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Spencer H, Anderton RS. Trait Impulsivity as a Feature of Parkinson's Disease Treatment and Progression. PARKINSON'S DISEASE 2024; 2024:8770997. [PMID: 38766569 PMCID: PMC11102119 DOI: 10.1155/2024/8770997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 04/15/2024] [Accepted: 04/17/2024] [Indexed: 05/22/2024]
Abstract
Heightened trait impulsivity in both subclinical and pathological senses is becoming increasingly recognised in Parkinson's disease (PD). Impulsive behaviours and impulse control disorders (ICDs) are a consequence of perturbation to the rewards pathway leading individuals to conduct activities in a repetitive, excessive, and maladaptive fashion. Commonly linked to PD, heightened trait impulsivity has been found to primarily manifest in the forms of hypersexuality, pathological gambling, compulsive shopping, and binge eating, all of which may significantly impact social and financial standing. Subsequent burden to quality of life for both individuals with PD and caregivers are common. Although risk factors and indicators for ICDs in PD are currently lacking, it is recognised that the condition is often precipitated by dopamine replacement therapies, primarily dopamine agonist administration. While this nonmotor symptom is being increasingly diagnosed in PD populations, it remains relatively elusive in comparison to its motor counterparts. Through discussion of impulsivity characteristics, neuroanatomy, and neurochemistry, in addition to reviewing existing research on the potential contributing factors to impulsivity in PD, this review highlights impulsivity as a significant and detrimental PD symptom. Thus, emphasising the imperative need to establish efficacious diagnostic tools and treatments.
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Affiliation(s)
- Holly Spencer
- School of Health Sciences, University of Notre Dame Australia, Fremantle, WA, Australia
| | - Ryan S. Anderton
- School of Health Sciences, University of Notre Dame Australia, Fremantle, WA, Australia
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Byrne MK, Cook R, Murta JCD, Bressington D, Meyer BJ. Dietary Intakes of Long-Chain Polyunsaturated Fatty Acids and Impulsivity: Comparing Non-Restricted, Vegetarian, and Vegan Diets. Nutrients 2024; 16:875. [PMID: 38542786 PMCID: PMC10975088 DOI: 10.3390/nu16060875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/08/2024] [Accepted: 03/15/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND Research suggests a link between deficiencies in omega-3 long-chain polyunsaturated fatty acids (LCPUFAs) and impulsivity among psychiatric populations. However, this association is less evident in non-clinical populations. As omega-3 LCPUFAs are predominantly sourced through fish consumption, non-fish dieters may be more vulnerable to higher impulsivity. METHODS This cross-sectional observational study explored the association between lower intakes of omega-3 LCPUFA food sources and higher self-reported measures of impulsivity among healthy adults consuming non-restricted, vegetarian, and vegan diets. RESULTS The results from the validated Food Frequency Questionnaire showed significantly lower estimated omega-3 LCPUFA intakes among vegans and vegetarians when compared with people consuming non-restricted diets. Furthermore, although all groups scored within the normal range of impulsivity measures, vegans scored comparatively higher. Vegans also scored significantly higher in impulsivity control relating to attention than those consuming non-restricted diets. CONCLUSIONS The significantly lower omega-3 LCPUFA dietary intakes in the vegan diets were associated with higher scores in the second-order attentional aspect of self-reported impulsiveness.
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Affiliation(s)
- Mitchell K. Byrne
- Faculty of Health, Charles Darwin University, Ellengowan Drive, Darwin, NT 0810, Australia; (M.K.B.); (R.C.); (J.C.D.M.); (D.B.)
| | - Rebecca Cook
- Faculty of Health, Charles Darwin University, Ellengowan Drive, Darwin, NT 0810, Australia; (M.K.B.); (R.C.); (J.C.D.M.); (D.B.)
| | - Janina C. D. Murta
- Faculty of Health, Charles Darwin University, Ellengowan Drive, Darwin, NT 0810, Australia; (M.K.B.); (R.C.); (J.C.D.M.); (D.B.)
| | - Daniel Bressington
- Faculty of Health, Charles Darwin University, Ellengowan Drive, Darwin, NT 0810, Australia; (M.K.B.); (R.C.); (J.C.D.M.); (D.B.)
- Faculty of Nursing, Chiang Mai University, 110/406 Inthawaroros Road, Sri Phum District, Chiang Mai 50200, Thailand
| | - Barbara J. Meyer
- School of Medical, Indigenous and Health Sciences, Lipid Research Centre, Molecular Horizons, University of Wollongong, Wollongong, NSW 2522, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia
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3
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Bakeberg MC, Gorecki AM, Kenna JE, Jefferson A, Byrnes M, Ghosh S, Horne MK, McGregor S, Stell R, Walters S, Mastaglia FL, Anderton RS. Elevated HDL Levels Linked to Poorer Cognitive Ability in Females With Parkinson's Disease. Front Aging Neurosci 2021; 13:656623. [PMID: 34177552 PMCID: PMC8226251 DOI: 10.3389/fnagi.2021.656623] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/10/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction Cholesterol levels have been associated with age-related cognitive decline, however, such an association has not been comprehensively explored in people with Parkinson's disease (PD). To address this uncertainty, the current cross-sectional study examined the cholesterol profile and cognitive performance in a cohort of PD patients. Methods Cognitive function was evaluated using two validated assessments (ACE-R and SCOPA-COG) in 182 people with PD from the Australian Parkinson's Disease Registry. Total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and Triglyceride (TRG) levels were examined within this cohort. The influence of individual lipid subfractions on domain-specific cognitive performance was investigated using covariate-adjusted generalised linear models. Results Females with PD exhibited significantly higher lipid subfraction levels (TC, HDL, and LDL) when compared to male counterparts. While accounting for covariates, HDL levels were strongly associated with poorer performance across multiple cognitive domains in females but not males. Conversely, TC and LDL levels were not associated with cognitive status in people with PD. Conclusion Higher serum HDL associates with poorer cognitive function in females with PD and presents a sex-specific biomarker for cognitive impairment in PD.
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Affiliation(s)
- Megan C Bakeberg
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia
| | - Anastazja M Gorecki
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,School of Biological Sciences, The University of Western Australia, Perth, WA, Australia
| | - Jade E Kenna
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia
| | - Alexa Jefferson
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Michelle Byrnes
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia
| | - Soumya Ghosh
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia
| | - Malcolm K Horne
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia.,Centre for Clinical Neurosciences and Neurological Research, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Sarah McGregor
- Centre for Clinical Neurosciences and Neurological Research, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Rick Stell
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia
| | - Sue Walters
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia
| | - Ryan S Anderton
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia.,School of Health Sciences, Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA, Australia
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Giovannelli F, Menichetti C, Kiferle L, Raglione LM, Brotini S, Vanni P, Bacci D, Baldini M, Borgheresi A, Del Bene A, Grassi E, Guidi L, Toscani L, Volpi G, Palumbo P, Viggiano MP, Cincotta M. Impulsivity traits and awareness of motor intention in Parkinson's disease: a proof-of-concept study. Neurol Sci 2021; 43:335-340. [PMID: 34050422 DOI: 10.1007/s10072-021-05325-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 05/15/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION In patients with Parkinson's disease (PD), impulsivity is still a matter of investigation. It has been hypothesized that impulsive personality traits may favour impulse control disorder (ICD) onset during dopaminergic therapy. In healthy subjects, a relationship between the awareness of motor intention and impulsive personality traits assessed by the Barratt impulsivity scale (BIS-11) has been reported. The aim of this study was to evaluate the relationship between the awareness of voluntary action and impulsivity traits in PD. METHODS Twenty-eight PD patients (stages I-III on the Hoehn and Yahr scale) underwent an impulsivity trait assessment by the BIS-11 scale and a task based on the Libet's clock. Participants were requested to perform a self-initiated movement and report the time they first feel their intention to move (W-judgement) or the time of the actual movement (M-judgement). RESULTS In patients with higher BIS-11 scores, the time lag between the W-judgement and the actual movement was significantly lower than in patients with lower BIS-11. No difference emerged in the M-judgement. CONCLUSION Data suggest that also in PD patients, the impulsive personality trait is related to a "delayed" awareness of motor intention and therefore to a shorter interval to allow a conscious "veto" of the impending action. Characterization of the temporal profile of awareness of motor intention could prove useful in identifying PD patients at risk of developing ICDs during dopaminergic treatment.
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Affiliation(s)
- Fabio Giovannelli
- Section of Psychology - Department of Neuroscience, Psychology, Drug Research and Child's Health (NEUROFARBA), University of Florence, Florence, Italy.,Unit of Neurology of Florence, Cerebrovascular and Neurodegenerative Disease Area of the Department of Medical Specialties, Central Tuscany Local Health Authority, Florence, Italy
| | - Chiara Menichetti
- Unit of Neurology of Pistoia, Cerebrovascular and Neurodegenerative Disease Area of the Department of Medical Specialties, Central Tuscany Local Health Authority, Florence, Italy
| | - Lorenzo Kiferle
- Unit of Neurology of Prato, Cerebrovascular and Neurodegenerative Disease Area of the Department of Medical Specialties, Central Tuscany Local Health Authority, Florence, Italy
| | - Laura Maria Raglione
- Unit of Neurology of Florence, Cerebrovascular and Neurodegenerative Disease Area of the Department of Medical Specialties, Central Tuscany Local Health Authority, Florence, Italy
| | - Stefania Brotini
- Unit of Neurology of Empoli, Cerebrovascular and Neurodegenerative Disease Area of the Department of Medical Specialties, Central Tuscany Local Health Authority, Florence, Italy
| | - Paola Vanni
- Unit of Neurology of Florence-OSMA, Cerebrovascular and Neurodegenerative Disease Area of the Department of Medical Specialties, Central Tuscany Local Health Authority, Florence, Italy
| | - Duccio Bacci
- Unit of Neurology of Florence-OSMA, Cerebrovascular and Neurodegenerative Disease Area of the Department of Medical Specialties, Central Tuscany Local Health Authority, Florence, Italy
| | - Mariella Baldini
- Unit of Neurology of Empoli, Cerebrovascular and Neurodegenerative Disease Area of the Department of Medical Specialties, Central Tuscany Local Health Authority, Florence, Italy
| | - Alessandra Borgheresi
- Unit of Neurology of Florence, Cerebrovascular and Neurodegenerative Disease Area of the Department of Medical Specialties, Central Tuscany Local Health Authority, Florence, Italy
| | - Alessandra Del Bene
- Unit of Neurology of Pistoia, Cerebrovascular and Neurodegenerative Disease Area of the Department of Medical Specialties, Central Tuscany Local Health Authority, Florence, Italy
| | - Enrico Grassi
- Unit of Neurology of Prato, Cerebrovascular and Neurodegenerative Disease Area of the Department of Medical Specialties, Central Tuscany Local Health Authority, Florence, Italy
| | - Leonello Guidi
- Unit of Neurology of Empoli, Cerebrovascular and Neurodegenerative Disease Area of the Department of Medical Specialties, Central Tuscany Local Health Authority, Florence, Italy
| | - Lucia Toscani
- Unit of Neurology of Florence-OSMA, Cerebrovascular and Neurodegenerative Disease Area of the Department of Medical Specialties, Central Tuscany Local Health Authority, Florence, Italy
| | - Gino Volpi
- Unit of Neurology of Pistoia, Cerebrovascular and Neurodegenerative Disease Area of the Department of Medical Specialties, Central Tuscany Local Health Authority, Florence, Italy
| | - Pasquale Palumbo
- Unit of Neurology of Prato, Cerebrovascular and Neurodegenerative Disease Area of the Department of Medical Specialties, Central Tuscany Local Health Authority, Florence, Italy
| | - Maria Pia Viggiano
- Section of Psychology - Department of Neuroscience, Psychology, Drug Research and Child's Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Massimo Cincotta
- Unit of Neurology of Florence, Cerebrovascular and Neurodegenerative Disease Area of the Department of Medical Specialties, Central Tuscany Local Health Authority, Florence, Italy.
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Shakeshaft A, Panjwani N, McDowall R, Crudgington H, Peña Ceballos J, Andrade DM, Beier CP, Fong CY, Gesche J, Greenberg DA, Hamandi K, Koht J, Lim KS, Orsini A, Rees MI, Rubboli G, Selmer KK, Smith AB, Striano P, Syvertsen M, Talvik I, Thomas RH, Zarubova J, Richardson MP, Strug LJ, Pal DK. Trait impulsivity in Juvenile Myoclonic Epilepsy. Ann Clin Transl Neurol 2020; 8:138-152. [PMID: 33264519 PMCID: PMC7818143 DOI: 10.1002/acn3.51255] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 01/22/2023] Open
Abstract
Objective Impulsivity is a multidimensional construct that can predispose to psychopathology. Meta‐analysis demonstrates an association between response impulsivity and Juvenile Myoclonic Epilepsy (JME), a common genetic generalized epilepsy. Here, we test the hypotheses that trait impulsivity is (i) elevated in JME compared to controls; (ii) moderated by specific seizure characteristics; and (iii) associated with psychiatric adverse effects of antiepileptic drugs (AEDs). Methods 322 participants with JME and 126 age and gender‐matched controls completed the Barratt’s Impulsiveness Scale (BIS‐brief) alongside information on seizure history and AED use. We compared group BIS‐brief scores and assessed associations of JME BIS‐brief scores with seizure characteristics and AED adverse effects. Results The mean BIS‐brief score in JME was 18.1 ± 4.4 compared with 16.2 ± 4.1 in controls (P = 0.0007). Elevated impulsivity was associated with male gender (P = 0.027), frequent absence seizures (P = 0.0004) and lack of morning predominance of myoclonus (P = 0.008). High impulsivity significantly increased the odds of a psychiatric adverse event on levetiracetam (P = 0.036), but not any other psychiatric or somatic adverse effects. Interpretation Trait impulsivity is elevated in JME and comparable to scores in personality and neurotic disorders. Increased seizure frequency and absence of circadian seizure pattern moderate BIS score, suggesting disruption of both cortico‐striatal and thalamocortical networks as a shared mechanism between seizures and impulsivity in JME. These findings warrant consideration of impulsivity as a distinct target of intervention, and as a stratifying factor for AED treatment in JME, and perhaps other types of epilepsy. The role of impulsivity in treatment adherence and psychosocial outcome requires further investigation.
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Affiliation(s)
- Amy Shakeshaft
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.,MRC Centre for Neurodevelopmental Disorders, King's College London, UK
| | | | - Robert McDowall
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Holly Crudgington
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Javier Peña Ceballos
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | | | | | - Choong Yi Fong
- Division of Paediatric Neurology, Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | | | - Jeanette Koht
- Department of Neurology, Drammen Hospital, Vestre Viken Health Trust, Oslo, Norway.,University of Oslo, Oslo, Norway
| | - Kheng Seang Lim
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Alessandro Orsini
- Department of Clinical & Experimental Medicine, Pisa University Hospital, Italy
| | - Mark I Rees
- Neurology Research Group, Swansea University Medical School, UK
| | - Guido Rubboli
- Danish Epilepsy Centre, Dianalund, Denmark.,University of Copenhagen, Denmark
| | - Kaja K Selmer
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Norway.,National Centre for Epilepsy, Oslo University Hospital, Norway
| | - Anna B Smith
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Pasquale Striano
- IRCCS Istituto 'G. Gaslini', Genova, Italy.,University of Genova, Genova, Italy
| | - Marte Syvertsen
- Department of Neurology, Drammen Hospital, Vestre Viken Health Trust, Oslo, Norway
| | | | - Rhys H Thomas
- Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
| | - Jana Zarubova
- Department of Neurology, Motol University Hospital, Prague, Czech Republic.,Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Mark P Richardson
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.,MRC Centre for Neurodevelopmental Disorders, King's College London, UK.,King's College Hospital, London, UK
| | | | - Deb K Pal
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.,MRC Centre for Neurodevelopmental Disorders, King's College London, UK.,King's College Hospital, London, UK.,Evelina London Children's Hospital, London, UK
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Scott BM, Eisinger RS, Burns MR, Lopes J, Okun MS, Gunduz A, Bowers D. Co-occurrence of apathy and impulse control disorders in Parkinson disease. Neurology 2020; 95:e2769-e2780. [PMID: 33004605 DOI: 10.1212/wnl.0000000000010965] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 07/22/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To empirically test whether apathy and impulse control disorders (ICDs) represent independent, opposite ends of a motivational spectrum. METHODS In this single-center, cross-sectional study, we obtained retrospective demographics and clinical data for 887 patients with idiopathic Parkinson disease (PD) seen at a tertiary care center. Mood and motivation disturbances were classified using recommended cutoff scores from self-reported measures of apathy, ICD, anxiety, and depression. RESULTS Prevalence rates included 29.0% of patients with PD with depression, 40.7% with anxiety, 41.3% with apathy, 27.6% with ICDs, and 17.0% with both apathy and ICD. The majority (61.6%) of people reporting clinically significant ICDs also reported clinically significant apathy, and more than a third of patients with apathy (41.3%) also reported elevated ICD. Anxiety and depression were highest in patients with both apathy and ≥1 ICDs. Dopamine agonist use was higher in people with only ICD compared to people with only apathy. Mood significantly interacted with demographic variables to predict motivational disturbances. CONCLUSIONS Motivational disturbances are common comorbid conditions in patients with PD. In addition, these complex behavioral syndromes interact with mood in clinically important ways that may influence the design of future clinical trials and the development of novel therapies. This study challenges the concept of apathy and ICD in PD as opposite ends of a spectrum.
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Affiliation(s)
- Bonnie M Scott
- From the Department of Clinical and Health Psychology (B.M.S., D.B.), Departments of Neuroscience (R.S.E., A.G.) and Neurology (M.R.B., J.L., M.S.O.), Norman Fixel Institute of Neurological Diseases, and J. Crayton Pruitt Department of Biomedical Engineering (A.G.), University of Florida, Gainesville.
| | - Robert S Eisinger
- From the Department of Clinical and Health Psychology (B.M.S., D.B.), Departments of Neuroscience (R.S.E., A.G.) and Neurology (M.R.B., J.L., M.S.O.), Norman Fixel Institute of Neurological Diseases, and J. Crayton Pruitt Department of Biomedical Engineering (A.G.), University of Florida, Gainesville
| | - Matthew R Burns
- From the Department of Clinical and Health Psychology (B.M.S., D.B.), Departments of Neuroscience (R.S.E., A.G.) and Neurology (M.R.B., J.L., M.S.O.), Norman Fixel Institute of Neurological Diseases, and J. Crayton Pruitt Department of Biomedical Engineering (A.G.), University of Florida, Gainesville
| | - Janine Lopes
- From the Department of Clinical and Health Psychology (B.M.S., D.B.), Departments of Neuroscience (R.S.E., A.G.) and Neurology (M.R.B., J.L., M.S.O.), Norman Fixel Institute of Neurological Diseases, and J. Crayton Pruitt Department of Biomedical Engineering (A.G.), University of Florida, Gainesville
| | - Michael S Okun
- From the Department of Clinical and Health Psychology (B.M.S., D.B.), Departments of Neuroscience (R.S.E., A.G.) and Neurology (M.R.B., J.L., M.S.O.), Norman Fixel Institute of Neurological Diseases, and J. Crayton Pruitt Department of Biomedical Engineering (A.G.), University of Florida, Gainesville
| | - Aysegul Gunduz
- From the Department of Clinical and Health Psychology (B.M.S., D.B.), Departments of Neuroscience (R.S.E., A.G.) and Neurology (M.R.B., J.L., M.S.O.), Norman Fixel Institute of Neurological Diseases, and J. Crayton Pruitt Department of Biomedical Engineering (A.G.), University of Florida, Gainesville
| | - Dawn Bowers
- From the Department of Clinical and Health Psychology (B.M.S., D.B.), Departments of Neuroscience (R.S.E., A.G.) and Neurology (M.R.B., J.L., M.S.O.), Norman Fixel Institute of Neurological Diseases, and J. Crayton Pruitt Department of Biomedical Engineering (A.G.), University of Florida, Gainesville
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Bakeberg MC, Riley M, Byrnes M, Jefferson A, Ghosh S, Horne MK, McGregor S, Stell R, Walters S, Evans T, Roberts K, Mastaglia FL, Anderton RS. Elevated Serum Ceruloplasmin Levels Are Associated with Higher Impulsivity in People with Parkinson's Disease. PARKINSON'S DISEASE 2020; 2020:8296203. [PMID: 33062249 PMCID: PMC7545407 DOI: 10.1155/2020/8296203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/21/2020] [Accepted: 09/19/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Heightened impulsivity has been reported in a subset of people with Parkinson's disease (PwP) and is considered a risk factor for the development of impulse control disorders (ICDs). However, at present, there are no recognised biochemical markers of heightened impulsivity. OBJECTIVES To determine if ceruloplasmin, a serum marker involved in the regulation of iron and copper homeostasis, is associated with trait impulsivity in PwP. METHODS The study measured serum ceruloplasmin and impulsivity using the Barratt Impulsiveness Scale (BIS-11) in an Australian cohort of 214 PwP. Multivariate general linear models (GLMs) were used to identify whether higher serum ceruloplasmin levels (>75th percentile) were significantly predictive of BIS-11 scores. RESULTS Serum ceruloplasmin was higher in females with PD (p < 0.001) and associated with MDS-UPDRS III, Hoehn and Yahr, and ACE-R scores (p < 0.05). When correcting for covariates, higher serum ceruloplasmin concentrations were associated with the 2nd order nonplanning impulsivity and with the 1st order self-control and cognitive complexity impulsivity domains. CONCLUSIONS Higher serum ceruloplasmin levels are independently associated with heightened nonplanning impulsivity in PwP. Thus, serum ceruloplasmin levels may have clinical utility as a marker for heightened impulsivity in PD.
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Affiliation(s)
- Megan C. Bakeberg
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, Western Australia, Australia
| | - Maddeson Riley
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
- School of Health Sciences, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Michelle Byrnes
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, Western Australia, Australia
| | - Alexa Jefferson
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
| | - Souyma Ghosh
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, Western Australia, Australia
| | - Malcom K. Horne
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria 3010, Australia
- Centre for Clinical Neurosciences and Neurological Research, St. Vincent's Hospital Melbourne, Fitzroy, Victoria 3065, Australia
| | - Sarah McGregor
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria 3010, Australia
- Centre for Clinical Neurosciences and Neurological Research, St. Vincent's Hospital Melbourne, Fitzroy, Victoria 3065, Australia
| | - Rick Stell
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, Western Australia, Australia
| | - Sue Walters
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, Western Australia, Australia
| | - Tess Evans
- Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Katherine Roberts
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, Western Australia, Australia
| | - Frank L. Mastaglia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, Western Australia, Australia
- Centre for Molecular Medicine & Innovative Therapeutics, Murdoch University, Perth, Western Australia, Australia
| | - Ryan S. Anderton
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, Western Australia, Australia
- School of Health Sciences, University of Notre Dame Australia, Fremantle, Western Australia, Australia
- Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia
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Increased large-scale inter-network connectivity in relation to impulsivity in Parkinson's disease. Sci Rep 2020; 10:11418. [PMID: 32651411 PMCID: PMC7351767 DOI: 10.1038/s41598-020-68266-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 06/11/2020] [Indexed: 12/21/2022] Open
Abstract
Impulsivity is a neuropsychiatric feature of Parkinson’s disease (PD). We investigated the pathophysiology of impulsivity in PD using resting-state functional magnetic resonance imaging (rs-fMRI). We investigated 45 patients with idiopathic PD and 21 healthy controls. Based on Barratt Impulsiveness Scale (BIS-11) score, PD patients were classified as higher (PD-HI) or lower impulsivity (PD-LI). Functional connectivity (FC) between various large-scale brain networks were analysed using the CONN toolbox. FC between the right frontoparietal network (FPN) and medial visual network (MVN) was significantly higher in PD-HI patients than PD-LI patients (false discovery rate [FDR]-adjusted p = 0.0315). FC between the right FPN and MVN had a significant positive correlation with total BIS-11 score (FDR-adjusted p = 0.010) and the attentional impulsivity (FDR-adjusted p = 0.046) and non-planning impulsivity subscale scores (FDR-adjusted p = 0.018). On the other hand, motor impulsivity subscale score had a significant negative correlation with the FC between the default-mode and salience networks (right supramarginal gyrus, FDR-adjusted p = 0.018; anterior cingulate cortex, FDR-adjusted p = 0.027); this trend was observed in healthy controls. The attentional and non-planning impulsivity, regarded as ‘cognitive’ impulsivity, may be associated with dysfunction in integration of perceptual information and flexible cognitive control in PD.
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Trait Impulsivity Is Independent of Mild Cognitive Impairment in a Parkinson's Disease Cohort. PARKINSONS DISEASE 2019; 2019:2672075. [PMID: 31662842 PMCID: PMC6791270 DOI: 10.1155/2019/2672075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/07/2019] [Accepted: 09/12/2019] [Indexed: 01/16/2023]
Abstract
Introduction Patients with Parkinson's disease (PD) commonly experience cognitive deficits and some also develop impulse control disorders (ICDs); however, the relationship between impulsivity and cognitive dysfunction remains unclear. This study investigated whether trait impulsivity associates with mild cognitive impairment (MCI), or is altered in a PD patient cohort with MCI. Methods A total of 302 patients with idiopathic PD were recruited sequentially from three Australian Movement Disorder clinics. Based on cognitive scores, participants were divided into two groups, one defined as having mild cognitive impairment (PD-MCI; n = 113) and the other with normal cognitive function (PD-C; n = 189). Trait impulsivity was evaluated using the Barrett Impulsiveness Scale 11 (BIS-11). Total impulsivity scores, as well as subscale scores, were compared between PD-C and PD-MCI groups. Results The PD-MCI cohort had significantly lower scores in all cognitive domains, and mirrored expected clinical differences in medication, motor symptoms, and disease duration, when compared to the PD-C cohort. Self-reported impulsivity was not significantly different between groups, nor was there a difference within first-order subscale scores: attention (p=0.137), cognitive instability (p=0.787), self-control (p=0.503), cognitive complexity (p=0.157), motor impulsivity (p=0.559), or perseverance (p=0.734) between the PD-MCI and PD-C groups. Conclusions These findings suggest that impulsive traits and behaviors are independent of changes in cognitive state and are not altered in PD patients with mild cognitive impairment.
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Eisinger RS, Ramirez-Zamora A, Carbunaru S, Ptak B, Peng-Chen Z, Okun MS, Gunduz A. Medications, Deep Brain Stimulation, and Other Factors Influencing Impulse Control Disorders in Parkinson's Disease. Front Neurol 2019; 10:86. [PMID: 30863353 PMCID: PMC6399407 DOI: 10.3389/fneur.2019.00086] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 01/22/2019] [Indexed: 12/18/2022] Open
Abstract
Impulse control disorders (ICDs) in Parkinson's disease (PD) have a high cumulative incidence and negatively impact quality of life. ICDs are influenced by a complex interaction of multiple factors. Although it is now well-recognized that dopaminergic treatments and especially dopamine agonists underpin many ICDs, medications alone are not the sole cause. Susceptibility to ICD is increased in the setting of PD. While causality can be challenging to ascertain, a wide range of modifiable and non-modifiable risk factors have been linked to ICDs. Common characteristics of PD patients with ICDs have been consistently identified across many studies; for example, males with an early age of PD onset and dopamine agonist use have a higher risk of ICD. However, not all cases of ICDs in PD can be directly attributable to dopamine, and studies have concluded that additional factors such as genetics, smoking, and/or depression may be more predictive. Beyond dopamine, other ICD associations have been described but remain difficult to explain, including deep brain stimulation surgery, especially in the setting of a reduction in dopaminergic medication use. In this review, we will summarize the demographic, genetic, behavioral, and clinical contributions potentially influencing ICD onset in PD. These associations may inspire future preventative or therapeutic strategies.
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Affiliation(s)
- Robert S. Eisinger
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Adolfo Ramirez-Zamora
- Hospital Padre Hurtado, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Samuel Carbunaru
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Brandon Ptak
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Zhongxing Peng-Chen
- Hospital Padre Hurtado, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Michael S. Okun
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
- Department of Neurology, Fixel Center for Neurological Diseases, University of Florida, Gainesville, FL, United States
| | - Aysegul Gunduz
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
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