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Dawson A, Ortelli P, Carter A, Ferrazzoli D, Dissanayaka NN, Evans A, Chye Y, Lorenzetti V, Frazzitta G, Yücel M. Motivational and myopic mechanisms underlying dopamine medication-induced impulsive-compulsive behaviors in Parkinson's disease. Front Behav Neurosci 2023; 16:949406. [PMID: 36744102 PMCID: PMC9889554 DOI: 10.3389/fnbeh.2022.949406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 12/27/2022] [Indexed: 01/20/2023] Open
Abstract
Introduction Dopaminergic medications can trigger impulsive-compulsive behaviors (ICBs) in pre-disposed patients with Parkinson's disease (PD), but what this implies on a neurocognitive level is unclear. Previous findings highlighted potentially exacerbated incentive motivation (willingness to work for rewards) and choice impulsivity (preferring smaller, immediate rewards over larger, delayed rewards) in PD patients with ICBs (PD + ICBs). Methods To deeply understand this evidence, we studied 24 PD + ICBs and 28 PD patients without ICBs (PD-ICBs). First of all, patients underwent the assessment of impulsivity traits, mood, anxiety, and addiction condition. We further administered robust objective and subjective measures of specific aspects of motivation. Finally, we explored whether these processes might link to any heightened antisocial behavior (aggression and risky driving) in PD + ICBs. Results High levels of positive urgency trait characterized PD + ICBs. They choose to exert more effort for rewards under the conditions of low and medium reward probability and as reward magnitude increases. Findings on choice impulsivity show a great tendency to delay discounting in PD + ICBs, other than a high correlation between delay and probability discounting. In addition, we found what appears to be the first evidence of heightened reactive aggression in PD patients with ICBs. Exacerbated incentive motivation and delay discounting trended toward positively predicting reactive aggression in PD + ICBs. Discussion Our promising results suggest that there might be immense value in future large-scale studies adopting a transdiagnostic neurocognitive endophenotype approach to understanding and predicting the addictive and aggressive behaviors that can arise from dopaminergic medication in PD.
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Affiliation(s)
- Andrew Dawson
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, VIC, Australia
| | - Paola Ortelli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, Vipiteno-Sterzing, Italy,Department of Movement Disorders and Brain Injury Rehabilitation, “Moriggia-Pelascini” Hospital, Como, Italy,*Correspondence: Paola Ortelli ✉
| | - Adrian Carter
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, VIC, Australia
| | - Davide Ferrazzoli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, Vipiteno-Sterzing, Italy,Department of Movement Disorders and Brain Injury Rehabilitation, “Moriggia-Pelascini” Hospital, Como, Italy
| | - Nadeeka N. Dissanayaka
- Faculty of Medicine, University of Queensland Centre for Clinical Research, The University of Queensland, Herston, QLD, Australia,Department of Neurology, Royal Brisbane and Women's Hospital, Herston, QLD, Australia,School of Psychology, The University of Queensland, St. Lucia, QLD, Australia
| | - Andrew Evans
- Department of Movement Disorders, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Yann Chye
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, VIC, Australia
| | | | | | - Murat Yücel
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, VIC, Australia
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2
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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: 6] [Impact Index Per Article: 6.0] [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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3
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Cometa A, Falasconi A, Biasizzo M, Carpaneto J, Horn A, Mazzoni A, Micera S. Clinical neuroscience and neurotechnology: An amazing symbiosis. iScience 2022; 25:105124. [PMID: 36193050 PMCID: PMC9526189 DOI: 10.1016/j.isci.2022.105124] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In the last decades, clinical neuroscience found a novel ally in neurotechnologies, devices able to record and stimulate electrical activity in the nervous system. These technologies improved the ability to diagnose and treat neural disorders. Neurotechnologies are concurrently enabling a deeper understanding of healthy and pathological dynamics of the nervous system through stimulation and recordings during brain implants. On the other hand, clinical neurosciences are not only driving neuroengineering toward the most relevant clinical issues, but are also shaping the neurotechnologies thanks to clinical advancements. For instance, understanding the etiology of a disease informs the location of a therapeutic stimulation, but also the way stimulation patterns should be designed to be more effective/naturalistic. Here, we describe cases of fruitful integration such as Deep Brain Stimulation and cortical interfaces to highlight how this symbiosis between clinical neuroscience and neurotechnology is closer to a novel integrated framework than to a simple interdisciplinary interaction.
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4
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Poisson CL, Engel L, Saunders BT. Dopamine Circuit Mechanisms of Addiction-Like Behaviors. Front Neural Circuits 2021; 15:752420. [PMID: 34858143 PMCID: PMC8631198 DOI: 10.3389/fncir.2021.752420] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/08/2021] [Indexed: 12/16/2022] Open
Abstract
Addiction is a complex disease that impacts millions of people around the world. Clinically, addiction is formalized as substance use disorder (SUD), with three primary symptom categories: exaggerated substance use, social or lifestyle impairment, and risky substance use. Considerable efforts have been made to model features of these criteria in non-human animal research subjects, for insight into the underlying neurobiological mechanisms. Here we review evidence from rodent models of SUD-inspired criteria, focusing on the role of the striatal dopamine system. We identify distinct mesostriatal and nigrostriatal dopamine circuit functions in behavioral outcomes that are relevant to addictions and SUDs. This work suggests that striatal dopamine is essential for not only positive symptom features of SUDs, such as elevated intake and craving, but also for impairments in decision making that underlie compulsive behavior, reduced sociality, and risk taking. Understanding the functional heterogeneity of the dopamine system and related networks can offer insight into this complex symptomatology and may lead to more targeted treatments.
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Affiliation(s)
- Carli L. Poisson
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, United States
- Medical Discovery Team on Addiction, University of Minnesota, Minneapolis, MN, United States
- Graduate Program in Neuroscience, University of Minnesota, Minneapolis, MN, United States
| | - Liv Engel
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, United States
- Medical Discovery Team on Addiction, University of Minnesota, Minneapolis, MN, United States
| | - Benjamin T. Saunders
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, United States
- Medical Discovery Team on Addiction, University of Minnesota, Minneapolis, MN, United States
- Graduate Program in Neuroscience, University of Minnesota, Minneapolis, MN, United States
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5
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Outeiro TF, Heutink P, Bezard E, Cenci AM. From iPS Cells to Rodents and Nonhuman Primates: Filling Gaps in Modeling Parkinson's Disease. Mov Disord 2020; 36:832-841. [PMID: 33200446 DOI: 10.1002/mds.28387] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/12/2020] [Accepted: 10/27/2020] [Indexed: 12/20/2022] Open
Abstract
Parkinson's disease (PD) is primarily known as a movement disorder because of typical clinical manifestations associated with the loss of dopaminergic neurons in the substantia nigra. However, it is now widely recognized that PD is a much more complex condition, with multiple and severe nonmotor features implicating additional brain areas and organs in the disease process. Pathologically, typical forms of PD are characterized by the accumulation of α-synuclein-rich protein inclusions known as Lewy bodies and Lewy neurites, although other types of protein inclusions are also often present in the brain. Familial forms of PD have provided a wealth of information about molecular pathways leading to neurodegeneration, but only to add to the complexity of the problem and uncover new knowledge gaps. Therefore, modeling PD in the laboratory has become increasingly challenging. Here, we discuss knowledge gaps and challenges in the use of laboratory models for the study of a disease that is clinically heterogeneous and multifactorial. We propose that the combined use of patient-derived cells and animal models, along with current technological tools, will not only expand our molecular and pathophysiological understanding of PD, but also assist in the identification of therapeutic strategies targeting relevant pathogenic pathways. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Tiago F Outeiro
- Department of Experimental Neurodegeneration, Center for Biostructural Imaging of Neurodegeneration, University Medical Center Goettingen, Goettingen, Germany.,Max Planck Institute for Experimental Medicine, Goettingen, Germany.,Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Peter Heutink
- German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Erwan Bezard
- Univ. de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France.,CNRS, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France
| | - Angela M Cenci
- Department of Experimental Medical Science, Basal Ganglia Pathophysiology Unit, Lund University, Lund, Sweden
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6
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Gibson AS, Keefe KA, Furlong TM. Accelerated habitual learning resulting from L-dopa exposure in rats is prevented by N-acetylcysteine. Pharmacol Biochem Behav 2020; 198:173033. [PMID: 32888972 DOI: 10.1016/j.pbb.2020.173033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 08/29/2020] [Accepted: 08/31/2020] [Indexed: 10/23/2022]
Abstract
Instrumental actions are initially goal-directed and driven by their associated outcome. However, with repeated experience habitual actions develop which are automated and efficient, as they are instead driven by antecedent stimuli. Dopamine is thought to facilitate the transition from goal-directed to habitual actions. This idea has been largely derived from evidence that psychostimulants accelerate the development of habitual actions. In the current study, we examined the impact of L-dopa (levodopa or L-dihydroxyphenylalanine), which also potentiates dopamine activity, on habitual learning. L-dopa was systemically administered prior to training rats to press a lever for a food outcome. When tested, L-dopa exposed animals were insensitive to changes in the value of the food outcome, and hence demonstrated accelerated habitual behavioral control compared to control animals that remained goal directed. We also showed that when N-acetylcysteine (NAC), an antioxidant and regulator of glutamate activity, was co-administered with L-dopa, it prevented the transition to habitual behavior; an effect demonstrated previously for cocaine. Therefore, this study establishes similarities between L-dopa and psychostimulants in both the development and prevention of habitual actions, and supports the notion that excess dopamine potentiates habitual learning. This finding extends the limited existing knowledge of the impact of L-dopa on learning and behavior, and has implications for neurological disorders where L-dopa is the primary treatment.
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Affiliation(s)
- Anne S Gibson
- Department of Pharmacology and Toxicology, University of Utah, Salt Lake City, UT, USA; Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA
| | - Kristen A Keefe
- Department of Pharmacology and Toxicology, University of Utah, Salt Lake City, UT, USA; Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA
| | - Teri M Furlong
- Department of Pharmacology and Toxicology, University of Utah, Salt Lake City, UT, USA; Neuroscience Research Australia, 139 Barker Street, Randwick, NSW, Australia; School of Medical Sciences, University of New South Wales, Kensington, NSW, Australia.
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7
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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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8
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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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9
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Seeding of protein aggregation causes cognitive impairment in rat model of cortical synucleinopathy. Mov Disord 2019; 34:1699-1710. [DOI: 10.1002/mds.27810] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 07/09/2019] [Accepted: 07/11/2019] [Indexed: 12/15/2022] Open
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The NeuroD6 Subtype of VTA Neurons Contributes to Psychostimulant Sensitization and Behavioral Reinforcement. eNeuro 2019; 6:ENEURO.0066-19.2019. [PMID: 31097625 PMCID: PMC6565376 DOI: 10.1523/eneuro.0066-19.2019] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/07/2019] [Accepted: 05/09/2019] [Indexed: 01/13/2023] Open
Abstract
Reward-related behavior is complex and its dysfunction correlated with neuropsychiatric illness. Dopamine (DA) neurons of the ventral tegmental area (VTA) have long been associated with different aspects of reward function, but it remains to be disentangled how distinct VTA DA neurons contribute to the full range of behaviors ascribed to the VTA. Here, a recently identified subtype of VTA neurons molecularly defined by NeuroD6 (NEX1M) was addressed. Among all VTA DA neurons, less than 15% were identified as positive for NeuroD6. In addition to dopaminergic markers, sparse NeuroD6 neurons expressed the vesicular glutamate transporter 2 (Vglut2) gene. To achieve manipulation of NeuroD6 VTA neurons, NeuroD6(NEX)-Cre-driven mouse genetics and optogenetics were implemented. First, expression of vesicular monoamine transporter 2 (VMAT2) was ablated to disrupt dopaminergic function in NeuroD6 VTA neurons. Comparing Vmat2lox/lox;NEX-Cre conditional knock-out (cKO) mice with littermate controls, it was evident that baseline locomotion, preference for sugar and ethanol, and place preference upon amphetamine-induced and cocaine-induced conditioning were similar between genotypes. However, locomotion upon repeated psychostimulant administration was significantly elevated above control levels in cKO mice. Second, optogenetic activation of NEX-Cre VTA neurons was shown to induce DA release and glutamatergic postsynaptic currents within the nucleus accumbens. Third, optogenetic stimulation of NEX-Cre VTA neurons in vivo induced significant place preference behavior, while stimulation of VTA neurons defined by Calretinin failed to cause a similar response. The results show that NeuroD6 VTA neurons exert distinct regulation over specific aspects of reward-related behavior, findings that contribute to the current understanding of VTA neurocircuitry.
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Magnard R, Vachez Y, Carcenac C, Boulet S, Houeto JL, Savasta M, Belin D, Carnicella S. Nigrostriatal Dopaminergic Denervation Does Not Promote Impulsive Choice in the Rat: Implication for Impulse Control Disorders in Parkinson's Disease. Front Behav Neurosci 2018; 12:312. [PMID: 30618665 PMCID: PMC6300586 DOI: 10.3389/fnbeh.2018.00312] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 11/29/2018] [Indexed: 11/27/2022] Open
Abstract
Impulse control disorders (ICDs) are frequent behavioral complications of dopaminergic (DA) replacement therapies (DRTs) in Parkinson’s disease (PD). Impulsive choice, which refers to an inability to tolerate delays to reinforcement, has been identified as a core pathophysiological process of ICDs. Although impulsive choices are exacerbated in PD patients with ICDs under DRTs, some clinical and preclinical studies suggest that the DA denervation of the dorsal striatum induced by the neurodegenerative process as well as a pre-existing high impulsivity trait, may both contribute to the emergence of ICDs in PD. We therefore investigated in a preclinical model in rats, specifically designed to study PD-related non-motor symptoms, the effect of nigrostriatal DA denervation on impulsive choice, in relation to pre-existing levels of impulsivity, measured in a Delay Discounting Task (DDT). In this procedure, rats had the choice between responding for a small sucrose reinforcer delivered immediately, or a larger sucrose reinforcer, delivered after a 0, 5, 10 or 15 s delay. In two different versions of the task, the preference for the large reinforcer decreased as the delay increased. However, and in contrast to our initial hypothesis, this discounting effect was neither exacerbated by, or related to, the extent of the substantia nigra pars compacta (SNc) DA lesion, nor it was influenced by pre-existing variability in impulsive choice. These results therefore question the potential implication of the nigrostriatal DA system in impulsive choice, as well as the DA neurodegenerative process as a factor contributing significantly to the development of ICDs in PD.
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Affiliation(s)
- Robin Magnard
- INSERM U1216 and Univ. Grenoble Alpes, Grenoble Institut des Neurosciences (GIN), Grenoble, France
| | - Yvan Vachez
- INSERM U1216 and Univ. Grenoble Alpes, Grenoble Institut des Neurosciences (GIN), Grenoble, France
| | - Carole Carcenac
- INSERM U1216 and Univ. Grenoble Alpes, Grenoble Institut des Neurosciences (GIN), Grenoble, France
| | - Sabrina Boulet
- INSERM U1216 and Univ. Grenoble Alpes, Grenoble Institut des Neurosciences (GIN), Grenoble, France
| | - Jean-Luc Houeto
- CIC-INSERM 1402, Service de Neurologie, CHU de Poitiers, Université de Poitiers, Poitiers, France
| | - Marc Savasta
- INSERM U1216 and Univ. Grenoble Alpes, Grenoble Institut des Neurosciences (GIN), Grenoble, France
| | - David Belin
- Department of Psychology, Faculty of Biology, University of Cambridge, Cambridge, United Kingdom
| | - Sebastien Carnicella
- INSERM U1216 and Univ. Grenoble Alpes, Grenoble Institut des Neurosciences (GIN), Grenoble, France
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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: 17] [Impact Index Per Article: 2.8] [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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13
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Modeling Parkinson’s disease and treatment complications in rodents: Potentials and pitfalls of the current options. Behav Brain Res 2018; 352:142-150. [DOI: 10.1016/j.bbr.2017.12.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 12/07/2017] [Accepted: 12/09/2017] [Indexed: 01/05/2023]
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14
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Impulse control disorders in Parkinson's disease. J Neural Transm (Vienna) 2018; 125:1299-1312. [PMID: 29511827 DOI: 10.1007/s00702-018-1870-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 02/27/2018] [Indexed: 10/17/2022]
Abstract
Impulse control disorders (ICD) are frequent side effects of dopamine replacement therapy (DRT) used in Parkinson's disease (PD) with devastating consequences on the patients and caregivers. ICD are behavioural addictions including compulsive gambling, shopping, sexual behaviour, and binge eating that are mainly associated with dopamine D2/D3 agonists. Their management is a real clinical challenge due to the lack of therapeutic alternative. Clinical studies have identified demographic and clinical risk factors for ICD such as younger age at disease onset, male gender, prior history of depression or substance abuse, REM sleep behaviour disorders and higher rate of dyskinesia. PD patients with ICD may also have a specific pattern of dopaminergic denervation in the ventral striatum. Specific evaluation tools have now been designed to better evaluate the severity and impact of ICD in PD. Patients with ICD display altered processing of reward and loss, and decisional bias associated with altered activity in cortical and subcortical areas such as the orbitofrontal cortex, amygdala, insula, anterior cingular cortex, and ventral striatum. Preclinical studies have demonstrated that D2/D3 agonists induce impairments in behavioural processes likely relevant to ICD such as risk-taking behaviour, preference for uncertainty, perseverative responding and sustained drive to engage in gambling-like behaviour. Whether interactions between dopamine denervation and DRT significantly contribute to the pathogenesis of ICD remains poorly understood so far, although features unique to PD have been identified in patients with ICD. Large-scale longitudinal studies are needed to better identify subjects with increased risk to develop ICD and develop therapeutic options.
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Masilamoni GJ, Smith Y. Chronic MPTP administration regimen in monkeys: a model of dopaminergic and non-dopaminergic cell loss in Parkinson's disease. J Neural Transm (Vienna) 2017; 125:337-363. [PMID: 28861737 DOI: 10.1007/s00702-017-1774-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 07/29/2017] [Indexed: 12/17/2022]
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder clinically characterized by cardinal motor deficits including bradykinesia, tremor, rigidity and postural instability. Over the past decades, it has become clear that PD symptoms extend far beyond motor signs to include cognitive, autonomic and psychiatric impairments, most likely resulting from cortical and subcortical lesions of non-dopaminergic systems. In addition to nigrostriatal dopaminergic degeneration, pathological examination of PD brains, indeed, reveals widespread distribution of intracytoplasmic inclusions (Lewy bodies) and death of non-dopaminergic neurons in the brainstem and thalamus. For that past three decades, the MPTP-treated monkey has been recognized as the gold standard PD model because it displays some of the key behavioral and pathophysiological changes seen in PD patients. However, a common criticism raised by some authors about this model, and other neurotoxin-based models of PD, is the lack of neuronal loss beyond the nigrostriatal dopaminergic system. In this review, we argue that this assumption is largely incorrect and solely based on data from monkeys intoxicated with acute administration of MPTP. Work achieved in our laboratory and others strongly suggest that long-term chronic administration of MPTP leads to brain pathology beyond the dopaminergic system that displays close similarities to that seen in PD patients. This review critically examines these data and suggests that the chronically MPTP-treated nonhuman primate model may be suitable to study the pathophysiology and therapeutics of some non-motor features of PD.
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Affiliation(s)
- Gunasingh J Masilamoni
- Yerkes National Primate Research Center, Emory University, 954, Gatewood Rd NE, Atlanta, GA, 30322, USA.
- Udall Center of Excellence for Parkinson's Disease, Emory University, 954, Gatewood Rd NE, Atlanta, GA, 30322, USA.
| | - Yoland Smith
- Yerkes National Primate Research Center, Emory University, 954, Gatewood Rd NE, Atlanta, GA, 30322, USA
- Department of Neurology, Emory University, 954, Gatewood Rd NE, Atlanta, GA, 30322, USA
- Udall Center of Excellence for Parkinson's Disease, Emory University, 954, Gatewood Rd NE, Atlanta, GA, 30322, USA
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Carvalho MM, Campos FL, Marques M, Soares-Cunha C, Kokras N, Dalla C, Leite-Almeida H, Sousa N, Salgado AJ. Effect of Levodopa on Reward and Impulsivity in a Rat Model of Parkinson's Disease. Front Behav Neurosci 2017; 11:145. [PMID: 28848409 PMCID: PMC5550717 DOI: 10.3389/fnbeh.2017.00145] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 07/21/2017] [Indexed: 01/14/2023] Open
Abstract
The use of dopamine replacement therapies (DRT) in the treatment of Parkinson’s disease (PD) can lead to the development of dopamine dysregulation syndrome (DDS) and impulse control disorders (ICD), behavioral disturbances characterized by compulsive DRT self-medication and development of impulsive behaviors. However, the mechanisms behind these disturbances are poorly understood. In animal models of PD, the assessment of the rewarding properties of levodopa (LD), one of the most common drugs used in PD, has produced conflicting results, and its ability to promote increased impulsivity is still understudied. Moreover, it is unclear whether acute and chronic LD therapy differently affects reward and impulsivity. In this study we aimed at assessing, in an animal model of PD with bilateral mesostriatal and mesocorticolimbic degeneration, the behavioral effects of LD therapy regarding reward and impulsivity. Animals with either sham or 6-hydroxydopamine (6-OHDA)-induced bilateral lesions in the substantia nigra pars compacta (SNc) and ventral tegmental area (VTA) were exposed to acute and chronic LD treatment. We used the conditioned place preference (CPP) paradigm to evaluate the rewarding effects of LD, whereas impulsive behavior was measured with the variable delay-to-signal (VDS) task. Correlation analyses between behavioral measurements of reward or impulsivity and lesion extent in SNc/VTA were performed to pinpoint possible anatomical links of LD-induced behavioral changes. We show that LD, particularly when administered chronically, caused the development of impulsive-like behaviors in 6-OHDA-lesioned animals in the VDS. However, neither acute or chronic LD administration had rewarding effects in 6-OHDA-lesioned animals in the CPP. Our results show that in a bilateral rat model of PD, LD leads to the development of impulsive behaviors, strengthening the association between DRT and DDS/ICD in PD.
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Affiliation(s)
- Miguel M Carvalho
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus de GualtarBraga, Portugal.,ICVS/3B's, PT Government Associate LaboratoryGuimarães, Portugal
| | - Filipa L Campos
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus de GualtarBraga, Portugal.,ICVS/3B's, PT Government Associate LaboratoryGuimarães, Portugal
| | - Mariana Marques
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus de GualtarBraga, Portugal.,ICVS/3B's, PT Government Associate LaboratoryGuimarães, Portugal
| | - Carina Soares-Cunha
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus de GualtarBraga, Portugal.,ICVS/3B's, PT Government Associate LaboratoryGuimarães, Portugal
| | - Nikolaos Kokras
- Department of Pharmacology, Medical School, National and Kapodistrian University of AthensAthens, Greece.,First Department of Psychiatry, Medical School, National and Kapodistrian University of AthensAthens, Greece
| | - Christina Dalla
- Department of Pharmacology, Medical School, National and Kapodistrian University of AthensAthens, Greece
| | - Hugo Leite-Almeida
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus de GualtarBraga, Portugal.,ICVS/3B's, PT Government Associate LaboratoryGuimarães, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus de GualtarBraga, Portugal.,ICVS/3B's, PT Government Associate LaboratoryGuimarães, Portugal
| | - António J Salgado
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus de GualtarBraga, Portugal.,ICVS/3B's, PT Government Associate LaboratoryGuimarães, Portugal
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17
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Jiménez-Murcia S, Granero R, Wolz I, Baño M, Mestre-Bach G, Steward T, Agüera Z, Hinney A, Diéguez C, Casanueva FF, Gearhardt AN, Hakansson A, Menchón JM, Fernández-Aranda F. Food Addiction in Gambling Disorder: Frequency and Clinical Outcomes. Front Psychol 2017; 8:473. [PMID: 28421009 PMCID: PMC5378803 DOI: 10.3389/fpsyg.2017.00473] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 03/14/2017] [Indexed: 01/08/2023] Open
Abstract
Background: The food addiction (FA) model is receiving increasing interest from the scientific community. Available empirical evidence suggests that this condition may play an important role in the development and course of physical and mental health conditions such as obesity, eating disorders, and other addictive behaviors. However, no epidemiological data exist on the comorbidity of FA and gambling disorder (GD), or on the phenotype for the co-occurrence of GD+FA. Objectives: To determine the frequency of the comorbid condition GD+FA, to assess whether this comorbidity features a unique clinical profile compared to GD without FA, and to generate predictive models for the presence of FA in a GD sample. Method: Data correspond to N = 458 treatment-seeking patients who met criteria for GD in a hospital unit specialized in behavioral addictions. Results: Point prevalence for FA diagnosis was 9.2%. A higher ratio of FA was found in women (30.5%) compared to men (6.0%). Lower FA prevalence was associated with older age. Patients with high FA scores were characterized by worse psychological state, and the risk of a FA diagnosis was increased in patients with high scores in the personality traits harm avoidance and self-transcendence, and low scores in cooperativeness (R2 = 0.18). Conclusion: The co-occurrence of FA in treatment-seeking GD patients is related to poorer emotional and psychological states. GD treatment interventions and related behavioral addictions should consider potential associations with problematic eating behavior and aim to include techniques that aid patients in better managing this behavior.
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Affiliation(s)
- Susana Jiménez-Murcia
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos IIIBarcelona, Spain.,Department of Clinical Sciences, Faculty of Medicine, University of BarcelonaBarcelona, Spain
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos IIIBarcelona, Spain.,Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de BarcelonaBarcelona, Spain
| | - Ines Wolz
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos IIIBarcelona, Spain
| | - Marta Baño
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain
| | - Gemma Mestre-Bach
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos IIIBarcelona, Spain
| | - Trevor Steward
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos IIIBarcelona, Spain
| | - Zaida Agüera
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos IIIBarcelona, Spain
| | - Anke Hinney
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-EssenEssen, Germany
| | - Carlos Diéguez
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos IIIBarcelona, Spain.,Department of Physiology, Centro Singular de Investigación en Medicina Molecular y Enfermedades Crónicas, University of Santiago de Compostela-Instituto de Investigación SanitariaSantiago de Compostela, Spain
| | - Felipe F Casanueva
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos IIIBarcelona, Spain.,Laboratory of Molecular and Cellular Endocrinology, Research Area, Complejo Hospitalario Universitario de Santiago de CompostelaSantiago de Compostela, Spain
| | | | - Anders Hakansson
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, PsychiatryLund, Sweden
| | - José M Menchón
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain.,Department of Clinical Sciences, Faculty of Medicine, University of BarcelonaBarcelona, Spain.,Ciber Salud Mental (CIBERSAM), Instituto Carlos IIIBarcelona, Spain
| | - Fernando Fernández-Aranda
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos IIIBarcelona, Spain.,Department of Clinical Sciences, Faculty of Medicine, University of BarcelonaBarcelona, Spain
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18
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Magnard R, Vachez Y, Carcenac C, Krack P, David O, Savasta M, Boulet S, Carnicella S. What can rodent models tell us about apathy and associated neuropsychiatric symptoms in Parkinson's disease? Transl Psychiatry 2016; 6:e753. [PMID: 26954980 PMCID: PMC4872443 DOI: 10.1038/tp.2016.17] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 01/11/2016] [Accepted: 01/19/2016] [Indexed: 12/19/2022] Open
Abstract
In addition to classical motor symptoms, Parkinson's disease (PD) patients display incapacitating neuropsychiatric manifestations, such as apathy, anhedonia, depression and anxiety. These hitherto generally neglected non-motor symptoms, have gained increasing interest in medical and scientific communities over the last decade because of the extent of their negative impact on PD patients' quality of life. Although recent clinical and functional imaging studies have provided useful information, the pathophysiology of apathy and associated affective impairments remains elusive. Our aim in this review is to summarize and discuss recent advances in the development of rodent models of PD-related neuropsychiatric symptoms using neurotoxin lesion-based approaches. The data collected suggest that bilateral and partial lesions of the nigrostriatal system aimed at inducing reliable neuropsychiatric-like deficits while avoiding severe motor impairments that may interfere with behavioral evaluation, is a more selective and efficient strategy than medial forebrain bundle lesions. Moreover, of all the different classes of pharmacological agents, D2/D3 receptor agonists such as pramipexole appear to be the most efficient treatment for the wide range of behavioral deficits induced by dopaminergic lesions. Lesion-based rodent models, therefore, appear to be relevant tools for studying the pathophysiology of the non-motor symptoms of PD. Data accumulated so far confirm the causative role of dopaminergic depletion, especially in the nigrostriatal system, in the development of behavioral impairments related to apathy, depression and anxiety. They also put forward D2/D3 receptors as potential targets for the treatment of such neuropsychiatric symptoms in PD.
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Affiliation(s)
- R Magnard
- Inserm U1216, Grenoble, France,Université Grenoble Alpes, Grenoble Institut des Neurosciences, Grenoble, France
| | - Y Vachez
- Inserm U1216, Grenoble, France,Université Grenoble Alpes, Grenoble Institut des Neurosciences, Grenoble, France
| | - C Carcenac
- Inserm U1216, Grenoble, France,Université Grenoble Alpes, Grenoble Institut des Neurosciences, Grenoble, France
| | - P Krack
- Inserm U1216, Grenoble, France,Université Grenoble Alpes, Grenoble Institut des Neurosciences, Grenoble, France,Movement Disorder Unit, Department of Psychiatry and Neurology, CHU de Grenoble, Grenoble, France
| | - O David
- Inserm U1216, Grenoble, France,Université Grenoble Alpes, Grenoble Institut des Neurosciences, Grenoble, France
| | - M Savasta
- Inserm U1216, Grenoble, France,Université Grenoble Alpes, Grenoble Institut des Neurosciences, Grenoble, France
| | - S Boulet
- Inserm U1216, Grenoble, France,Université Grenoble Alpes, Grenoble Institut des Neurosciences, Grenoble, France
| | - S Carnicella
- Inserm U1216, Grenoble, France,Université Grenoble Alpes, Grenoble Institut des Neurosciences, Grenoble, France,Inserm U1216, Grenoble Institute of Neuroscience, Site Santé La Tronche - BP 170, 38042 Grenoble, France. E-mail:
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19
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Houeto JL, Magnard R, Dalley JW, Belin D, Carnicella S. Trait Impulsivity and Anhedonia: Two Gateways for the Development of Impulse Control Disorders in Parkinson's Disease? Front Psychiatry 2016; 7:91. [PMID: 27303314 PMCID: PMC4884740 DOI: 10.3389/fpsyt.2016.00091] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 05/17/2016] [Indexed: 12/03/2022] Open
Abstract
Apathy and impulsivity are two major comorbid syndromes of Parkinson's disease (PD) that may represent two extremes of a behavioral spectrum modulated by dopamine-dependent processes. PD is characterized by a progressive loss of dopaminergic neurons in the substantia nigra pars compacta to which are attributed the cardinal motor symptoms of the disorder. Dopamine replacement therapy (DRT), used widely to treat these motor symptoms, is often associated with deficits in hedonic processing and motivation, including apathy and depression, as well as impulse control disorders (ICDs). ICDs comprise pathological gambling, hypersexuality, compulsive shopping, binge eating, compulsive overuse of dopaminergic medication, and punding. More frequently observed in males with early onset PD, ICDs are associated not only with comorbid affective symptoms, such as depression and anxiety, but also with behavioral traits, such as novelty seeking and impulsivity, as well as with personal or familial history of alcohol use. This constellation of associated risk factors highlights the importance of inter-individual differences in the vulnerability to develop comorbid psychiatric disorders in PD patients. Additionally, withdrawal from DRT in patients with ICDs frequently unmasks a severe apathetic state, suggesting that apathy and ICDs may be caused by overlapping neurobiological mechanisms within the cortico-striato-thalamo-cortical networks. We suggest that altered hedonic and impulse control processes represent distinct prodromal substrates for the development of these psychiatric symptoms, the etiopathogenic mechanisms of which remain unknown. Specifically, we argue that deficits in hedonic and motivational states and impulse control are mediated by overlapping, yet dissociable, neural mechanisms that differentially interact with DRT to promote the emergence of ICDs in vulnerable individuals. Thus, we provide a novel heuristic framework for basic and clinical research to better define and treat comorbid ICDs in PD.
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Affiliation(s)
- Jean-Luc Houeto
- Service de Neurologie, CIC-INSERM 1402, CHU de Poitiers, Université de Poitiers , Poitiers , France
| | - Robin Magnard
- INSERM U1216, Grenoble Institut des Neurosciences (GIN), University Grenoble Alpes , Grenoble , France
| | - Jeffrey W Dalley
- Department of Psychology, University of Cambridge, Cambridge, UK; Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - David Belin
- Department of Pharmacology, University of Cambridge , Cambridge , UK
| | - Sebastien Carnicella
- INSERM U1216, Grenoble Institut des Neurosciences (GIN), University Grenoble Alpes , Grenoble , France
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