-striatal connectivity to be associated with increased risk of impulsive-compulsive behaviour in Parkinson's disease. Therefore, another aim of this study was to investigate the relationship between severity of impulsive-compulsive behaviour, dopamine synthesis capacity and fronto-striatal connectivity. Eighty participants underwent resting state functional MRI and anatomical T1-weighted images [mean age: 68 ± 9.9 years, 67% male (patients)]. In 59 participants, 18F-DOPA-PET was obtained and voxel-wise Patlak slopes indicating dopamine synthesis capacity were calculated. All participants completed the QUIP-RS questionnaire, a well validated test to quantify severity of impulsive-compulsive behaviour in Parkinson's disease. A voxel-wise correlation analysis between dopamine synthesis capacity and QUIP-RS score was calculated for striatal regions. To investigate the relationship between symptom severity and functional connectivity, voxel-wise correlations were performed. A negative correlation was found between dopamine synthesis capacity and QUIP-RS score in the nucleus accumbens (r = -0.57, P = 0.001), a region functionally connected to the rostral anterior cingulate cortex. The connectivity strength was modulated by QUIP-RS, i.e. patients with more severe impulsive-compulsive behaviours had a weaker functional connectivity between rostral anterior cingulate cortex and the nucleus accumbens. In addition, cortical thickness and severity of impulsive-compulsive behaviour were positively correlated in the subgenual rostral anterior cingulate cortex. We found three factors to be associated with severity of impulsive-compulsive behaviour: (i) decreased dopamine synthesis capacity in the nucleus accumbens; (ii) decreased functional connectivity of the rostral anterior cingulate cortex with the nucleus accumbens; and (iii) increased cortical thickness of the subgenual rostral anterior cingulate cortex. Rather than a downregulation of dopamine transporters, a reduction of mesolimbic dopaminergic projections in conjunction with a dysfunctional rostral anterior cingulate cortex-a region known to play a key role in impulse control-could be the most crucial neurobiological risk factor for the development of impulsive-compulsive behaviours in patients with Parkinson's disease under dopamine replacement therapy.
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Affiliation(s)
- Jochen Hammes
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Hendrik Theis
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Kathrin Giehl
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Merle C Hoenig
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Andrea Greuel
- Department of Neurology, University Hospital of Marburg, Germany
| | - Marc Tittgemeyer
- Max Planck Institute for Metabolism Research, Cologne, Germany.,Cologne Cluster of Excellence in Cellular Stress and Aging-Associated Disease (CECAD), University of Cologne, Germany
| | - Lars Timmermann
- Department of Neurology, University Hospital of Marburg, Germany
| | - Gereon R Fink
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany.,Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Germany
| | - Alexander Drzezga
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Germany
| | - Carsten Eggers
- Department of Neurology, University Hospital of Marburg, Germany
| | - Thilo van Eimeren
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany.,Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany.,Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Germany
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Marín-Lahoz J, Sampedro F, Horta-Barba A, Martínez-Horta S, Aracil-Bolaños I, Camacho V, Bejr-kasem H, Pascual-Sedano B, Pérez-Pérez J, Gironell A, Pagonabarraga J, Carrió I, Kulisevsky J. Preservation of brain metabolism in recently diagnosed Parkinson’s impulse control disorders. Eur J Nucl Med Mol Imaging 2020; 47:2165-2174. [DOI: 10.1007/s00259-019-04664-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 12/16/2019] [Indexed: 12/16/2022]
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31
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Strafella AP. Mesolimbic dopamine and anterior cingulate cortex connectivity changes lead to impulsive behaviour in Parkinson's disease. Brain 2019; 142:496-498. [PMID: 30810212 DOI: 10.1093/brain/awz010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Antonio P Strafella
- The Edmond J. Safra Program in Parkinson's Disease and Movement Disorder Unit, Toronto Western Hospital, University Health Network, University of Toronto, Ontario, Canada.,Krembil Research Institute, University Health Network, University of Toronto, Ontario, Canada.,Research Imaging Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, University of Toronto, Ontario, Canada
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Neural bases of impulse control disorders in Parkinson’s disease: A systematic review and an ALE meta-analysis. Neurosci Biobehav Rev 2019; 107:672-685. [DOI: 10.1016/j.neubiorev.2019.09.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/24/2019] [Accepted: 09/28/2019] [Indexed: 12/16/2022]
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Majuri J, Joutsa J. Molecular imaging of impulse control disorders in Parkinson’s disease. Eur J Nucl Med Mol Imaging 2019; 46:2220-2222. [DOI: 10.1007/s00259-019-04459-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 07/22/2019] [Indexed: 12/29/2022]
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Navalpotro-Gomez I, Dacosta-Aguayo R, Molinet-Dronda F, Martin-Bastida A, Botas-Peñin A, Jimenez-Urbieta H, Delgado-Alvarado M, Gago B, Quiroga-Varela A, Rodriguez-Oroz MC. Nigrostriatal dopamine transporter availability, and its metabolic and clinical correlates in Parkinson's disease patients with impulse control disorders. Eur J Nucl Med Mol Imaging 2019; 46:2065-2076. [PMID: 31273436 DOI: 10.1007/s00259-019-04396-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 06/10/2019] [Indexed: 01/11/2023]
Abstract
PURPOSE Previous studies in patients with Parkinson's disease (PD) and impulse control disorders (ICDs) have produced heterogeneous results regarding striatal dopamine transporter (DaT) binding and activity in the mesocorticolimbic network. Our aim here was to study the relationship between striatal DaT availability and cortical metabolism, as well as motor, behavioural and cognitive features of PD patients with ICD. METHODS In a group of PD patients with ICD (PD-ICD, n = 16) and 16 matched PD patients without ICD (PD-noICD, n = 16), DaT single-photon emission computed tomography (SPECT) imaging (DaTSCAN) was used to study DaT availability in predefined striatal volumes of interest (VOIs): putamen, caudate nucleus and ventral striatum (VS). In addition, the specific association of striatal DaT binding with cortical limbic and associative metabolic activity was evaluated by 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in PD-ICD patients and investigated using statistical parametric mapping (SPM8). Finally, associations between DaT availability and motor, behavioural and cognitive features were assessed. RESULTS PD-ICD patients had a significantly lower DaT density in the VS than PD-noICD patients, which was inversely associated with ICD severity. Lower DaT availability in the VS was associated with lower FDG uptake in several cortical areas belonging to the limbic and associative circuits, and in other regions involved in reward and inhibition processes (p < 0.0001 uncorrected; k > 50 voxels). No significant results were observed using a higher conservative threshold (p < 0.05; FDR corrected). PD-ICD patients also displayed impairment in interference and attentional Stroop Task execution, and more anxiety, all associated with reduced DaT availability in the VS and caudate nucleus. CONCLUSIONS ICDs in PD patients are related to reduced DaT binding in the VS, which accounts for dysfunction in a complex cortico-subcortical network that involves areas of the mesolimbic and mesocortical systems, being associated with reward evaluation, salience attribution and inhibitory control processes.
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Affiliation(s)
- I Navalpotro-Gomez
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastian, Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases, CIBERNED, Madrid, Spain
| | - R Dacosta-Aguayo
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastian, Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases, CIBERNED, Madrid, Spain
| | - F Molinet-Dronda
- MicroPET Research Unit, Center for Applied Medical Research, Universidad de Navarra, Pamplona, Spain
| | - A Martin-Bastida
- Department of Neurology, Clínica Universidad de Navarra, Universidad de Navarra, Pamplona, Spain
| | - A Botas-Peñin
- Department of Biomedical Engineering, Tecnun, Universidad de Navarra, Pamplona, Spain
| | - H Jimenez-Urbieta
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastian, Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases, CIBERNED, Madrid, Spain
| | - M Delgado-Alvarado
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastian, Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases, CIBERNED, Madrid, Spain.,Neurology Department, Sierrallana Hospital, Torrelavega, Spain
| | - B Gago
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastian, Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases, CIBERNED, Madrid, Spain
| | - A Quiroga-Varela
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastian, Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases, CIBERNED, Madrid, Spain.,Neuroscience Area, Center for Applied Medical Research (CIMA), Universidad de Navarra, Pamplona, Spain
| | - Maria C Rodriguez-Oroz
- Network Center for Biomedical Research in Neurodegenerative Diseases, CIBERNED, Madrid, Spain. .,Department of Neurology, Clínica Universidad de Navarra, Universidad de Navarra, Pamplona, Spain. .,Neuroscience Area, Center for Applied Medical Research (CIMA), Universidad de Navarra, Pamplona, Spain. .,Ikerbasque (Basque Foundation of Science), Bilbao, Spain. .,Basque Center on Cognition, Brain and Language (BCBL), San Sebastian, Spain.
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Girard R, Obeso I, Thobois S, Park SA, Vidal T, Favre E, Ulla M, Broussolle E, Krack P, Durif F, Dreher JC. Wait and you shall see: sexual delay discounting in hypersexual Parkinson's disease. Brain 2019; 142:146-162. [PMID: 30590514 DOI: 10.1093/brain/awy298] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 10/04/2018] [Indexed: 02/02/2023] Open
Abstract
Patients with Parkinson's disease may develop impulse control disorders under dopaminergic treatments. Impulse control disorders include a wide spectrum of behaviours, such as hypersexuality, pathological gambling or compulsive shopping. Yet, the neural systems engaged in specific impulse control disorders remain poorly characterized. Here, using model-based functional MRI, we aimed to determine the brain systems involved during delay-discounting of erotic rewards in hypersexual patients with Parkinson's disease (PD+HS), patients with Parkinson's disease without hypersexuality (PD - HS) and controls. Patients with Parkinson's disease were evaluated ON and OFF levodopa (counterbalanced). Participants had to decide between two options: (i) wait for 1.5 s to briefly view an erotic image; or (ii) wait longer to see the erotic image for a longer period of time. At the time of decision-making, we investigated which brain regions were engaged with the subjective valuation of the delayed erotic reward. At the time of the rewarded outcome, we searched for the brain regions responding more robustly after waiting longer to view the erotic image. PD+HS patients showed reduced discounting of erotic delayed rewards, compared to both patients with Parkinson's disease and controls, suggesting that they accepted waiting longer to view erotic images for a longer period of time. Thus, when using erotic stimuli that motivate PD+HS, these patients were less impulsive for the immediate reward. At the brain system level, this effect was paralleled by the fact that PD+HS, as compared to controls and PD - HS, showed a negative correlation between subjective value of the delayed reward and activity of medial prefrontal cortex and ventral striatum. Consistent with the incentive salience hypothesis combining learned cue-reward associations with current relevant physiological state, dopaminergic treatment in PD+HS boosted excessive 'wanting' of rewards and heightened activity in the anterior medial prefrontal cortex and the posterior cingulate cortex, as reflected by higher correlation with subjective value of the option associated to the delayed reward when ON medication as compared to the OFF medication state. At the time of outcome, the anterior medial prefrontal/rostral anterior cingulate cortex showed an interaction between group (PD+HS versus PD - HS) and medication (ON versus OFF), suggesting that dopaminergic treatment boosted activity of this brain region in PD+HS when viewing erotic images after waiting for longer periods of time. Our findings point to reduced delay discounting of erotic rewards in PD+HS, both at the behavioural and brain system levels, and abnormal reinforcing effect of levodopa when PD+HS patients are confronted with erotic stimuli.10.1093/brain/awy298_video1awy298media15983845074001.
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Affiliation(s)
- Romuald Girard
- Neuroeconomics, Reward and Decision-making Team, Institut des Sciences Cognitives Marc Jeannerod, Centre National de la Recherche Scientifique, UMR 5229, Bron, France.,University Claude Bernard Lyon, Lyon 1, Villeurbanne, France.,Section of Neurosurgery, The University of Chicago Medicine and Biological Sciences, Chicago, IL, USA
| | - Ignacio Obeso
- Neuroeconomics, Reward and Decision-making Team, Institut des Sciences Cognitives Marc Jeannerod, Centre National de la Recherche Scientifique, UMR 5229, Bron, France.,University Claude Bernard Lyon, Lyon 1, Villeurbanne, France.,HM Hospitales - Centro Integral en Neurociencias HM CINAC, Móstoles, Madrid, Spain
| | - Stéphane Thobois
- Université de Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux, Oullins, France.,Neurologie C, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.,Physiopathology of basal ganglia, Institut des Sciences Cognitives Marc Jeannerod, Centre National de la Recherche Scientifique, UMR 5229, Bron, France
| | - Seongmin A Park
- Neuroeconomics, Reward and Decision-making Team, Institut des Sciences Cognitives Marc Jeannerod, Centre National de la Recherche Scientifique, UMR 5229, Bron, France.,University Claude Bernard Lyon, Lyon 1, Villeurbanne, France
| | - Tiphaine Vidal
- Neurology Department, CHU de Clermont-Ferrand, Clermont-Ferrand, France.,University Clermont Auvergne, Clermont Ferrand, France
| | - Emilie Favre
- Neurologie C, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - Miguel Ulla
- Neurology Department, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Emmanuel Broussolle
- University Claude Bernard Lyon, Lyon 1, Villeurbanne, France.,Neurologie C, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.,Physiopathology of basal ganglia, Institut des Sciences Cognitives Marc Jeannerod, Centre National de la Recherche Scientifique, UMR 5229, Bron, France
| | - Paul Krack
- University Grenoble Alpes, Grenoble Institut des Neurosciences, Grenoble, France, Inserm, Grenoble, France.,Movement Disorders Unit, Neurology Department, CHU de Grenoble, Grenoble, France
| | - Franck Durif
- Neurology Department, CHU de Clermont-Ferrand, Clermont-Ferrand, France.,University Clermont Auvergne, Clermont Ferrand, France
| | - Jean-Claude Dreher
- Neuroeconomics, Reward and Decision-making Team, Institut des Sciences Cognitives Marc Jeannerod, Centre National de la Recherche Scientifique, UMR 5229, Bron, France.,University Claude Bernard Lyon, Lyon 1, Villeurbanne, France
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Abstract
In addition to motor symptoms, behavioural complications are commonly found in patients with Parkinson's disease (PD). Behavioural complications, including depression, anxiety, apathy, impulse control disorder and psychosis, together have a large impact on PD patient's quality of life. Many neuroimaging studies using PET, SPECT and MRI techniques have been conducted to study the underlying neural mechanisms of PD pathogenesis and pathophysiology in relation to its behavioural complications. This review will survey these PET, SPECT and MRI studies to describe the current understanding of the neuro-chemical, functional and structural changes associated with behavioural complications in PD patients.
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Ryu DW, Kim JS, Yoo SW, Oh YS, Lee KS. The Impact of Impulsivity on Quality of Life in Early Drug-Naïve Parkinson's Disease Patients. J Mov Disord 2019; 12:172-176. [PMID: 31390856 PMCID: PMC6763718 DOI: 10.14802/jmd.19004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 05/29/2019] [Indexed: 12/30/2022] Open
Abstract
Objective Impulse control disorders (ICDs) in Parkinson’s disease (PD) are mostly related to dopamine replacement therapy (DRT); however, drug-naïve PD patients have also frequently experienced impulsivity. This phenomenon makes clinicians hesitate treating patients with DRT. In this study, we assessed the effect of impulsivity on quality of life (QOL) in drug-naïve PD patients. Methods Two hundred three newly diagnosed, nonmedicated PD patients were enrolled, and they received structured clinical interviews, physical examinations and validated questionnaires to evaluate motor and nonmotor symptoms and QOL. Impulsivity was evaluated using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease-Rating Scale (QUIP-RS). Results Thirty-eight patients (18.7%) had impulsivity with QUIP-RS scores ≥ 1 and 4 patients (2.0%) were diagnosed with combined ICDs. Motor and nonmotor symptoms were significantly correlated with the Parkinson’s Disease Questionnaire-39 summary index. Female sex and QUIP-RS scores were also correlated with QOL in drug-naïve PD patients. Conclusion The results of the present study showed that impulsivity negatively influences QOL in early drug-naïve PD patients. In addition, more severe motor and nonmotor symptoms were also associated with lower QOL. Such findings complicate treatment but provide valuable information for managing early PD.
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Affiliation(s)
- Dong-Woo Ryu
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Joong-Seok Kim
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sang-Won Yoo
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoon-Sang Oh
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kwang-Soo Lee
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Abstract
Purpose of Review Parkinson’s disease (PD) has a wide spectrum of symptoms including the presence of psychiatric disease. At present, most treatment plans, comprised of dopaminergic drugs, are chronic and complex. Though dopaminergic agents are quite efficient in managing the motor aspects of the disease, chronic pharmacotherapy specifically with dopamine receptor agonists has been highly linked to the occurrence of Impulse Compulsive disorder (ICD), which can be problematic for individual patients. Recent Findings Much of what is known today about PD-related ICD stems from brain imaging studies, however, evidence is not quite conclusive. Research in the field has been focused on identifying the underlying mechanisms of PD-related ICD and understanding the functions of the structures involved in the reward network. Summary This article presents an update of recent findings from key neuroimaging studies in PD-related ICD, discusses results from controversial studies, and identifies areas for future research in the field.
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Affiliation(s)
- Andreas-Antonios Roussakis
- Neurology Imaging Unit, Imperial College London - Hammersmith Hospital, 1st Floor, B-Block, Du Cane Road, London, W12 0NN, UK
| | - Nicholas P Lao-Kaim
- Neurology Imaging Unit, Imperial College London - Hammersmith Hospital, 1st Floor, B-Block, Du Cane Road, London, W12 0NN, UK
| | - Paola Piccini
- Neurology Imaging Unit, Imperial College London - Hammersmith Hospital, 1st Floor, B-Block, Du Cane Road, London, W12 0NN, UK.
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Gatto EM, Aldinio V. Impulse Control Disorders in Parkinson's Disease. A Brief and Comprehensive Review. Front Neurol 2019; 10:351. [PMID: 31057473 PMCID: PMC6481351 DOI: 10.3389/fneur.2019.00351] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 03/22/2019] [Indexed: 12/25/2022] Open
Abstract
Impulse control and related disorders (ICDs-RD) encompasses a heterogeneous group of disorders that involve pleasurable behaviors performed repetitively, excessively, and compulsively. The key common symptom in all these disorders is the failure to resist an impulse or temptation to control an act or specific behavior, which is ultimately harmful to oneself or others and interferes in major areas of life. The major symptoms of ICDs include pathological gambling (PG), hypersexualtiy (HS), compulsive buying/shopping (CB) and binge eating (BE) functioning. ICDs and ICDs-RD have been included in the behavioral spectrum of non-motor symptoms in Parkinson's disease (PD) leading, in some cases, to serious financial, legal and psychosocial devastating consequences. Herein we present the prevalence of ICDs, the risk factors, its pathophysiological mechanisms, the link with agonist dopaminergic therapies and therapeutic managements.
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Affiliation(s)
- Emilia M Gatto
- Department of Neurology, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina.,Instituto de Neurociencias Buenos Aires, Ineba, Buenos Aires, Argentina
| | - Victoria Aldinio
- Department of Neurology, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina
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Meder D, Herz DM, Rowe JB, Lehéricy S, Siebner HR. The role of dopamine in the brain - lessons learned from Parkinson's disease. Neuroimage 2019; 190:79-93. [DOI: 10.1016/j.neuroimage.2018.11.021] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 10/25/2018] [Accepted: 11/16/2018] [Indexed: 11/30/2022] Open
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Striatal DAT and extrastriatal SERT binding in early-stage Parkinson's disease and dementia with Lewy bodies, compared with healthy controls: An 123I-FP-CIT SPECT study. NEUROIMAGE-CLINICAL 2019; 22:101755. [PMID: 30884365 PMCID: PMC6424141 DOI: 10.1016/j.nicl.2019.101755] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 01/27/2019] [Accepted: 03/09/2019] [Indexed: 12/20/2022]
Abstract
Parkinson's disease (PD) and dementia with Lewy bodies (DLB) are thought to be part of a spectrum: both have a clinical profile including symptoms associated with dopaminergic and serotonergic loss, yet few imaging studies have focused on serotonergic neurodegeneration in both disorders. We aimed to study degeneration of terminals with dopamine and serotonin transporter (DAT and SERT, respectively) in patients with early-stage PD and DLB relative to healthy controls, using 123I-N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropane (123I-FP-CIT) single photon emission computed tomography (SPECT). We conducted region of interest (ROI) and voxel-based analyses on 123I-FP-CIT SPECT scans. Using the cerebellum as a reference region, we determined binding ratios (BRs) for bilateral ROIs in the DAT-rich striatum (head of the caudate nucleus and posterior putamen) and SERT-rich extrastriatal brain regions (thalamus, hypothalamus and hippocampus). We compared BRs in PD and DLB patients with BRs in healthy controls (all groups: n = 16). Both PD and DLB patients had lower striatal 123I-FP-CIT BRs than healthy controls for the bilateral caudate head (PD-left: F(1,29) = 28.778, P < .001, ω2 = 0.35; right: F(1,29) = 35.338, P < .001, ω2 = 0.42; DLB-left: F(1,29) = 28.241, P < .001, ω2 = 0.31; right: F(1,29) = 18.811, P < .001, ω2 = 0.26) and bilateral posterior putamen (PD-left: F(1,29) = 107.531, P < .001, ω2 = 0.77; right: F(1,29) = 87.525, P < .001, ω2 = 0.72; DLB-left: F(1,29) = 39.910, P < .001, ω2 = 0.48; right: F(1,29) = 26.882, P < .001, ω2 = 0.38). DLB patients had lower hypothalamic 123I-FP-CIT BRs than healthy controls (F(1,29) = 6.059, P = .020, ω2 = 0.12). In the voxel-based analysis, PD and DLB patients had significantly lower striatal binding than healthy controls. Both PD patients in the early disease stages and DLB patients have reduced availability of striatal DAT, and DLB patients lower hypothalamic SERT compared with healthy controls. These observations add to the growing body of evidence that PD and DLB are not merely dopaminergic diseases, thereby providing additional clinicopathological insights.
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42
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Ramdave S, Dawson A, Carter A, Dissanayaka NNW. Unmasking neurobiological commonalities between addictive disorders and impulse control disorders in Parkinson’s disease. Brain Imaging Behav 2019; 14:2785-2798. [PMID: 30707344 DOI: 10.1007/s11682-019-00041-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Changes in reward circuitry have been studied extensively in substance and behavioural addictions. However, comparatively little is known about the neurobiology underlying impulse control disorders (ICDs) in Parkinson's disease, which show roughly similar risk factors and behavioural presentations to both stimulant and behavioural addictions. ICDs occur in a subset of susceptible patients with Parkinson's disease (PD) following intake of dopamine replacement therapy (DRT). These behavioural disorders often have debilitating effects on a patient's quality of life and increase caregiver burden. This comprehensive review examined findings of 40 neuroimaging studies of ICDs in PD to determine (a) whether there are putative neurobiological commonalities between traditional substance and behavioural addictions and DRT-induced ICD in PD and (b) opportunities for future studies to advance current neurobiological understanding of the phenomenon. Results revealed that strikingly similar (a) deficits in dopaminergic receptor expression, (b) connectivity changes in corticostriatal circuitry and (c) neural responses to cue exposure are observed in both ICDs in PD and addictive disorders. These findings point to the value of adopting a transdiagnostic approach when studying addicted populations and pave the way for demystifying this peculiar, often-devastating phenomenon in PD that has so far proven extremely difficult to treat and predict with any precision.
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Affiliation(s)
- Swathi Ramdave
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia.
- School of Psychology, The University of Queensland, Brisbane, Australia.
| | - Andrew Dawson
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Australia
| | - Adrian Carter
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Australia
| | - Nadeeka N W Dissanayaka
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- School of Psychology, The University of Queensland, Brisbane, Australia
- Department of Neurology, Royal Brisbane & Woman's Hospital, Brisbane, Australia
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Meyer GM, Spay C, Laurencin C, Ballanger B, Sescousse G, Boulinguez P. Functional imaging studies of Impulse Control Disorders in Parkinson's disease need a stronger neurocognitive footing. Neurosci Biobehav Rev 2019; 98:164-176. [PMID: 30639672 DOI: 10.1016/j.neubiorev.2019.01.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 11/22/2018] [Accepted: 01/07/2019] [Indexed: 02/06/2023]
Abstract
Impulse control disorders (ICDs) in Parkinson's disease (PD) are associated with dopaminergic dysfunction and treatment, but have no satisfactory therapeutic solution. While studies assessing the neurofunctional bases of ICDs are important for advancing our understanding and management of ICDs, they remain sparse and inconsistent. Based on a systematic analysis of the neuroimaging literature, the present review pinpoints various abnormalities beyond the mesocorticolimbic circuit that supports reward processing, suggesting possible dysfunction at the sensorimotor, executive and affective levels. We advocate that: 1) Future studies should use more sophisticated psychological models and behavioral designs that take into account the potentially multifaceted aspect of ICDs; this would allow a more accurate assessment of the underlying neurocognitive processes, which are not all dependent on the dopaminergic system. 2) Future neuroimaging studies should rely more strongly on task-based, event-related analyses to disentangle the various mechanisms that can be dysfunctional in ICDs. We believe these guidelines constitute a prerequisite towards distinguishing causes, correlates and individual susceptibility factors of PD patients with ICDs.
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Affiliation(s)
- Garance M Meyer
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon Neuroscience Research Center, INSERM, U 1028, CNRS, UMR 5292, Action Control and Related Disorders team, F-69000, Lyon, France
| | - Charlotte Spay
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon Neuroscience Research Center, INSERM, U 1028, CNRS, UMR 5292, Action Control and Related Disorders team, F-69000, Lyon, France
| | - Chloé Laurencin
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon Neuroscience Research Center, INSERM, U 1028, CNRS, UMR 5292, Neuroplasticity and Neuropathology of Olfactory Perception team, F-69000, Lyon, France; Service de Neurologie C, Centre Expert Parkinson, Hôpital Neurologique Pierre, Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - Bénédicte Ballanger
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon Neuroscience Research Center, INSERM, U 1028, CNRS, UMR 5292, Neuroplasticity and Neuropathology of Olfactory Perception team, F-69000, Lyon, France
| | - Guillaume Sescousse
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon Neuroscience Research Center, INSERM, U 1028, CNRS, UMR 5292, PsyR2 team, F-69000, Lyon, France
| | - Philippe Boulinguez
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon Neuroscience Research Center, INSERM, U 1028, CNRS, UMR 5292, Action Control and Related Disorders team, F-69000, Lyon, France.
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Martini A, Dal Lago D, Edelstyn NMJ, Salgarello M, Lugoboni F, Tamburin S. Dopaminergic Neurotransmission in Patients With Parkinson's Disease and Impulse Control Disorders: A Systematic Review and Meta-Analysis of PET and SPECT Studies. Front Neurol 2018; 9:1018. [PMID: 30568628 PMCID: PMC6290338 DOI: 10.3389/fneur.2018.01018] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 11/12/2018] [Indexed: 12/18/2022] Open
Abstract
Background: Around 30% Parkinson's disease (PD) patients develop impulse control disorders (ICDs) to D2/3 dopamine agonists and, to a lesser extent, levodopa. We aim to investigate striatal dopaminergic function in PD patients with and without ICD. Methods: PubMed, Science Direct, EBSCO, and ISI Web of Science databases were searched (from inception to March 7, 2018) to identify PET or SPECT studies reporting striatal dopaminergic function in PD patients with ICD (ICD+) compared to those without ICD (ICD–). Studies which included drug naïve patients, explored non-pharmacological procedures (e.g., deep brain stimulation), and those using brain blood perfusion or non-dopaminergic markers were excluded. Standardized mean difference (SDM) was used and random-effect models were applied. Separate meta-analyses were performed for dopamine transporter level, dopamine release, and dopamine receptors availability in the putamen, caudate, dorsal, and ventral striatum. Results: A total of 238 studies were title and abstract screened, of which 19 full-texts were assessed. Nine studies (ICD+: N = 117; ICD–: N = 175 patients) were included in the analysis. ICD+ showed a significant reduction of dopamine transporter binding in the putamen (SDM = −0.46; 95% CI: −0.80, −0.11; Z = 2.61; p = 0.009), caudate (SDM = −0.38; 95% CI: −0.73, −0.04; Z = 2.18; p = 0.03) and dorsal striatum (SDM = −0.45; 95% CI: −0.77, −0.13; Z = 2.76; p = 0.006), and increased dopamine release to reward-related stimuli/gambling tasks in the ventral striatum (SDM = −1.04; 95% CI: −1.73, −0.35; Z = 2.95; p = 0.003). Dopamine receptors availability did not differ between groups. Heterogeneity was low for dopamine transporter in the dorsal striatum (I2 = 0%), putamen (I2 = 0%) and caudate (I2 = 0%), and pre-synaptic dopamine release in the dorsal (I2 = 0%) and ventral striatum (I2 = 0%); heterogeneity was high for dopamine transporter levels in the ventral striatum (I2 = 80%), and for dopamine receptors availability in the ventral (I2 = 89%) and dorsal (I2 = 86%) striatum, putamen (I2 = 93%), and caudate (I2 = 71%). Conclusions: ICD+ patients show lower dopaminergic transporter levels in the dorsal striatum and increased dopamine release in the ventral striatum when engaged in reward-related stimuli/gambling tasks. This dopaminergic imbalance might represent a biological substrate for ICD in PD. Adequately powered longitudinal studies with drug naïve patients are needed to understand whether these changes may represent biomarkers of premorbid vulnerability to ICD.
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Affiliation(s)
- Alice Martini
- School of Psychology, Keele University, Newcastle-under-Lyme, United Kingdom
| | - Denise Dal Lago
- School of Psychology, Keele University, Newcastle-under-Lyme, United Kingdom
| | - Nicola M J Edelstyn
- School of Psychology, Keele University, Newcastle-under-Lyme, United Kingdom
| | - Matteo Salgarello
- Department of Nuclear Medicine, Ospedale Sacro Cuore Don Calabria, Verona, Italy
| | - Fabio Lugoboni
- Addiction Unit, Department of Internal Medicine, University Hospital of Verona, Verona, Italy
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Pramipexole-induced impulsivity in mildparkinsonian rats: a model of impulse control disorders in Parkinson's disease. Neurobiol Aging 2018; 75:126-135. [PMID: 30572183 DOI: 10.1016/j.neurobiolaging.2018.11.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 10/20/2018] [Accepted: 11/17/2018] [Indexed: 11/21/2022]
Abstract
Treatment with dopaminergic agonists such as pramipexole (PPX) contributes to the development of impulse control disorders (ICDs) in patients with Parkinson's disease (PD). As such, animal models of abnormal impulse control in PD are needed to better study the pathophysiology of these behaviors. Thus, we investigated impulsivity and related behaviors using the 5-choice serial reaction time task, as well as FosB/ΔFosB expression, in rats with mild parkinsonism induced by viral-mediated substantia nigra overexpression of human A53T mutated α-synuclein, and following chronic PPX treatment (0.25 mg/kg/d) for 4 weeks. The bilateral loss of striatal dopamine transporters (64%) increased the premature response rate of these rats, indicating enhanced waiting impulsivity. This behavior persisted in the OFF state after the second week of PPX treatment and it was further exacerbated in the ON state throughout the treatment period. The enhanced rate of premature responses following dopaminergic denervation was positively correlated with the premature response rate following PPX treatment (both in the ON and OFF states). Moreover, the striatal dopaminergic deficit was negatively correlated with the premature response rate at all times (pretreatment, ON and OFF states) and it was positively correlated with the striatal FosB/ΔFosB expression. By contrast, PPX treatment was not associated with changes in compulsivity (perseverative responses rate). This model recapitulates some features of PD with ICD, namely the dopaminergic deficit of early PD and the impulsivity traits provoked by dopaminergic loss in association with PPX treatment, making this model a useful tool to study the pathophysiology of ICDs.
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Filip P, Linhartová P, Hlavatá P, Šumec R, Baláž M, Bareš M, Kašpárek T. Disruption of Multiple Distinctive Neural Networks Associated With Impulse Control Disorder in Parkinson's Disease. Front Hum Neurosci 2018; 12:462. [PMID: 30519167 PMCID: PMC6258801 DOI: 10.3389/fnhum.2018.00462] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 11/01/2018] [Indexed: 01/02/2023] Open
Abstract
The phenomenon of impulsivity in Parkinson's disease appears as an arduous side effect of dopaminergic therapy with potentially detrimental consequences for the life of the patients. Although conceptualized as a result of non-physiologic chronic dopaminergic stimulation, recent advances speculate on combined disruption of other networks as well. In the search for neuroanatomical correlates of this multifaceted disturbance, this study employs two distinct, well-defined tasks of close association to motor inhibition and decision-making impulsivity, Go/No Go and Delay discounting. The fMRI and functional connectivity analysis in 21 Parkinson's disease patients, including 8 patients suffering from severe impulse control disorder, and 28 healthy controls, revealed in impulsive Parkinson's disease patients not only decreased fMRI activation in the dorsolateral prefrontal cortex and bilateral striatum, but also vast functional connectivity changes of both caudate nuclei as decreased connectivity to the superior parietal cortex and increased connectivity to the insular area, clearly beyond the commonly stated areas, which indicates that orbitofronto-striatal and mesolimbic functional disruptions are not the sole mechanisms underlying impulse control disorder in Parkinson's disease. Ergo, our results present a refinement and synthesis of gradually developing ideas about the nature of impulsive control disorder in Parkinson's disease—an umbrella term encompassing various behavioral deviations related to distinct neuronal networks and presumably neurotransmitter systems, which greatly exceed the previously envisioned dopaminergic pathways as the only culprit.
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Affiliation(s)
- Pavel Filip
- First Department of Neurology, Faculty of Medicine, Masaryk University and University Hospital of St. Anne, Brno, Czechia.,Center for Magnetic Resonance Research (CMRR), University of Minnesota, Minneapolis, MN, United States
| | - Pavla Linhartová
- Department of Psychiatry, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czechia
| | - Pavlína Hlavatá
- Department of Psychiatry, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czechia
| | - Rastislav Šumec
- First Department of Neurology, Faculty of Medicine, Masaryk University and University Hospital of St. Anne, Brno, Czechia
| | - Marek Baláž
- First Department of Neurology, Faculty of Medicine, Masaryk University and University Hospital of St. Anne, Brno, Czechia
| | - Martin Bareš
- First Department of Neurology, Faculty of Medicine, Masaryk University and University Hospital of St. Anne, Brno, Czechia.,Department of Neurology, School of Medicine, University of Minnesota, Minneapolis, MN, United States
| | - Tomáš Kašpárek
- Department of Psychiatry, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czechia
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47
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De Micco R, Russo A, Tedeschi G, Tessitore A. Impulse Control Behaviors in Parkinson's Disease: Drugs or Disease? Contribution From Imaging Studies. Front Neurol 2018; 9:893. [PMID: 30410465 PMCID: PMC6209663 DOI: 10.3389/fneur.2018.00893] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 10/01/2018] [Indexed: 12/13/2022] Open
Abstract
Impulse control behaviors (ICB) are recognized as non-motor complications of dopaminergic medications in patients with Parkinson's disease (PD). Compelling evidence suggests that ICB are not merely due to the PD-related pathology itself. Several risk factors have been identified, either demographic, clinical, genetic or neuropsychological. Neuroimaging studies have yielded controversial results regarding ICB correlates in PD and still it is not clear whether they can be triggered by the PD biology or the dopaminergic treatment stimulation. We provided an overview of the imaging studies that offered the most relevant insights into the debate about the role of drugs and disease in ICB pathophysiology. Understanding neural correlates and potential predisposing factors of these severe neuropsychiatric symptoms will be crucial to guide clinical practice and to foster preventive strategies.
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Affiliation(s)
- Rosa De Micco
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli, " Naples, Italy.,MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli, " Naples, Italy
| | - Antonio Russo
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli, " Naples, Italy.,MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli, " Naples, Italy
| | - Gioacchino Tedeschi
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli, " Naples, Italy.,MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli, " Naples, Italy
| | - Alessandro Tessitore
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli, " Naples, Italy.,MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli, " Naples, Italy
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De Micco R, Russo A, Tessitore A. Structural MRI in Idiopathic Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 141:405-438. [PMID: 30314605 DOI: 10.1016/bs.irn.2018.08.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Among modern neuroimaging modalities, magnetic resonance imaging (MRI) is a widely available, non-invasive, and cost-effective method to detect structural and functional abnormalities related to neurodegenerative disorders. In the last decades, MRI have been widely implemented to support PD diagnosis as well as to provide further insights into motor and non-motor symptoms pathophysiology, complications and treatment-related effects. Different aspects of the brain morphology and function may be derived from a single scan, by applying different analytic approaches. Biomarkers of neurodegeneration as well as tissue microstructural changes may be extracted from structural MRI techniques. In this chapter, we analyze the role of structural imaging to differentiate PD patients from controls and to define neural substrates of motor and non-motor PD symptoms. Evidence collected in the premotor PD phase will be also critically discussed. White matter as well as gray matter integrity imaging studies has been reviewed, aiming to highlight points of strength and limits to their potential application in clinical settings.
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Affiliation(s)
- Rosa De Micco
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy; MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Antonio Russo
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy; MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Alessandro Tessitore
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy; MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Napoli, Italy.
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49
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Könik A, De Beenhouwer J, Mukherjee JM, Kalluri K, Banerjee S, Zeraatkar N, Fromme T, King MA. Simulations of a Multi-Pinhole SPECT Collimator for Clinical Dopamine Transporter (DAT) Imaging. IEEE TRANSACTIONS ON RADIATION AND PLASMA MEDICAL SCIENCES 2018; 2:444-451. [PMID: 31011693 PMCID: PMC6474676 DOI: 10.1109/trpms.2018.2831208] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
SPECT imaging of the dopamine transporter (DAT) is used for diagnosis and monitoring progression of Parkinson's Disease (PD), and differentiation of PD from other neurological disorders. The diagnosis is based on the DAT binding in the caudate and putamen structures in the striatum. We previously proposed a relatively inexpensive method to improve the detection and quantification of these structures for dual-head SPECT by replacing one of the fan-beam collimators with a specially designed multi-pinhole (MPH) collimator. In this work, we developed a realistic model of the proposed MPH system using the GATE simulation package and verified the geometry with an analytic simulator. Point source projections from these simulations closely matched confirming the accuracy of the pinhole geometries. The reconstruction of a hot-rod phantom showed that 4.8 mm resolution is achievable. The reconstructions of the XCAT brain phantom showed clear separation of the putamen and caudate, which is expected to improve the quantification of DAT imaging and PD diagnosis. Using this GATE model, point spread functions modeling physical factors will be generated for use in reconstruction. Also, further improvements in geometry are being investigated to increase the sensitivity of this base system while maintaining a target spatial resolution of 4.5-5 mm.
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Affiliation(s)
- Arda Könik
- Department of Radiology, UMass Medical School, Worcester, MA, USA
| | | | | | - Kesava Kalluri
- Department of Radiology, UMass Medical School, Worcester, MA, USA
| | | | - Navid Zeraatkar
- Department of Radiology, UMass Medical School, Worcester, MA, USA
| | | | - Michael A King
- Department of Radiology, UMass Medical School, Worcester, MA, USA
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50
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Mojtahed Zadeh M, Ashraf-Ganjouei A, Ghazi Sherbaf F, Haghshomar M, Aarabi MH. White Matter Tract Alterations in Drug-Naïve Parkinson's Disease Patients With Impulse Control Disorders. Front Neurol 2018; 9:163. [PMID: 29662464 PMCID: PMC5890183 DOI: 10.3389/fneur.2018.00163] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 03/05/2018] [Indexed: 12/18/2022] Open
Abstract
Impulse control disorders (ICDs) are relatively frequent in patients with Parkinson’s disease (PD), although it is still unclear whether an underlying pathological process plays a significant role in the development of ICD in PD apart from dopaminergic replacement therapy. In this study, we have investigated alterations of white matter tract in drug-naïve PD patients with ICDs via diffusion MRI connectometry. Our results showed that disrupted connectivity in the complex network of dynamic connections between cerebellum, basal ganglia, cortex, and its spinal projections serves as the underlying neuropathology of ICD in PD not interfered with the contribution of dopaminergic replacement therapy. These findings provide the first evidence on involved white matter tracts in the neuropathogenesis of ICD in drug-naïve PD population, supporting the hypothesis that neural disturbances intrinsic to PD may confer an increased risk for ICDs. Future studies are needed to validate the attribution of the impaired corticocerebellar network to impulsivity in PD.
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Affiliation(s)
- Mahtab Mojtahed Zadeh
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Ashraf-Ganjouei
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Ghazi Sherbaf
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Haghshomar
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hadi Aarabi
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
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