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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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2
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Dormegny-Jeanjean LC, Mainberger OAE, de Crespin de Billy C, Obrecht A, Danila V, Erb A, Arcay HM, Weibel S, Blanc F, Meyer G, Tomsa M, Bertschy G, Duval F, Foucher JR. Safety and tolerance of combination of monoamine oxidase inhibitors and direct dopamine agonists in adults and older adults with highly resistant depression. L'ENCEPHALE 2024; 50:137-142. [PMID: 37005193 DOI: 10.1016/j.encep.2023.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/09/2023] [Accepted: 01/27/2023] [Indexed: 04/03/2023]
Abstract
INTRODUCTION Dopamine (DA) is likely to be involved in some depressive dimensions, such as anhedonia and amotivation, which account for a part of treatment-resistant forms. Monoamine oxidase inhibitors (MAOI) and direct D2 and D3 receptors agonists (D2/3r-dAG) are known to help, but we lack safety data about their combined usage. We report on safety and tolerance of the MAOI+D2r-dAG combination in a clinical series. METHOD All patients referred to our recourse center for depression between 2013 and 2021 were screened to select those who did receive the combo. Data were extracted from clinical files. RESULTS Sixteen patients of 60±17 years of age (8 women, 7 with age>65years, all suffered from treatment resistant depression, 7 with bipolar disorder) received the combo. There were no life-threatening adverse effects (AE). However, AE were reported by 14 patients (88%) most of which were mild and consisted of insomnia, nausea, nervousness, confusion, impulse control disorder and/or "sleep attacks". One patient presented a serious AE requiring a short hospitalization for confusion. Intolerance led to failure to introduce treatment in two patients (13%). The retrospective non-interventional design, the variety of molecules, and the modest sample size limited the scope of these results. CONCLUSION There was no life-threatening safety issue in combining MAOI and D2/3r-dAG, especially regarding cardiovascular side effects. The systematic screening of AE might account for their frequency, but these precluded the treatment in only two patients. Comparative studies are needed to assess the efficacy of this new combination.
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Affiliation(s)
- L C Dormegny-Jeanjean
- Non-Invasive neuroModulation Center of Strasbourg (CEMNIS), University Hospital of Strasbourg, 67000 Strasbourg, France; CNRS UMR 7357 iCube, neurophysiology, FMTS, University of Strasbourg, 67000 Strasbourg, France.
| | - O A E Mainberger
- Non-Invasive neuroModulation Center of Strasbourg (CEMNIS), University Hospital of Strasbourg, 67000 Strasbourg, France; CNRS UMR 7357 iCube, neurophysiology, FMTS, University of Strasbourg, 67000 Strasbourg, France
| | - C de Crespin de Billy
- Non-Invasive neuroModulation Center of Strasbourg (CEMNIS), University Hospital of Strasbourg, 67000 Strasbourg, France; CNRS UMR 7357 iCube, neurophysiology, FMTS, University of Strasbourg, 67000 Strasbourg, France
| | - A Obrecht
- Non-Invasive neuroModulation Center of Strasbourg (CEMNIS), University Hospital of Strasbourg, 67000 Strasbourg, France; CNRS UMR 7357 iCube, neurophysiology, FMTS, University of Strasbourg, 67000 Strasbourg, France
| | - V Danila
- Department of Psychiatry "pole 8/9", Rouffach Psychiatric Hospital, 68250 Rouffach, France
| | - A Erb
- Department of Psychiatry "pole 8/9", Rouffach Psychiatric Hospital, 68250 Rouffach, France
| | - H M Arcay
- CNRS UMR 7357 iCube, neurophysiology, FMTS, University of Strasbourg, 67000 Strasbourg, France
| | - S Weibel
- Department of Psychiatry and Mental Health-University Hospital of Strasbourg, University of Strasbourg, 67000 Strasbourg, France; Inserm UMR 1114, Physiopathology and Cognitive Psychopathology of Schizophrenia, University of Strasbourg, 67000 Strasbourg, France
| | - F Blanc
- CNRS UMR 7357 iCube, neurophysiology, FMTS, University of Strasbourg, 67000 Strasbourg, France; Geriatrics Department and Expert Center for Neurocognitive Disorders, University Hospital of Strasbourg, University of Strasbourg, 67000 Strasbourg, France
| | - G Meyer
- Pharmacopsy Alsace, Clinical Pharmacy Department, Établissement Public de Santé Alsace Nord, Brumath, France; Pharmacy Department, University Hospital of Strasbourg, 67000 Strasbourg, France
| | - M Tomsa
- Department of Psychiatry "pole 8/9", Rouffach Psychiatric Hospital, 68250 Rouffach, France
| | - G Bertschy
- Department of Psychiatry and Mental Health-University Hospital of Strasbourg, University of Strasbourg, 67000 Strasbourg, France; Inserm UMR 1114, Physiopathology and Cognitive Psychopathology of Schizophrenia, University of Strasbourg, 67000 Strasbourg, France
| | - F Duval
- Department of Psychiatry "pole 8/9", Rouffach Psychiatric Hospital, 68250 Rouffach, France
| | - J R Foucher
- Non-Invasive neuroModulation Center of Strasbourg (CEMNIS), University Hospital of Strasbourg, 67000 Strasbourg, France; CNRS UMR 7357 iCube, neurophysiology, FMTS, University of Strasbourg, 67000 Strasbourg, France
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Austgen G, Marsh L. Cognitive dysfunction and neuropsychiatric aspects of Parkinson's disease. PROGRESS IN BRAIN RESEARCH 2022; 269:59-90. [PMID: 35248207 DOI: 10.1016/bs.pbr.2022.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Movement abnormalities, by definition, and cognitive changes, to varying extents, affect every patient with Parkinson's disease (PD) and are attributed to the underlying neurodegenerative disease. Various psychiatric disorders occur in most patients at some point over the course of PD, including in the prodromal phase. Even though psychiatric disturbances tend to aggravate motor and cognitive deficits, they are under-recognized and under-treated, and the role of the underlying neurological disease is often minimized. To provide an integrated approach to understanding neuropsychiatric aspects of PD, this chapter reviews how cognitive changes in PD relate to the common psychiatric disturbances in PD along with the prevalence, phenomenology, pathophysiology, and treatment of each.
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Affiliation(s)
- Gabriela Austgen
- Behavioral Neurology & Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Laura Marsh
- Mental Health Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Professor, Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences and Department of Neurology, Baylor College of Medicine, Houston, TX, United States.
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Tripathi A, Gupta PK, Bansal T. Management of Psychiatric Disorders in Patients with Parkinson's Diseases. Indian J Psychiatry 2022; 64:S330-S343. [PMID: 35602377 PMCID: PMC9122177 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_29_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 01/04/2022] [Accepted: 01/10/2022] [Indexed: 11/18/2022] Open
Abstract
Parkinson's disease (PD) is a heterogeneous progressive neurodegenerative disorder, with a triad of motor symptoms with akinesia/bradykinesia, resting tremor (4-6 Hz), and rigidity. It is the second most common neurodegenerative disease after Alzheimer's disease. The overall management of PD depends on the status of symptoms, functioning of the patients, impairment, disability, and its impact on quality of life. Depression, anxiety disorders, apathy, anhedonia, psychosis, cognitive impairments, dementia, and impulse control disorders (ICDs) are the common psychiatric symptoms/disorders comorbid with PD. Depression remains the most common psychiatric disorder reported to be comorbid with PD. Several pharmacological and nonpharmacological management strategies are used for the treatment of comorbid psychiatric disorders in PD. Selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors are used to treat depression in patients with PD. The best evidence of efficacy in PD psychosis is for clozapine and pimavanserin. The treatment for cognitive impairments in PD remains poorly researched. Rivastigmine is the only approved treatment for PD as per the Food and Drug Administration. Pramipexole, a dopamine agonist (DA), is reported to cause improvement in the symptoms of decreased willingness in apathy. The treatment approaches for different sleep disorders in PD are different. Identifying the cause, reviewing the patient's ongoing medications, and evaluating the impact of comorbid medical conditions and sleep hygiene are common to all conditions related to sleep disorders. The first approach for treating ICD symptoms is the reduction or discontinuation of DAs. The psychiatric symptoms in patients with PD are highly prevalent, and their management should be included in the basic treatment algorithm for PD. This paper summarizes common psychiatric symptoms/disorders in PD and their management approaches.
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Affiliation(s)
- Adarsh Tripathi
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Pawan Kumar Gupta
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Teena Bansal
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
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Rodríguez-Violante M, Ríos-Solís Y, Esquivel-Zapata O, Herrera F, López-Alamillo S, Sarabia-Tapia C, Cervantes-Arriaga A. Assessment of therapeutic strategies for management of impulse control disorder in Parkinson's disease. ARQUIVOS DE NEURO-PSIQUIATRIA 2021; 79:989-994. [PMID: 34816991 DOI: 10.1590/0004-282x-anp-2020-0507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/13/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Impulse control disorders (ICD) occur frequently in individuals with Parkinson's disease. So far, prevention is the best treatment. Several strategies for its treatment have been suggested, but their frequency of use and benefit have scarcely been explored. OBJECTIVE To investigate which strategy is the most commonly used in a real-life setting and its rate of response. METHODS A longitudinal study was conducted. At the baseline evaluation, data on current treatment and ICD status according to QUIP-RS were collected. The treatment strategies were categorized as "no-change", dopamine agonist (DA) dose lowering, DA removal, DA switch or add-on therapy. At the six-month follow-up visit, the same tools were applied. RESULTS A total of 132 individuals (58.3% men) were included; 18.2% had at least one ICD at baseline. The therapeutic strategy most used in the ICD group was no-change (37.5%), followed by DA removal (16.7%), DA switch (12.5%) and DA lowering (8.3%). Unexpectedly, in 20.8% of the ICD subjects the DA dose was increased. Overall, nearly 80% of the subjects showed remission of their ICD at follow-up. CONCLUSIONS Regardless of the therapy used, most of the subjects presented remission of their ICD at follow-up Further research with a longer follow-up in a larger sample, with assessment of decision-making processes, is required in order to better understand the efficacy of strategies for ICD treatment.
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Affiliation(s)
- Mayela Rodríguez-Violante
- National Institute of Neurology and Neurosurgery, Clinical Neurodegenerative Research Unit, Mexico City, Mexico.,National Institute of Neurology and Neurosurgery, Movement Disorder Clinic, Mexico City, Mexico
| | - Yazmín Ríos-Solís
- National Institute of Neurology and Neurosurgery, Clinical Neurodegenerative Research Unit, Mexico City, Mexico
| | - Oscar Esquivel-Zapata
- National Institute of Neurology and Neurosurgery, Clinical Neurodegenerative Research Unit, Mexico City, Mexico
| | - Fanny Herrera
- National Institute of Neurology and Neurosurgery, Clinical Neurodegenerative Research Unit, Mexico City, Mexico.,National Institute of Neurology and Neurosurgery, Movement Disorder Clinic, Mexico City, Mexico
| | - Susana López-Alamillo
- National Institute of Neurology and Neurosurgery, Clinical Neurodegenerative Research Unit, Mexico City, Mexico
| | - Cynthia Sarabia-Tapia
- National Institute of Neurology and Neurosurgery, Clinical Neurodegenerative Research Unit, Mexico City, Mexico
| | - Amin Cervantes-Arriaga
- National Institute of Neurology and Neurosurgery, Clinical Neurodegenerative Research Unit, Mexico City, Mexico.,National Institute of Neurology and Neurosurgery, Movement Disorder Clinic, Mexico City, Mexico
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Marmol S, Feldman M, Singer C, Margolesky J. Amantadine Revisited: A Contender for Initial Treatment in Parkinson's Disease? CNS Drugs 2021; 35:1141-1152. [PMID: 34648150 DOI: 10.1007/s40263-021-00862-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 10/20/2022]
Abstract
The best practice for the initiation of symptomatic motor treatment for Parkinson's disease is an ongoing topic of debate. Fueled by interpretation of the results of the LEAP and MED Parkinson's disease studies, many practitioners opt for early initiation of levodopa formulations, avoiding dopamine agonists to circumvent potential deleterious side effects, namely impulse control disorder. Compared with levodopa, monoamine oxidase inhibitors may lack necessary potency. Ignored in this academic debate is another therapeutic option for patients with Parkinson's disease requiring treatment initiation: amantadine. Amantadine was first reported effective in the treatment of Parkinson's disease in 1969 and several studies were published in the 1970s supporting its efficacy. Currently, amantadine is mainly utilized as an add-on therapy to mitigate levodopa-related dyskinesia and, more recently, new long-acting amantadine formulations have been developed, with new indications to treat motor fluctuations. Amantadine has not been reported to cause dyskinesia and is rarely implicated in impulse control disorder.
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Affiliation(s)
- Sarah Marmol
- Department of Neurology, University of Miami Miller School of Medicine, 1150 NW 14th Street, Suite 609, Miami, FL, 33136, USA
| | - Matthew Feldman
- Department of Neurology, University of Miami Miller School of Medicine, 1150 NW 14th Street, Suite 609, Miami, FL, 33136, USA
| | - Carlos Singer
- Department of Neurology, University of Miami Miller School of Medicine, 1150 NW 14th Street, Suite 609, Miami, FL, 33136, USA
| | - Jason Margolesky
- Department of Neurology, University of Miami Miller School of Medicine, 1150 NW 14th Street, Suite 609, Miami, FL, 33136, USA.
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Grassi G, Albani G, Terenzi F, Razzolini L, Ramat S. New pharmacological and neuromodulation approaches for impulsive-compulsive behaviors in Parkinson's disease. Neurol Sci 2021; 42:2673-2682. [PMID: 33852081 DOI: 10.1007/s10072-021-05237-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/07/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION A significant proportion of patients with Parkinson's disease (PD) display a set of impulsive-compulsive behaviors at some point during the course of illness. These behaviors range from the so-called behavioral addictions to dopamine dysregulation syndrome, punding and hoarding disorders. These behaviors have been consistently linked to the use of dopaminergic medications used to treat PD motor symptoms (dopamine agonists, levodopa, and other agents) and less consistently to neuromodulation techniques such as deep brain stimulation (DBS). Since there are still no approved treatments for these conditions, their pharmacological management is still a big challenge for clinicians. METHODS We conducted an extensive review of current pharmacological and neuromodulation literature for the management of impulsive-compulsive disorders in PD patients. RESULTS Pharmacological treatment approaches for impulsive-compulsive behaviors and DDS in PD patients include reduction of levodopa (LD), reduction/cessation of dopamine agonist (DA), and initiation of infusion therapies (apomorphine infusion and duodopa). Also, atomoxetine, a noradrenergic agent approved for the treatment of attention deficit hyperactivity disorder, showed some interesting preliminary results but there is still a lack of controlled longitudinal studies. Finally, while DBS effects on impulsive-compulsive disorders are still controversial, non-invasive techniques (such as transcranial magnetic stimulation and transcranial direct current stimulation) could have a potential positive effect but, again, there is still a lack of controlled trials. CONCLUSION Managing impulsivity and compulsivity in PD patients is still a non-evidence-based challenge for clinicians. Controlled trials on promising approaches such as atomoxetine and non-invasive neuromodulation techniques are needed.
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Affiliation(s)
- Giacomo Grassi
- Brain Center Firenze, Viale Belfiore 36, 5014, Florence, Italy.
| | | | | | - Lorenzo Razzolini
- Brain Center Firenze, Viale Belfiore 36, 5014, Florence, Italy.,University of Florence, Florence, Italy
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Neuropsychiatric aspects of Parkinson disease psychopharmacology: Insights from circuit dynamics. HANDBOOK OF CLINICAL NEUROLOGY 2020; 165:83-121. [PMID: 31727232 DOI: 10.1016/b978-0-444-64012-3.00007-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Parkinson disease (PD) is a neurodegenerative disorder with a complex pathophysiology characterized by the progressive loss of dopaminergic neurons within the substantia nigra. Persons with PD experience several motoric and neuropsychiatric symptoms. Neuropsychiatric features of PD include depression, anxiety, psychosis, impulse control disorders, and apathy. In this chapter, we will utilize the National Institutes of Mental Health Research Domain Criteria (RDoC) to frame and integrate observations from two prevailing disease constructions: neurotransmitter anomalies and circuit physiology. When there is available evidence, we posit how unified translational observations may have clinical relevance and postulate importance outside of PD. Finally, we review the limited evidence available for pharmacologic management of these symptoms.
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Abstract
Purpose of Review Parkinson’s disease (PD) has a wide spectrum of symptoms including the presence of psychiatric disease. At present, most treatment plans, comprised of dopaminergic drugs, are chronic and complex. Though dopaminergic agents are quite efficient in managing the motor aspects of the disease, chronic pharmacotherapy specifically with dopamine receptor agonists has been highly linked to the occurrence of Impulse Compulsive disorder (ICD), which can be problematic for individual patients. Recent Findings Much of what is known today about PD-related ICD stems from brain imaging studies, however, evidence is not quite conclusive. Research in the field has been focused on identifying the underlying mechanisms of PD-related ICD and understanding the functions of the structures involved in the reward network. Summary This article presents an update of recent findings from key neuroimaging studies in PD-related ICD, discusses results from controversial studies, and identifies areas for future research in the field.
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Affiliation(s)
- Andreas-Antonios Roussakis
- Neurology Imaging Unit, Imperial College London - Hammersmith Hospital, 1st Floor, B-Block, Du Cane Road, London, W12 0NN, UK
| | - Nicholas P Lao-Kaim
- Neurology Imaging Unit, Imperial College London - Hammersmith Hospital, 1st Floor, B-Block, Du Cane Road, London, W12 0NN, UK
| | - Paola Piccini
- Neurology Imaging Unit, Imperial College London - Hammersmith Hospital, 1st Floor, B-Block, Du Cane Road, London, W12 0NN, UK.
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Berardelli I, Belvisi D, Pasquini M, Fabbrini A, Petrini F, Fabbrini G. Treatment of psychiatric disturbances in hypokinetic movement disorders. Expert Rev Neurother 2019; 19:965-981. [PMID: 31241368 DOI: 10.1080/14737175.2019.1636648] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Introduction: We reviewed studies that assessed the treatment of psychiatric disturbances in Parkinson's disease and atypical parkinsonisms. Neuropsychiatric disturbances in these conditions are frequent and have a profound impact on quality of life of patients and of their caregivers. It is therefore important to be familiar with the appropriate pharmacological and non-pharmacological interventions for treating these disorders. Areas covered: The authors searched for papers in English in Pubmed using the following keywords: Parkinson's disease, multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration, Lewy body dementia, depression, apathy, anxiety, fatigue, sleep disorders, obsessive compulsive disorders, psychosis, hallucinations, delusions, impulse control disorders. Expert opinion: In Parkinson's disease, depression may benefit from the optimization of dopaminergic therapy, from the use of antidepressants acting on both the serotoninergic and noradrenergic pathways and from cognitive behavioral therapy. Psychosis in Parkinson's disease may improve with the use of clozapine; the serotonin inverse agonist pimavanserin has been shown to be effective. Treatment of impulse control disorders is primarily based on the removal of dopamine agonists. No controlled studies have investigated the treatment of neuropsychiatric disorders in multiple system atrophy, progressive supranuclear palsy or corticobasal degeneration. Acethylcholinesterase inhibitors may be used to treat hallucinations in Lewy body dementia.
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Affiliation(s)
- Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome , Rome , Italy
| | | | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome , Rome , Italy
| | - Andrea Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome , Rome , Italy
| | - Federica Petrini
- Department of Neurosciences and Mental Health, Azienda Universitaria Policlinico Umberto I° , Rome , Italy
| | - Giovanni Fabbrini
- IRCCS Neuromed , Pozzilli , Italy.,Department of Human Neurosciences, Sapienza University of Rome , Rome , Italy
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Liu B, Luo W, Mo Y, Wei C, Tao R, Han M. Meta-analysis of related factors of impulse control disorders in patients with Parkinson's disease. Neurosci Lett 2019; 707:134313. [PMID: 31167116 DOI: 10.1016/j.neulet.2019.134313] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/08/2019] [Accepted: 05/31/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND To explore the related factors of impulse control disorders (ICDs) in patients with Parkinson's disease (PD). METHODS We conducted a comprehensive search to identify studies on impulse control disorders in patients with Parkinson's disease. The related factors were compared to discriminate between PD patients with ICDs (PD-ICDs+)and PD patients without ICDs(PD-ICDs-)by a meta-analysis. RESULTS 96 full-texts were assessed, and 15 were included (PD-ICDs+: 999; PD-ICDs-: 3507). The results showed that PD-ICDs + were significantly associated with younger age (SMD =-0.39, 95% CI: -0.50 - -0.28, P < 0.01), male sex(OR = 1.64, 95% CI: 1.34-2.02, P < 0.01), smoking habit(OR = 2.28, 95% CI: 1.16-4.47,P = 0.02), dopamine receptor agonist use(DA use) (OR = 3.41, 95% CI: 1.86-6.26,P < 0.01), dopamine receptor agonist equivalent daily dose(DA LEDD) (SMD = 0.42, 95% CI: 0.14 - 0.70,P = 0.003), levodopa equivalent daily dose(total LEDD) (SMD = 0.32, 95% CI: 0.14 - 0.49,P < 0.01), and amantadine use(OR = 2.26, 95% CI: 1.67-3.06,P < 0.01). While levodopa dose (SMD = 0.05, 95% CI: -0.09 -0.19,P = 0.48), Hoehn and Yahr stage(H & Y stage) (SMD =-0.05, 95% CI: -0.14 - 0.04,P = 0.27), MDS-UPDRS Part III score(UPDRS III score) (SMD =-0.05, 95% CI: -0.13 - 0.03,P = 0.24), PD duration (SMD =-0.23, 95% CI: 0.10 - 0.37,P < 0.01)and Mini-Mental Status Examination score (MMSE score) (SMD = 0.10, 95% CI: -0.11 - 0.31,P = 0.33)were not related with PD-ICDs+. CONCLUSION Our study confirmed the previous results that younger age, male gender, smoking habit, longer PD duration, DA use, DA LEDD, total LEDD were high risk factors of PD-ICDs+.
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Affiliation(s)
- Bo Liu
- The Cadre Ward in Department of Neurology, The People's Hospital of Guangxi Zhuang Autonomous Region, No. 6, Tao Yuan Road, Nanning, Guangxi, 530021, China
| | - Wenjing Luo
- The Cadre Ward in Department of Neurology, The People's Hospital of Guangxi Zhuang Autonomous Region, No. 6, Tao Yuan Road, Nanning, Guangxi, 530021, China
| | - Yingmin Mo
- The Cadre Ward in Department of Neurology, The People's Hospital of Guangxi Zhuang Autonomous Region, No. 6, Tao Yuan Road, Nanning, Guangxi, 530021, China
| | - Chunying Wei
- The Cadre Ward in Department of Neurology, The People's Hospital of Guangxi Zhuang Autonomous Region, No. 6, Tao Yuan Road, Nanning, Guangxi, 530021, China
| | - Ran Tao
- The Cadre Ward in Department of Neurology, The People's Hospital of Guangxi Zhuang Autonomous Region, No. 6, Tao Yuan Road, Nanning, Guangxi, 530021, China
| | - Min Han
- The Cadre Ward in Department of Neurology, The People's Hospital of Guangxi Zhuang Autonomous Region, No. 6, Tao Yuan Road, Nanning, Guangxi, 530021, China.
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Vitale C, Amboni M, Erro R, Picillo M, Pellecchia MT, Barone P, Trojano L, Santangelo G. Parkinson’s disease management and impulse control disorders: current state and future perspectives. Expert Rev Neurother 2019; 19:495-508. [DOI: 10.1080/14737175.2019.1620603] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Carmine Vitale
- Department of Motor Sciences and Health, University “Parthenope”, Naples, Italy
| | - Marianna Amboni
- Neurodegenerative Diseases Center, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Roberto Erro
- Neurodegenerative Diseases Center, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Marina Picillo
- Neurodegenerative Diseases Center, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Maria Teresa Pellecchia
- Neurodegenerative Diseases Center, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Paolo Barone
- Neurodegenerative Diseases Center, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Luigi Trojano
- Department of Psychology, University “Luigi Vanvitelli”, Caserta, Italy
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Gatto EM, Aldinio V. Impulse Control Disorders in Parkinson's Disease. A Brief and Comprehensive Review. Front Neurol 2019; 10:351. [PMID: 31057473 PMCID: PMC6481351 DOI: 10.3389/fneur.2019.00351] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 03/22/2019] [Indexed: 12/25/2022] Open
Abstract
Impulse control and related disorders (ICDs-RD) encompasses a heterogeneous group of disorders that involve pleasurable behaviors performed repetitively, excessively, and compulsively. The key common symptom in all these disorders is the failure to resist an impulse or temptation to control an act or specific behavior, which is ultimately harmful to oneself or others and interferes in major areas of life. The major symptoms of ICDs include pathological gambling (PG), hypersexualtiy (HS), compulsive buying/shopping (CB) and binge eating (BE) functioning. ICDs and ICDs-RD have been included in the behavioral spectrum of non-motor symptoms in Parkinson's disease (PD) leading, in some cases, to serious financial, legal and psychosocial devastating consequences. Herein we present the prevalence of ICDs, the risk factors, its pathophysiological mechanisms, the link with agonist dopaminergic therapies and therapeutic managements.
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Affiliation(s)
- Emilia M Gatto
- Department of Neurology, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina.,Instituto de Neurociencias Buenos Aires, Ineba, Buenos Aires, Argentina
| | - Victoria Aldinio
- Department of Neurology, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina
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14
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Vargas AP, Cardoso FEC. Impulse control and related disorders in Parkinson's disease. ARQUIVOS DE NEURO-PSIQUIATRIA 2018; 76:399-410. [PMID: 29972423 DOI: 10.1590/0004-282x20180052] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 03/17/2018] [Indexed: 12/29/2022]
Abstract
Neuropsychiatric disorders are common among patients with Parkinson's disease and may appear in any stage of the disease. However, these disorders often go undiagnosed and receive insufficient treatment. Observations in recent years have revealed that dopamine replacement therapy may lead to the development or worsening of conditions, such as gambling disorder, compulsive sexual behavior, compulsive buying and binge eating, in addition to punding and dopamine dysregulation syndrome. The pathophysiology of these disorders seems to be related to abnormal dopaminergic stimulation of the basal regions of the basal ganglia, especially via nigro-mesolimbic pathways. The aim of the present study was to perform a literature review on impulsivity, impulse control disorders and related conditions among patients with Parkinson's disease, with emphasis on their epidemiology, clinical characteristics and treatment.
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Affiliation(s)
- Antonio Pedro Vargas
- Rede SARAH de Hospitais de Reabilitação, Departamento de Neurologia, Belo Horizonte MG, Brasil
| | - Francisco Eduardo Costa Cardoso
- Universidade Federal de Minas Gerais, Unidade de Distúrbios do Movimento, Departamento de Clínica Médica, Serviço de Neurologia, Belo Horizonte MG, Brasil
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15
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Garcia-Borreguero D, Cano-Pumarega I, Marulanda R. Management of treatment failure in restless legs syndrome (Willis-Ekbom disease). Sleep Med Rev 2018; 41:50-60. [DOI: 10.1016/j.smrv.2018.01.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 12/16/2017] [Accepted: 01/02/2018] [Indexed: 10/18/2022]
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16
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Bina RW, Langevin JP. Closed Loop Deep Brain Stimulation for PTSD, Addiction, and Disorders of Affective Facial Interpretation: Review and Discussion of Potential Biomarkers and Stimulation Paradigms. Front Neurosci 2018; 12:300. [PMID: 29780303 PMCID: PMC5945819 DOI: 10.3389/fnins.2018.00300] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 04/18/2018] [Indexed: 01/06/2023] Open
Abstract
The treatment of psychiatric diseases with Deep Brain Stimulation (DBS) is becoming more of a reality as studies proliferate the indications and targets for therapies. Opinions on the initial failures of DBS trials for some psychiatric diseases point to a certain lack of finesse in using an Open Loop DBS (OLDBS) system in these dynamic, cyclical pathologies. OLDBS delivers monomorphic input into dysfunctional brain circuits with modulation of that input via human interface at discrete time points with no interim modulation or adaptation to the changing circuit dynamics. Closed Loop DBS (CLDBS) promises dynamic, intrinsic circuit modulation based on individual physiologic biomarkers of dysfunction. Discussed here are several psychiatric diseases which may be amenable to CLDBS paradigms as the neurophysiologic dysfunction is stochastic and not static. Post-Traumatic Stress Disorder (PTSD) has several peripheral and central physiologic and neurologic changes preceding stereotyped hyper-activation behavioral responses. Biomarkers for CLDBS potentially include skin conductance changes indicating changes in the sympathetic nervous system, changes in serum and central neurotransmitter concentrations, and limbic circuit activation. Chemical dependency and addiction have been demonstrated to be improved with both ablation and DBS of the Nucleus Accumbens and as a serendipitous side effect of movement disorder treatment. Potential peripheral biomarkers are similar to those proposed for PTSD with possible use of environmental and geolocation based cues, peripheral signs of physiologic arousal, and individual changes in central circuit patterns. Non-substance addiction disorders have also been serendipitously treated in patients with OLDBS for movement disorders. As more is learned about these behavioral addictions, DBS targets and effectors will be identified. Finally, discussed is the use of facial recognition software to modulate activation of inappropriate responses for psychiatric diseases in which misinterpretation of social cues feature prominently. These include Autism Spectrum Disorder, PTSD, and Schizophrenia-all of which have a common feature of dysfunctional interpretation of facial affective clues. Technological advances and improvements in circuit-based, individual-specific, real-time adaptable modulation, forecast functional neurosurgery treatments for heretofore treatment-resistant behavioral diseases.
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Affiliation(s)
- Robert W Bina
- Division of Neurosurgery, Banner University Medical Center, Tucson, AZ, United States
| | - Jean-Phillipe Langevin
- Neurosurgery Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States.,Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States
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The neurobiology of impulse control disorders in Parkinson's disease: from neurotransmitters to neural networks. Cell Tissue Res 2018; 373:327-336. [PMID: 29383446 PMCID: PMC6015621 DOI: 10.1007/s00441-017-2771-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 12/14/2017] [Indexed: 01/08/2023]
Abstract
Impulse control disorders (ICD) are common neuropsychiatric disorders that can arise in Parkinson’s disease (PD) patients after commencing dopamine replacement therapy. Approximately 15% of all patients develop these disorders and many more exhibit subclinical symptoms of impulsivity. ICD is thought to develop due to an interaction between the use of dopaminergic medication and an as yet unknown neurobiological vulnerability that either pre-existed before PD onset (possibly genetic) or is associated with neural alterations due to the PD pathology. This review discusses genes, neurotransmitters and neural networks that have been implicated in the pathophysiology of ICD in PD. Although dopamine and the related reward system have been the main focus of research, recently, studies have started to look beyond those systems to find new clues to the neurobiological underpinnings of ICD and come up with possible new targets for treatment. Studies on the whole-brain connectome to investigate the global alterations due to ICD development are currently lacking. In addition, there is a dire need for longitudinal studies that are able to disentangle the contributions of individual (genetic) traits and secondary effects of the PD pathology and chronic dopamine replacement therapy to the development of ICD in PD.
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Bronner G, Hassin-Baer S, Gurevich T. Sexual Preoccupation Behavior in Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2017; 7:175-182. [PMID: 27802244 DOI: 10.3233/jpd-160926] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
People with Parkinson's disease (PD) present with problematic sexual behaviors that are often misunderstood or ignored. Sexual problems in PD are part of a non-motor syndrome, and they play a prominent role in the life of affected individuals and their partners. Based on our considerable clinical experience, we describe four common types of sexual preoccupation behaviors in people with PD: (1) sexual behavior with underlying sexual dysfunction, (2) sexual desire discrepancy with partner after restored desire, (3) hypersexuality and compulsive sexual behavior, and (4) sexual behavior with underlying restless genital syndrome. We also suggest methods of assessing and diagnosing these sexual behaviors, and propose alternative possible treatments for people with PD and their partners/caregivers. Understanding these four behavioral types will assist healthcare professionals in explaining and educating people with PD and their partners, contribute to decreased stress and tension between them, and help them manage these sexual issues.
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Affiliation(s)
- Gila Bronner
- Sexual Medicine Center, Department of Urology, Sheba Medical Center, Tel-Hashomer, Israel.,Movement Disorders Institute, Department of Neurology, Sheba Medical Center, Tel-Hashomer, Israel
| | - Sharon Hassin-Baer
- Movement Disorders Institute, Department of Neurology, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Tanya Gurevich
- Movement Disorders Unit, Neurological Institute, Tel-Aviv Medical Center, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Israel
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No genetic association between attention-deficit/hyperactivity disorder (ADHD) and Parkinson's disease in nine ADHD candidate SNPs. ACTA ACUST UNITED AC 2017; 9:121-127. [PMID: 28176268 DOI: 10.1007/s12402-017-0219-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 01/18/2017] [Indexed: 01/01/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) and Parkinson's disease (PD) involve pathological changes in brain structures such as the basal ganglia, which are essential for the control of motor and cognitive behavior and impulsivity. The cause of ADHD and PD remains unknown, but there is increasing evidence that both seem to result from a complicated interplay of genetic and environmental factors affecting numerous cellular processes and brain regions. To explore the possibility of common genetic pathways within the respective pathophysiologies, nine ADHD candidate single nucleotide polymorphisms (SNPs) in seven genes were tested for association with PD in 5333 cases and 12,019 healthy controls: one variant, respectively, in the genes coding for synaptosomal-associated protein 25 k (SNAP25), the dopamine (DA) transporter (SLC6A3; DAT1), DA receptor D4 (DRD4), serotonin receptor 1B (HTR1B), tryptophan hydroxylase 2 (TPH2), the norepinephrine transporter SLC6A2 and three SNPs in cadherin 13 (CDH13). Information was extracted from a recent meta-analysis of five genome-wide association studies, in which 7,689,524 SNPs in European samples were successfully imputed. No significant association was observed after correction for multiple testing. Therefore, it is reasonable to conclude that candidate variants implicated in the pathogenesis of ADHD do not play a substantial role in PD.
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Taddei RN, Spinnato F, Jenner P. New Symptomatic Treatments for the Management of Motor and Nonmotor Symptoms of Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 132:407-452. [DOI: 10.1016/bs.irn.2017.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Polivka J, Polivka J, Krakorova K, Peterka M, Topolcan O. Current status of biomarker research in neurology. EPMA J 2016; 7:14. [PMID: 27379174 PMCID: PMC4931703 DOI: 10.1186/s13167-016-0063-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Accepted: 06/02/2016] [Indexed: 01/18/2023]
Abstract
Neurology is one of the typical disciplines where personalized medicine has been recently becoming an important part of clinical practice. In this article, the brief overview and a number of examples of the use of biomarkers and personalized medicine in neurology are described. The various issues in neurology are described in relation to the personalized medicine and diagnostic, prognostic as well as predictive blood and cerebrospinal fluid biomarkers. Such neurological domains discussed in this work are neuro-oncology and primary brain tumors glioblastoma and oligodendroglioma, cerebrovascular diseases focusing on stroke, neurodegenerative disorders especially Alzheimer's and Parkinson's diseases and demyelinating diseases such as multiple sclerosis. Actual state of the art and future perspectives in diagnostics and personalized treatment in diverse domains of neurology are given.
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Affiliation(s)
- Jiri Polivka
- Department of Neurology, Faculty of Medicine in Plzen, Charles University Prague, Husova 3, 301 66 Plzen, Czech Republic ; Department of Neurology, Faculty Hospital Plzen, E. Benese 13, 305 99 Plzen, Czech Republic
| | - Jiri Polivka
- Department of Histology and Embryology, Charles University Prague, Husova 3, 301 66 Plzen, Czech Republic ; Biomedical Centre, Faculty of Medicine in Plzen, Charles University Prague, Husova 3, 301 66 Plzen, Czech Republic
| | - Kristyna Krakorova
- Department of Neurology, Faculty of Medicine in Plzen, Charles University Prague, Husova 3, 301 66 Plzen, Czech Republic ; Department of Neurology, Faculty Hospital Plzen, E. Benese 13, 305 99 Plzen, Czech Republic
| | - Marek Peterka
- Department of Neurology, Faculty of Medicine in Plzen, Charles University Prague, Husova 3, 301 66 Plzen, Czech Republic ; Department of Neurology, Faculty Hospital Plzen, E. Benese 13, 305 99 Plzen, Czech Republic
| | - Ondrej Topolcan
- Central Imunoanalytical Laboratory, Faculty Hospital Plzen, E. Benese 13, 305 99 Plzen, Czech Republic
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