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Wu C, Wu H, Zhou C, Guan X, Guo T, Wu J, Chen J, Wen J, Qin J, Tan S, Duanmu X, Yuan W, Zheng Q, Zhang B, Xu X, Zhang M. Neurovascular coupling alteration in drug-naïve Parkinson's disease: The underlying molecular mechanisms and levodopa's restoration effects. Neurobiol Dis 2024; 191:106406. [PMID: 38199273 DOI: 10.1016/j.nbd.2024.106406] [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: 11/12/2023] [Revised: 12/25/2023] [Accepted: 01/06/2024] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Parkinson's disease (PD) patients exhibit an imbalance between neuronal activity and perfusion, referred to as abnormal neurovascular coupling (NVC). Nevertheless, the underlying molecular mechanism and how levodopa, the standard treatment in PD, regulates NVC is largely unknown. MATERIAL AND METHODS A total of 52 drug-naïve PD patients and 49 normal controls (NCs) were enrolled. NVC was characterized in vivo by relating cerebral blood flow (CBF) and amplitude of low-frequency fluctuations (ALFF). Motor assessments and MRI scanning were conducted on drug-naïve patients before and after levodopa therapy (OFF/ON state). Regional NVC differences between patients and NCs were identified, followed by an assessment of the associated receptors/transporters. The influence of levodopa on NVC, CBF, and ALFF within these abnormal regions was analyzed. RESULTS Compared to NCs, OFF-state patients showed NVC dysfunction in significantly lower NVC in left precentral, postcentral, superior parietal cortex, and precuneus, along with higher NVC in left anterior cingulate cortex, right olfactory cortex, thalamus, caudate, and putamen (P-value <0.0006). The distribution of NVC differences correlated with the density of dopaminergic, serotonin, MU-opioid, and cholinergic receptors/transporters. Additionally, levodopa ameliorated abnormal NVC in most of these regions, where there were primarily ALFF changes with limited CBF modifications. CONCLUSION Patients exhibited NVC dysfunction primarily in the striato-thalamo-cortical circuit and motor control regions, which could be driven by dopaminergic and nondopaminergic systems, and levodopa therapy mainly restored abnormal NVC by modulating neuronal activity.
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Affiliation(s)
- Chenqing Wu
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Haoting Wu
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Cheng Zhou
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojun Guan
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Tao Guo
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingjing Wu
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingwen Chen
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiaqi Wen
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianmei Qin
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Sijia Tan
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojie Duanmu
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Weijin Yuan
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qianshi Zheng
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Baorong Zhang
- Department of Neurology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojun Xu
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Minming Zhang
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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Mann LG, Servant M, Hay KR, Song AK, Trujillo P, Yan B, Kang H, Zald D, Donahue MJ, Logan GD, Claassen DO. The Role of a Dopamine-Dependent Limbic-Motor Network in Sensory Motor Processing in Parkinson Disease. J Cogn Neurosci 2023; 35:1806-1822. [PMID: 37677065 PMCID: PMC10594953 DOI: 10.1162/jocn_a_02048] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
Limbic and motor integration is enabled by a mesial temporal to motor cortex network. Parkinson disease (PD) is characterized by a loss of dorsal striatal dopamine but relative preservation of mesolimbic dopamine early in disease, along with changes to motor action control. Here, we studied 47 patients with PD using the Simon conflict task and [18F]fallypride PET imaging. Additionally, a cohort of 16 patients participated in a single-blinded dextroamphetamine (dAMPH) study. Task performance was evaluated using the diffusion model for conflict tasks, which allows for an assessment of interpretable action control processes. First, a voxel-wise examination disclosed a negative relationship, such that longer non-decision time is associated with reduced D2-like binding potential (BPND) in the bilateral putamen, left globus pallidus, and right insula. Second, an ROI analysis revealed a positive relationship, such that shorter non-decision time is associated with reduced D2-like BPND in the amygdala and ventromedial OFC. The difference in non-decision time between off-dAMPH and on-dAMPH trials was positively associated with D2-like BPND in the globus pallidus. These findings support the idea that dysfunction of the traditional striatal-motor loop underlies action control deficits but also suggest that a compensatory parallel limbic-motor loop regulates motor output.
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Affiliation(s)
- Leah G. Mann
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN 37232, USA
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Mathieu Servant
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive, Université de Franche-Comté, 25000 Besançon, France
| | - Kaitlyn R. Hay
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Alexander K. Song
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN 37232, USA
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Paula Trujillo
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Bailu Yan
- Deparment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37203, USA
| | - Hakmook Kang
- Deparment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37203, USA
| | - David Zald
- Department of Psychiatry, Rutgers University, Piscataway, NJ 08854, USA
| | - Manus J. Donahue
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Gordon D. Logan
- Department of Psychology, Vanderbilt University, Nashville, TN 37240, USA
| | - Daniel O. Claassen
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
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3
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Tichelaar JG, Sayalı C, Helmich RC, Cools R. Impulse control disorder in Parkinson's disease is associated with abnormal frontal value signalling. Brain 2023; 146:3676-3689. [PMID: 37192341 PMCID: PMC10473575 DOI: 10.1093/brain/awad162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/18/2023] [Accepted: 04/26/2023] [Indexed: 05/18/2023] Open
Abstract
Dopaminergic medication is well established to boost reward- versus punishment-based learning in Parkinson's disease. However, there is tremendous variability in dopaminergic medication effects across different individuals, with some patients exhibiting much greater cognitive sensitivity to medication than others. We aimed to unravel the mechanisms underlying this individual variability in a large heterogeneous sample of early-stage patients with Parkinson's disease as a function of comorbid neuropsychiatric symptomatology, in particular impulse control disorders and depression. One hundred and ninety-nine patients with Parkinson's disease (138 ON medication and 61 OFF medication) and 59 healthy controls were scanned with functional MRI while they performed an established probabilistic instrumental learning task. Reinforcement learning model-based analyses revealed medication group differences in learning from gains versus losses, but only in patients with impulse control disorders. Furthermore, expected-value related brain signalling in the ventromedial prefrontal cortex was increased in patients with impulse control disorders ON medication compared with those OFF medication, while striatal reward prediction error signalling remained unaltered. These data substantiate the hypothesis that dopamine's effects on reinforcement learning in Parkinson's disease vary with individual differences in comorbid impulse control disorder and suggest they reflect deficient computation of value in medial frontal cortex, rather than deficient reward prediction error signalling in striatum. See Michael Browning (https://doi.org/10.1093/brain/awad248) for a scientific commentary on this article.
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Affiliation(s)
- Jorryt G Tichelaar
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, 6525EN Nijmegen, The Netherlands
- Radboud University Medical Center, Department of Neurology, Centre of Expertise for Parkinson and Movement Disorders, 6525GA Nijmegen, The Netherlands
| | - Ceyda Sayalı
- The Johns Hopkins University School of Medicine, Center for Psychedelic and Consciousness Research, Baltimore, MD 21224, USA
| | - Rick C Helmich
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, 6525EN Nijmegen, The Netherlands
- Radboud University Medical Center, Department of Neurology, Centre of Expertise for Parkinson and Movement Disorders, 6525GA Nijmegen, The Netherlands
| | - Roshan Cools
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, 6525EN Nijmegen, The Netherlands
- Radboud University Medical Center, Department of Psychiatry, 6525GA Nijmegen, The Netherlands
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Hall A, Weightman M, Jenkinson N, MacDonald HJ. Performance on the balloon analogue risk task and anticipatory response inhibition task is associated with severity of impulse control behaviours in people with Parkinson's disease. Exp Brain Res 2023; 241:1159-1172. [PMID: 36894682 PMCID: PMC10082127 DOI: 10.1007/s00221-023-06584-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 02/24/2023] [Indexed: 03/11/2023]
Abstract
Dopamine agonist medication is one of the largest risk factors for development of problematic impulse control behaviours (ICBs) in people with Parkinson's disease. The present study investigated the potential of dopamine gene profiling and individual performance on impulse control tasks to explain ICB severity. Clinical, genetic and task performance data were entered into a mixed-effects linear regression model for people with Parkinson's disease taking (n = 50) or not taking (n = 25) dopamine agonist medication. Severity of ICBs was captured via the Questionnaire for Impulsive-compulsive disorders in Parkinson's disease Rating Scale. A cumulative dopamine genetic risk score (DGRS) was calculated for each participant from variance in five dopamine-regulating genes. Objective measures of impulsive action and impulsive choice were measured on the Anticipatory Response Inhibition Task and Balloon Analogue Risk Task, respectively. For participants on dopamine agonist medication, task performance reflecting greater impulsive choice (p = 0.014), and to a trend level greater impulsive action (p = 0.056), as well as a longer history of DA medication (p < 0.001) all predicted increased ICB severity. DGRS however, did not predict ICB severity (p = 0.708). No variables could explain ICB severity in the non-agonist group. Our task-derived measures of impulse control have the potential to predict ICB severity in people with Parkinson's and warrant further investigation to determine whether they can be used to monitor ICB changes over time. The DGRS appears better suited to predicting the incidence, rather than severity, of ICBs on agonist medication.
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Affiliation(s)
- Alison Hall
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.,Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Matthew Weightman
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.,Centre for Human Brain Health, University of Birmingham, Birmingham, UK.,Wellcome Centre for Integrative Neuroimaging, Department of Clinical Neurosciences, FMRIB, Nuffield, University of Oxford, Oxford, UK
| | - Ned Jenkinson
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.,Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Hayley J MacDonald
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK. .,Centre for Human Brain Health, University of Birmingham, Birmingham, UK. .,Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.
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5
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Song AK, Hay KR, Trujillo P, Aumann M, Stark AJ, Yan Y, Kang H, Donahue MJ, Zald DH, Claassen DO. Amphetamine-induced dopamine release and impulsivity in Parkinson's disease. Brain 2022; 145:3488-3499. [PMID: 34951464 DOI: 10.1093/brain/awab487] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/23/2021] [Accepted: 11/30/2021] [Indexed: 11/12/2022] Open
Abstract
Impulsive-compulsive behaviours manifest in a substantial proportion of subjects with Parkinson's disease. Reduced ventral striatum dopamine receptor availability, and increased dopamine release is noted in patients with these symptoms. Prior studies of impulsivity suggest that midbrain D2 autoreceptors regulate striatal dopamine release in a feedback inhibitory manner, and in healthy populations, greater impulsivity is linked to poor proficiency of this inhibition. This has not been assessed in a Parkinson's disease population. Here, we applied 18F-fallypride PET studies to assess striatal and extrastriatal D2-like receptor uptake in a placebo-controlled oral dextroamphetamine sequence. We hypothesized that Parkinson's disease patients with impulsive-compulsive behaviours would have greater ventral striatal dopaminergic response to dextroamphetamine, and that an inability to attenuate ventral striatal dopamine release via midbrain D2 autoreceptors would underlie this response. Twenty patients with Parkinson's disease (mean age = 64.1 ± 5.8 years) both with (n = 10) and without (n = 10) impulsive-compulsive behaviours, participated in a single-blind dextroamphetamine challenge (oral; 0.43 mg/kg) in an OFF dopamine state. All completed PET imaging with 18F-fallypride, a high-affinity D2-like receptor ligand, in the placebo and dextroamphetamine state. Both voxelwise and region of interest analyses revealed dextroamphetamine-induced endogenous dopamine release localized to the ventral striatum, and the caudal-medial orbitofrontal cortex. The endogenous dopamine release observed in the ventral striatum correlated positively with patient-reported participation in reward-based behaviours, as quantified by the self-reported Questionnaire for Impulsivity in Parkinson's disease Rating Scale. In participants without impulsive-compulsive behaviours, baseline midbrain D2 receptor availability negatively correlated with ventral striatal dopamine release; however, this relationship was absent in those with impulsive-compulsive behaviours. These findings emphasize that reward-based behaviours in Parkinson's disease are regulated by ventral striatal dopamine release, and suggest that loss of inhibitory feedback from midbrain autoreceptors may underlie the manifestation of impulsive-compulsive behaviours.
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Affiliation(s)
- Alexander K Song
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Kaitlyn R Hay
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Paula Trujillo
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Megan Aumann
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA.,Vanderbilt Brain Institute, Department of Psychology, Vanderbilt University, Nashville, TN 37232, USA
| | - Adam J Stark
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Yan Yan
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Hakmook Kang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37232, USA.,Center for Quantitative Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Manus J Donahue
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - David H Zald
- Department of Psychology, Vanderbilt University, Nashville, TN 37240, USA.,Department of Psychiatry, Rutgers University, Piscataway, NJ 08854, USA
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
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6
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Dopamine-induced changes to thalamic GABA concentration in impulsive Parkinson disease patients. NPJ Parkinsons Dis 2022; 8:37. [PMID: 35383185 PMCID: PMC8983736 DOI: 10.1038/s41531-022-00298-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 02/01/2022] [Indexed: 11/08/2022] Open
Abstract
Impulsivity is inherent to behavioral disorders such as substance abuse and binge eating. While the role of dopamine in impulse behavior is well established, γ-aminobutyric acid (GABA) therapies have promise for the treatment of maladaptive behaviors. In Parkinson disease (PD), dopaminergic therapies can result in the development of impulsive and compulsive behaviors, and this clinical syndrome shares similar pathophysiology to that seen in addiction, substance abuse, and binge-eating disorders. We hypothesized that impulsive PD patients have a reduced thalamic GABAergic response to dopamine therapy. To test this hypothesis, we employed GABA magnetic resonance spectroscopy, D2-like receptor PET imaging, and clinical and quantitative measures of impulsivity in PD patients (n = 33), before and after dopamine agonist administration. We find a blunted thalamic GABA response to dopamine agonists in patients with elevated impulsivity (p = 0.027). These results emphasize how dopamine treatment differentially augments thalamic GABA concentrations, which may modify behavioral impulsivity.
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7
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Cools R, Tichelaar JG, Helmich RCG, Bloem BR, Esselink RAJ, Smulders K, Timmer MHM. Role of dopamine and clinical heterogeneity in cognitive dysfunction in Parkinson's disease. PROGRESS IN BRAIN RESEARCH 2022; 269:309-343. [PMID: 35248200 DOI: 10.1016/bs.pbr.2022.01.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Parkinson's disease (PD) is commonly treated with dopaminergic medication, which enhances some, while impairing other cognitive functions. It can even contribute to impulse control disorder and addiction. We describe the history of research supporting the dopamine overdose hypothesis, which accounts for the large within-patient variability in dopaminergic medication effects across different tasks by referring to the spatially non-uniform pattern of dopamine depletion in dorsal versus ventral striatum. However, there is tremendous variability in dopaminergic medication effects not just within patients across distinct tasks, but also across different patients. In the second part of this chapter we review recent studies addressing the large individual variability in the negative side effects of dopaminergic medication on functions that implicate dopamine, such as value-based learning and choice. These studies begin to unravel the mechanisms of dopamine overdosing, thus revising the strict version of the overdose hypothesis. For example, the work shows that the canonical boosting of reward-versus punishment-based choice by medication is greater in patients with depression and a non-tremor phenotype, which both implicate, among other pathology, more rather than less severe dysregulation of the mesolimbic dopamine system. Future longitudinal cohort studies are needed to identify how to optimally combine different clinical, personality, cognitive, neural, genetic and molecular predictors of detrimental medication effects in order to account for as much of the relevant variability as possible. This will provide a useful tool for precision neurology, allowing individual and contextual tailoring of (the dose of) dopaminergic medication in order to maximize its cognitive benefits, yet minimize its side effects.
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Affiliation(s)
- Roshan Cools
- Radboud university medical center, Department of Psychiatry, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
| | - Jorryt G Tichelaar
- Radboud university medical center, Department of Neurology, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Rick C G Helmich
- Radboud university medical center, Department of Neurology, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Bastiaan R Bloem
- Radboud university medical center, Department of Neurology, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Rianne A J Esselink
- Radboud university medical center, Department of Neurology, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Katrijn Smulders
- Radboud university medical center, Department of Neurology, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Monique H M Timmer
- Radboud university medical center, Department of Neurology, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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8
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Weintraub D, Aarsland D, Chaudhuri KR, Dobkin RD, Leentjens AF, Rodriguez-Violante M, Schrag A. The neuropsychiatry of Parkinson's disease: advances and challenges. Lancet Neurol 2022; 21:89-102. [PMID: 34942142 PMCID: PMC8800169 DOI: 10.1016/s1474-4422(21)00330-6] [Citation(s) in RCA: 117] [Impact Index Per Article: 58.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 08/21/2021] [Accepted: 09/20/2021] [Indexed: 01/03/2023]
Abstract
In people with Parkinson's disease, neuropsychiatric signs and symptoms are common throughout the disease course. These symptoms can be disabling and as clinically relevant as motor symptoms, and their presentation can be similar to, or distinct from, their counterparts in the general population. Correlates and risk factors for developing neuropsychiatric signs and symptoms include demographic, clinical, and psychosocial characteristics. The underlying neurobiology of these presentations is complex and not well understood, with the strongest evidence for neuropathological changes associated with Parkinson's disease, mechanisms linked to dopaminergic therapy, and effects not specific to Parkinson's disease. Assessment instruments and formal diagnostic criteria exist, but there is little routine screening of these signs and symptoms in clinical practice. Mounting evidence supports a range of pharmacological and non-pharmacological interventions, but relatively few efficacious treatment options exist. Optimising the management of neuropsychiatric presentations in people with Parkinson's disease will require additional research, raised awareness, specialised training, and development of innovative models of care.
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Affiliation(s)
- Daniel Weintraub
- Departments of Psychiatry and Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Parkinson's Disease Research, Education and Clinical Center, Corporal Michael J Crescenz Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA.
| | - Dag Aarsland
- Department of Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Centre for Age-Related Disease, Stavanger University Hospital, Stavanger, Norway
| | - Kallol Ray Chaudhuri
- Department of Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Parkinson's Foundation Centre of Excellence, King's College Hospital, King's College London, London, UK
| | - Roseanne D Dobkin
- Department of Psychiatry, Rutgers University, Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | - Albert Fg Leentjens
- Department of Psychiatry, and School for Mental Health and Neuroscience, Maastricht University Hospital, Maastricht, Netherlands
| | - Mayela Rodriguez-Violante
- Clinical Neurodegenerative Diseases Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - Anette Schrag
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, UCL, London, UK
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Hay KR, Kukreti N, Trujillo P, Lin YC, Kang H, Claassen DO. Symptoms of Medication Withdrawal in Parkinson's Disease: Considerations for Informed Consent in Patient-Oriented Research. Pharmaceut Med 2021; 35:163-167. [PMID: 33914276 PMCID: PMC8721843 DOI: 10.1007/s40290-021-00387-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2021] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Dopamine medication withdrawal in Parkinson's disease (PD) is commonly employed in clinical practice and can be required for participation in research studies. When asked to withdraw from medications, participants often enquire as to what symptoms they should expect. OBJECTIVES This study sought to improve the informed consent process by identifying patient-reported symptoms when dopamine treatment is withheld. We also sought to provide clinical guidance regarding the extent of these symptoms and consider participant willingness to undergo these assessments. METHODS Participants were recruited from community-based PD programs and support groups in Nashville, Tennessee, USA. A patient-based questionnaire determined the frequency and severity of motor and nonmotor symptoms. The questionnaire also assessed whether patients would be willing to abstain from medication at a future date and under what circumstances. RESULTS A total of 31/90 participants reported willingness to withdraw from dopaminergic medications for clinical or research purposes. Tremor, walking, and balance were the most common motor symptoms that worsened during this time. Sleep dysfunction, constipation, and tremor were noted as the most severe symptoms. Of note, 10% of participants indicated that they would not be willing to go off medications again, suggesting that a minority of patients find this to be most discomforting. When prompted for a reason why participants would be willing to come off of their medications again, "for clinical purposes" was selected the most. CONCLUSIONS Study teams should list these symptoms in the applications to their institutional review board and in the informed consent to provide guidance for participants.
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Affiliation(s)
- Kaitlyn R Hay
- Department of Neurology, Vanderbilt University Medical Center, 1161 21st Ave South A-0118, Nashville, TN, 37232, USA
| | - Neevi Kukreti
- Department of Neurology, Vanderbilt University Medical Center, 1161 21st Ave South A-0118, Nashville, TN, 37232, USA
| | - Paula Trujillo
- Department of Neurology, Vanderbilt University Medical Center, 1161 21st Ave South A-0118, Nashville, TN, 37232, USA
| | - Ya-Chen Lin
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hakmook Kang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, 1161 21st Ave South A-0118, Nashville, TN, 37232, USA.
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Zhang JF, Wang XX, Feng Y, Fekete R, Jankovic J, Wu YC. Impulse Control Disorders in Parkinson's Disease: Epidemiology, Pathogenesis and Therapeutic Strategies. Front Psychiatry 2021; 12:635494. [PMID: 33633615 PMCID: PMC7900512 DOI: 10.3389/fpsyt.2021.635494] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/19/2021] [Indexed: 12/11/2022] Open
Abstract
Impulse control disorders (ICDs) in Parkinson's disease (PD) are aberrant behavior such as pathological gambling, hypersexuality, binge eating, and compulsive buying, which typically occur as a result of dopaminergic therapy. Numerous studies have focused on the broad spectrum of ICDs-related behaviors and their tremendous impact on patients and their family members. Recent advances have improved our understanding of ICDs. In this review, we discuss the epidemiology, pathogenesis and treatment of ICDs in the setting of PD.
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Affiliation(s)
- Jun-Fang Zhang
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xi-Xi Wang
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai General Hospital of Nanjing Medical University, Nanjing, China
| | - Ya Feng
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Robert Fekete
- Department of Neurology, New York Medical College, New York, NY, United States
| | - Joseph Jankovic
- Department of Neurology, Baylor College of Medicine, Houston, TX, United States
| | - Yun-Cheng Wu
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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11
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Olufunke D, Edidiong A, Oluwatomisin F, Alani A. Therapeutic activities of naringenin on efavirenz-induced sleep-like disorder in the midbrain of white albino mice. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2020; 23:1462-1470. [PMID: 33235704 PMCID: PMC7671428 DOI: 10.22038/ijbms.2020.47043.10852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Efavirenz, has proven to be effective in suppressing human immunodeficiency virus (HIV) viral load; however, complaints of sleep disorders including hallucination, and insomnia have greatly contributed to non-adherence to antiretroviral therapy. This study aimed at investigating therapeutic activities of naringenin on efavirenz-induced sleep disorder. MATERIALS AND METHODS Sixty mice were divided into six groups of control, combination antiretroviral therapy (cART), efavirenz, naringenin, naringenin/efavirenz and naringenin/cART. Efavirenz, cART, and naringenin were administered orally and daily at 15 mg/kg, 24 mg/kg and 50 mg/kg, respectively for 28 days. Post neurobehavioral test, oxidative stress, histology and immunohistochemistry for dopamine were carried out after administration process. RESULTS Efavirenz (P<0.0001) and cART (P<0.01) significantly increased immobility during open field (P<0.01), escape time in seconds (sec) in Morris water maze (P<0.001) and numbers of head-twitch response (HTR) (P<0.0001). Similarly, there was a significant increase in malondialdehyde (MDA) (P<0.0001) and decreased superoxide dismutase (SOD) (P<0.001) and reduced glutathione (GSH) (P<0.001); however, naringenin-treated groups potentiated anti-oxidant function by reducing oxidative stress (P<0.01). Histological evaluation demonstrated severe neurodegeneration, vacuolization and pyknosis in efavirenz and cART compared to naringenin groups. Dopaminergic neurons using immunohistochemial antibody (tyrosine hydroxylase) staining showed poor immunoreactivity in efavirenz and cART in contrast to naringenin groups. CONCLUSION Efavirenz and cART have the potential of inducing sleep disorder possibly due to their capability to trigger inflammation and deplete dopamine level. However, naringenin has proven to be effective in ameliorating these damages.
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Affiliation(s)
- Dosumu Olufunke
- Department of Anatomy, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Akang Edidiong
- Department of Anatomy, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Faniyan Oluwatomisin
- Department of Anatomy, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Akanmu Alani
- Department of Haematology and Blood Transfusion, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
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Weintraub D. Management of psychiatric disorders in Parkinson's disease : Neurotherapeutics - Movement Disorders Therapeutics. Neurotherapeutics 2020; 17:1511-1524. [PMID: 32514891 PMCID: PMC7851231 DOI: 10.1007/s13311-020-00875-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Affective disorders (depression and anxiety), psychosis, impulse control disorders, and apathy are common and sometimes disabling psychiatric conditions in Parkinson disease (PD). Psychiatric aspects of PD are associated with numerous adverse outcomes, yet in spite of this and their high frequency, there remains incomplete understanding of epidemiology, presentation, risk factors, neural substrate, and management strategies. Psychiatric features are typically co- or multimorbid, and there is great intra- and interindividual variability in presentation [1]. The neuropathophysiological changes that occur in PD, as well as the association between PD treatment and particular psychiatric disorders, suggest a neurobiological contribution to many psychiatric symptoms. There is evidence that psychiatric disorders in PD are still under-recognized and undertreated, and although psychotropic medication use is common, randomized controlled trials demonstrating efficacy and tolerability are largely lacking. Future research on neuropsychiatric complications in PD should be oriented toward determining modifiable correlates or risk factors, and most importantly, establishing efficacious and well-tolerated treatment strategies.
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Affiliation(s)
- Daniel Weintraub
- Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
- Parkinson's Disease Research, Education and Clinical Center (PADRECC), Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA.
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13
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Incentive-driven decision-making networks in de novo and drug-treated Parkinson's disease patients with impulsive-compulsive behaviors: A systematic review of neuroimaging studies. Parkinsonism Relat Disord 2020; 78:165-177. [PMID: 32927414 DOI: 10.1016/j.parkreldis.2020.07.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/30/2020] [Accepted: 07/20/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND In Parkinson's disease (PD), impulsive-compulsive behaviors (ICBs) may develop as side-effect of dopaminergic medications. Abnormal incentive-driven decision-making, which is supported by the cognitive control and motivation interaction, may represent an ICBs signature. This systematic review explored whether structural and/or functional brain differences between PD patients with vs without ICBs encompass incentive-driven decision-making networks. METHODS Structural and functional neuroimaging studies comparing PD patients with and without ICBs, either de novo or medicated, were included. RESULTS Thirty articles were identified. No consistent evidence of structural alteration both in de novo and medicated PD patients were found. Differences in connectivity within the default mode, the salience and the central executive networks predate ICBs development and remain stable once ICBs are fully developed. Medicated PD patients with ICBs show increased metabolism and cerebral blood flow in orbitofrontal and cingulate cortices, ventral striatum, amygdala, insula, temporal and supramarginal gyri. Abnormal ventral striatum connectivity with anterior cingulate cortex and limbic structures was reported in PD patients with ICBs. DISCUSSION Functional brain signatures of ICBs in PD encompass areas involved in cognitive control and motivational encoding networks of the incentive-driven decision-making. Functional alterations predating ICBs may be related to abnormal synaptic plasticity in these networks.
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14
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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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15
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Hu Y, LV F, Li Q, Liu R. Effect of post-labeling delay on regional cerebral blood flow in arterial spin-labeling MR imaging. Medicine (Baltimore) 2020; 99:e20463. [PMID: 32629629 PMCID: PMC7337483 DOI: 10.1097/md.0000000000020463] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Investigating the effect of post-labeling delay (PLD) on regional cerebral blood flow (CBF) in adults and optimizing the PLD for arterial spin-labeling (ASL) magnetic resonance (MR) imaging are important. METHODS Pseudo-continuous ASL imaging with a three PLDs protocol was performed in 90 healthy adult volunteers from January 2018 to February 2019. Healthy subjects were divided into youth group (mean age, 30.63 years; age range, 20-44 years), middle-aged group (mean age, 52.16 years; age range 45-59 years) and elderly group (mean age, 66.07 years; age range, 60-77 years). After preprocessing, analyses of variance (ANOVA) and volume-of-interest (VOI) were conducted to compare the CBF in each brain region. According to the trends of CBF changing with PLD and the results of ANOVA, we optimized the PLD for ASL imaging in different brain regions and age groups. RESULTS The CBF values of 87 VOIs [global gray matter (global GM) and other 86 VOIs] for each subject were obtained. Young people had less statistically significant VOIs than middle-aged and elderly people [Numbers of VOIs which had statistical significance (P < .05) in the analysis of ANOVA: 42 (youth group), 79 (middle-aged group), and 71 (elderly group)]. In youth group, the deep GM, occipital lobe and temporal lobe were more affected by PLDs than limbic system, frontal lobe and parietal lobe [VOIs with statistical significance (P < .05)/total VOIs: 8/8 (deep GM) > 8/12 (occipital lobe) > (8/14) (temporal lobe) > 5/12 (limbic system) > 11/28 (frontal lobe) > (2/12) parietal lobe]. In middle-aged group, the limbic system, deep GM and temporal lobe were more affected by PLDs than parietal lobe, frontal lobe and occipital lobe [VOIs with statistical significance (P < 0.05)/total VOIs: 12/12 (limbic system) = 8/8 (deep GM) > (13/14) (temporal lobe) > (11/12) parietal lobe > 25/28 (frontal lobe) > 9/12 (occipital lobe)]. In elderly group, the temporal lobe, parietal lobe, and frontal lobe were more affected by PLDs than occipital lobe, limbic system, and deep GM [VOIs with statistical significance (P < .05)/total VOIs: 14/14 (temporal lobe) > 12/12 (parietal lobe) > 22/28 (frontal lobe) > 9/12 (occipital lobe) > 8/12 (limbic system) > 5/8 (deep GM)]. The optimal PLD for most VOIs in youth group was 1525 ms. However, for middle-aged and elderly group, the optimal PLD for most VOIs was 2525 ms. CONCLUSION Young people are less affected by PLDs than middle-aged and elderly people. The middle-aged people are most affected by PLDs. In addition, the spatial distributions of PLD effect were different among the three age groups. Optimizing the PLD for ASL imaging according to age and brain regions can obtain more accurate and reliable CBF values.
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Affiliation(s)
- Ying Hu
- Department of Radiology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan
| | | | - Qi Li
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Rongbo Liu
- Department of Radiology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan
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16
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Donahue PMC, Crescenzi R, Lee C, Garza M, Patel NJ, Petersen KJ, Donahue MJ. Magnetic resonance imaging and bioimpedance evaluation of lymphatic abnormalities in patients with breast cancer treatment-related lymphedema. Breast Cancer Res Treat 2020; 183:83-94. [PMID: 32601969 DOI: 10.1007/s10549-020-05765-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 06/20/2020] [Indexed: 02/08/2023]
Abstract
PURPOSE Breast cancer treatment-related lymphedema (BCRL) evaluation is frequently performed using portable measures of limb volume and bioimpedance asymmetry. Here quantitative magnetic resonance imaging (MRI) is applied to evaluate deep and superficial tissue impairment, in both surgical and contralateral quadrants, to test the hypothesis that BCRL impairment is frequently bilateral and extends beyond regions commonly evaluated with portable external devices. METHODS 3-T MRI was applied to investigate BCRL topographical impairment. Female BCRL (n = 33; age = 54.1 ± 11.2 years; stage = 1.5 ± 0.8) and healthy (n = 33; age = 49.4 ± 11.0 years) participants underwent quantitative upper limb MRI relaxometry (T2), bioimpedance asymmetry, arm volume asymmetry, and physical evaluation. Parametric tests were applied to evaluate study measurements (i) between BCRL and healthy participants, (ii) between surgical and contralateral limbs, and (iii) in relation to clinical indicators of disease severity. Two-sided p-value < 0.05 was required for significance. RESULTS Bioimpedance asymmetry was significantly correlated with MRI-measured water relaxation (T2) in superficial tissue. Deep muscle (T2 = 37.6 ± 3.5 ms) and superficial tissue (T2 = 49.8 ± 13.2 ms) relaxation times were symmetric in healthy participants. In the surgical limbs of BCRL participants, deep muscle (T2 = 40.5 ± 4.9 ms) and superficial tissue (T2 = 56.0 ± 14.8 ms) relaxation times were elevated compared to healthy participants, consistent with an edematous micro-environment. This elevation was also observed in contralateral limbs of BCRL participants (deep muscle T2 = 40.3 ± 5.7 ms; superficial T2 = 56.6 ± 13.8 ms). CONCLUSIONS Regional MRI measures substantiate a growing literature speculating that superficial and deep tissue, in surgical and contralateral quadrants, is affected in BCRL. The implications of these findings in the context of titrating treatment regimens and understanding malignancy recurrence are discussed.
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Affiliation(s)
- Paula M C Donahue
- Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt Dayani Center for Health and Wellness, Nashville, TN, USA
| | - Rachelle Crescenzi
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Chelsea Lee
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Maria Garza
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Niral J Patel
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kalen J Petersen
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Manus J Donahue
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA. .,Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA. .,Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
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18
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Neural bases of impulse control disorders in Parkinson’s disease: A systematic review and an ALE meta-analysis. Neurosci Biobehav Rev 2019; 107:672-685. [DOI: 10.1016/j.neubiorev.2019.09.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/24/2019] [Accepted: 09/28/2019] [Indexed: 12/16/2022]
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19
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Weintraub D, Mamikonyan E. The Neuropsychiatry of Parkinson Disease: A Perfect Storm. Am J Geriatr Psychiatry 2019; 27:998-1018. [PMID: 31006550 PMCID: PMC7015280 DOI: 10.1016/j.jagp.2019.03.002] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/04/2019] [Accepted: 03/04/2019] [Indexed: 12/16/2022]
Abstract
Affective disorders, cognitive decline, and psychosis have long been recognized as common in Parkinson disease (PD), and other psychiatric disorders include impulse control disorders, anxiety symptoms, disorders of sleep and wakefulness, and apathy. Psychiatric aspects of PD are associated with numerous adverse outcomes, yet in spite of this and their frequent occurrence, there is incomplete understanding of epidemiology, presentation, risk factors, neural substrate, and management strategies. Psychiatric features are typically multimorbid, and there is great intra- and interindividual variability in presentation. The hallmark neuropathophysiological changes that occur in PD, plus the association between exposure to dopaminergic medications and certain psychiatric disorders, suggest a neurobiological basis for many psychiatric symptoms, although psychological factors are involved as well. There is evidence that psychiatric disorders in PD are still under-recognized and undertreated and although psychotropic medication use is common, controlled studies demonstrating efficacy and tolerability are largely lacking. Future research on neuropsychiatric complications in PD should be oriented toward determining modifiable correlates or risk factors and establishing efficacious and well-tolerated treatment strategies.
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Affiliation(s)
- Daniel Weintraub
- Perelman School of Medicine (DW, EM), University of Pennsylvania, Philadelphia; Parkinson's Disease Research, Education and Clinical Center (PADRECC) (DW), Philadelphia Veterans Affairs Medical Center, Philadelphia.
| | - Eugenia Mamikonyan
- Perelman School of Medicine (DW, EM), University of Pennsylvania, Philadelphia
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20
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Girard R, Obeso I, Thobois S, Park SA, Vidal T, Favre E, Ulla M, Broussolle E, Krack P, Durif F, Dreher JC. Wait and you shall see: sexual delay discounting in hypersexual Parkinson's disease. Brain 2019; 142:146-162. [PMID: 30590514 DOI: 10.1093/brain/awy298] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 10/04/2018] [Indexed: 02/02/2023] Open
Abstract
Patients with Parkinson's disease may develop impulse control disorders under dopaminergic treatments. Impulse control disorders include a wide spectrum of behaviours, such as hypersexuality, pathological gambling or compulsive shopping. Yet, the neural systems engaged in specific impulse control disorders remain poorly characterized. Here, using model-based functional MRI, we aimed to determine the brain systems involved during delay-discounting of erotic rewards in hypersexual patients with Parkinson's disease (PD+HS), patients with Parkinson's disease without hypersexuality (PD - HS) and controls. Patients with Parkinson's disease were evaluated ON and OFF levodopa (counterbalanced). Participants had to decide between two options: (i) wait for 1.5 s to briefly view an erotic image; or (ii) wait longer to see the erotic image for a longer period of time. At the time of decision-making, we investigated which brain regions were engaged with the subjective valuation of the delayed erotic reward. At the time of the rewarded outcome, we searched for the brain regions responding more robustly after waiting longer to view the erotic image. PD+HS patients showed reduced discounting of erotic delayed rewards, compared to both patients with Parkinson's disease and controls, suggesting that they accepted waiting longer to view erotic images for a longer period of time. Thus, when using erotic stimuli that motivate PD+HS, these patients were less impulsive for the immediate reward. At the brain system level, this effect was paralleled by the fact that PD+HS, as compared to controls and PD - HS, showed a negative correlation between subjective value of the delayed reward and activity of medial prefrontal cortex and ventral striatum. Consistent with the incentive salience hypothesis combining learned cue-reward associations with current relevant physiological state, dopaminergic treatment in PD+HS boosted excessive 'wanting' of rewards and heightened activity in the anterior medial prefrontal cortex and the posterior cingulate cortex, as reflected by higher correlation with subjective value of the option associated to the delayed reward when ON medication as compared to the OFF medication state. At the time of outcome, the anterior medial prefrontal/rostral anterior cingulate cortex showed an interaction between group (PD+HS versus PD - HS) and medication (ON versus OFF), suggesting that dopaminergic treatment boosted activity of this brain region in PD+HS when viewing erotic images after waiting for longer periods of time. Our findings point to reduced delay discounting of erotic rewards in PD+HS, both at the behavioural and brain system levels, and abnormal reinforcing effect of levodopa when PD+HS patients are confronted with erotic stimuli.10.1093/brain/awy298_video1awy298media15983845074001.
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Affiliation(s)
- Romuald Girard
- Neuroeconomics, Reward and Decision-making Team, Institut des Sciences Cognitives Marc Jeannerod, Centre National de la Recherche Scientifique, UMR 5229, Bron, France.,University Claude Bernard Lyon, Lyon 1, Villeurbanne, France.,Section of Neurosurgery, The University of Chicago Medicine and Biological Sciences, Chicago, IL, USA
| | - Ignacio Obeso
- Neuroeconomics, Reward and Decision-making Team, Institut des Sciences Cognitives Marc Jeannerod, Centre National de la Recherche Scientifique, UMR 5229, Bron, France.,University Claude Bernard Lyon, Lyon 1, Villeurbanne, France.,HM Hospitales - Centro Integral en Neurociencias HM CINAC, Móstoles, Madrid, Spain
| | - Stéphane Thobois
- Université de Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux, Oullins, France.,Neurologie C, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.,Physiopathology of basal ganglia, Institut des Sciences Cognitives Marc Jeannerod, Centre National de la Recherche Scientifique, UMR 5229, Bron, France
| | - Seongmin A Park
- Neuroeconomics, Reward and Decision-making Team, Institut des Sciences Cognitives Marc Jeannerod, Centre National de la Recherche Scientifique, UMR 5229, Bron, France.,University Claude Bernard Lyon, Lyon 1, Villeurbanne, France
| | - Tiphaine Vidal
- Neurology Department, CHU de Clermont-Ferrand, Clermont-Ferrand, France.,University Clermont Auvergne, Clermont Ferrand, France
| | - Emilie Favre
- Neurologie C, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - Miguel Ulla
- Neurology Department, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Emmanuel Broussolle
- University Claude Bernard Lyon, Lyon 1, Villeurbanne, France.,Neurologie C, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.,Physiopathology of basal ganglia, Institut des Sciences Cognitives Marc Jeannerod, Centre National de la Recherche Scientifique, UMR 5229, Bron, France
| | - Paul Krack
- University Grenoble Alpes, Grenoble Institut des Neurosciences, Grenoble, France, Inserm, Grenoble, France.,Movement Disorders Unit, Neurology Department, CHU de Grenoble, Grenoble, France
| | - Franck Durif
- Neurology Department, CHU de Clermont-Ferrand, Clermont-Ferrand, France.,University Clermont Auvergne, Clermont Ferrand, France
| | - Jean-Claude Dreher
- Neuroeconomics, Reward and Decision-making Team, Institut des Sciences Cognitives Marc Jeannerod, Centre National de la Recherche Scientifique, UMR 5229, Bron, France.,University Claude Bernard Lyon, Lyon 1, Villeurbanne, France
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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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22
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Meder D, Herz DM, Rowe JB, Lehéricy S, Siebner HR. The role of dopamine in the brain - lessons learned from Parkinson's disease. Neuroimage 2019; 190:79-93. [DOI: 10.1016/j.neuroimage.2018.11.021] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 10/25/2018] [Accepted: 11/16/2018] [Indexed: 11/30/2022] Open
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Martini A, Weis L, Fiorenzato E, Schifano R, Cianci V, Antonini A, Biundo R. Impact of Cognitive Profile on Impulse Control Disorders Presence and Severity in Parkinson's Disease. Front Neurol 2019; 10:266. [PMID: 30967834 PMCID: PMC6439312 DOI: 10.3389/fneur.2019.00266] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 02/27/2019] [Indexed: 12/12/2022] Open
Abstract
Background: Impulse control disorders (ICDs) and related behaviors are frequent in Parkinson's disease (PD). Mild cognitive impairment (PD-MCI) and dementia (PDD), both characterized by heterogeneous cognitive phenotypes, are also commonly reported in PD. However, the frequency and severity of ICD within PD cognitive states is unknown. Methods: Three hundred and twenty-six PD patients completed a comprehensive neuropsychological assessment and were classified as PD-MCI, PDD, or without cognitive alterations (PD-NC). The Minnesota impulsive disorders interview was used to ascertain the presence (ICD+) or absence (ICD–) of ICD. The Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale was used to assess ICD severity. A subsample of 286 patients evaluated with the same cognitive tasks was selected in order to investigate the characteristics of ICD in PD cognitive phenotypes. Results: ICDs were present in 55% of PD-NC, in 50% of PD-MCI, and in 42% of PDD patients. Frequencies of ICD+ with attentive (ICD+: 20% vs. ICD–: 4%; p = 0.031) and executive impairments (ICD+: 44% vs. ICD–: 30%; p = 0.027) were higher in the PD-MCI and PDD subgroups, respectively. As expected, no differences were observed in the PD-NC. PD-MCI with attentive impairments presented higher percentage of ICD+ with deficits in the Trail Making Test B-A but not in the Digit Span Sequencing task. In PDD, executive failures concerned Similarities task (ICD+: 67%; ICD–: 29%; p = 0.035), with no differences between ICD+ and ICD– in the Stroop task. Conclusions: Prevalence and severity of ICDs and related behaviors do not differ in PD with different cognitive states. However, ICD+ are more likely to show deficits, respectively in attentive and in executive domains, specifically in the Trail Making Test B-A task for the attention and working memory domain in PD-MCI and in the Similarities task for the executive function domain in PDD. Prospective studies should evaluate if these tests can be used as screening tool for ICDs in PD.
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Affiliation(s)
- Alice Martini
- School of Psychology, Keele University, Newcastle-under-Lyme, United Kingdom
| | - Luca Weis
- IRCCS San Camillo Hospital, Venice, Italy
| | | | | | | | - Angelo Antonini
- Department of Neuroscience (DNS), University of Padua, Padua, Italy
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Ramdave S, Dawson A, Carter A, Dissanayaka NNW. Unmasking neurobiological commonalities between addictive disorders and impulse control disorders in Parkinson’s disease. Brain Imaging Behav 2019; 14:2785-2798. [PMID: 30707344 DOI: 10.1007/s11682-019-00041-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Changes in reward circuitry have been studied extensively in substance and behavioural addictions. However, comparatively little is known about the neurobiology underlying impulse control disorders (ICDs) in Parkinson's disease, which show roughly similar risk factors and behavioural presentations to both stimulant and behavioural addictions. ICDs occur in a subset of susceptible patients with Parkinson's disease (PD) following intake of dopamine replacement therapy (DRT). These behavioural disorders often have debilitating effects on a patient's quality of life and increase caregiver burden. This comprehensive review examined findings of 40 neuroimaging studies of ICDs in PD to determine (a) whether there are putative neurobiological commonalities between traditional substance and behavioural addictions and DRT-induced ICD in PD and (b) opportunities for future studies to advance current neurobiological understanding of the phenomenon. Results revealed that strikingly similar (a) deficits in dopaminergic receptor expression, (b) connectivity changes in corticostriatal circuitry and (c) neural responses to cue exposure are observed in both ICDs in PD and addictive disorders. These findings point to the value of adopting a transdiagnostic approach when studying addicted populations and pave the way for demystifying this peculiar, often-devastating phenomenon in PD that has so far proven extremely difficult to treat and predict with any precision.
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Affiliation(s)
- Swathi Ramdave
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia.
- School of Psychology, The University of Queensland, Brisbane, Australia.
| | - Andrew Dawson
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Australia
| | - Adrian Carter
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Australia
| | - Nadeeka N W Dissanayaka
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- School of Psychology, The University of Queensland, Brisbane, Australia
- Department of Neurology, Royal Brisbane & Woman's Hospital, Brisbane, Australia
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Trujillo P, van Wouwe NC, Lin YC, Stark AJ, Petersen KJ, Kang H, Zald DH, Donahue MJ, Claassen DO. Dopamine effects on frontal cortical blood flow and motor inhibition in Parkinson's disease. Cortex 2019; 115:99-111. [PMID: 30776736 DOI: 10.1016/j.cortex.2019.01.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 12/15/2018] [Accepted: 01/17/2019] [Indexed: 12/31/2022]
Abstract
Parkinson's disease (PD) is characterized by dysfunction in frontal cortical and striatal networks that regulate action control. We investigated the pharmacological effect of dopamine agonist replacement therapy on frontal cortical activity and motor inhibition. Using Arterial Spin Labeling MRI, we examined 26 PD patients in the off- and on-dopamine agonist medication states to assess the effect of dopamine agonists on frontal cortical regional cerebral blood flow. Motor inhibition was measured by the Simon task in both medication states. We applied the dual process activation suppression model to dissociate fast response impulses from motor inhibition of incorrect responses. General linear regression model analyses determined the medication effect on regional cerebral blood flow and motor inhibition, and the relationship between regional cerebral blood flow and motor inhibitory proficiency. We show that dopamine agonist administration increases frontal cerebral blood flow, particularly in the pre-supplementary motor area (pre-SMA) and the dorsolateral prefrontal cortex (DLPFC). Higher regional blood flow in the pre-SMA, DLPFC and motor cortex was associated with better inhibitory control, suggesting that treatments which improve frontal cortical activity could ameliorate motor inhibition deficiency in PD patients.
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Affiliation(s)
- Paula Trujillo
- Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Ya-Chen Lin
- Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Adam J Stark
- Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kalen J Petersen
- Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hakmook Kang
- Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - David H Zald
- Psychiatry, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Manus J Donahue
- Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Psychiatry, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Daniel O Claassen
- Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
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26
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Martini A, Dal Lago D, Edelstyn NMJ, Salgarello M, Lugoboni F, Tamburin S. Dopaminergic Neurotransmission in Patients With Parkinson's Disease and Impulse Control Disorders: A Systematic Review and Meta-Analysis of PET and SPECT Studies. Front Neurol 2018; 9:1018. [PMID: 30568628 PMCID: PMC6290338 DOI: 10.3389/fneur.2018.01018] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 11/12/2018] [Indexed: 12/18/2022] Open
Abstract
Background: Around 30% Parkinson's disease (PD) patients develop impulse control disorders (ICDs) to D2/3 dopamine agonists and, to a lesser extent, levodopa. We aim to investigate striatal dopaminergic function in PD patients with and without ICD. Methods: PubMed, Science Direct, EBSCO, and ISI Web of Science databases were searched (from inception to March 7, 2018) to identify PET or SPECT studies reporting striatal dopaminergic function in PD patients with ICD (ICD+) compared to those without ICD (ICD–). Studies which included drug naïve patients, explored non-pharmacological procedures (e.g., deep brain stimulation), and those using brain blood perfusion or non-dopaminergic markers were excluded. Standardized mean difference (SDM) was used and random-effect models were applied. Separate meta-analyses were performed for dopamine transporter level, dopamine release, and dopamine receptors availability in the putamen, caudate, dorsal, and ventral striatum. Results: A total of 238 studies were title and abstract screened, of which 19 full-texts were assessed. Nine studies (ICD+: N = 117; ICD–: N = 175 patients) were included in the analysis. ICD+ showed a significant reduction of dopamine transporter binding in the putamen (SDM = −0.46; 95% CI: −0.80, −0.11; Z = 2.61; p = 0.009), caudate (SDM = −0.38; 95% CI: −0.73, −0.04; Z = 2.18; p = 0.03) and dorsal striatum (SDM = −0.45; 95% CI: −0.77, −0.13; Z = 2.76; p = 0.006), and increased dopamine release to reward-related stimuli/gambling tasks in the ventral striatum (SDM = −1.04; 95% CI: −1.73, −0.35; Z = 2.95; p = 0.003). Dopamine receptors availability did not differ between groups. Heterogeneity was low for dopamine transporter in the dorsal striatum (I2 = 0%), putamen (I2 = 0%) and caudate (I2 = 0%), and pre-synaptic dopamine release in the dorsal (I2 = 0%) and ventral striatum (I2 = 0%); heterogeneity was high for dopamine transporter levels in the ventral striatum (I2 = 80%), and for dopamine receptors availability in the ventral (I2 = 89%) and dorsal (I2 = 86%) striatum, putamen (I2 = 93%), and caudate (I2 = 71%). Conclusions: ICD+ patients show lower dopaminergic transporter levels in the dorsal striatum and increased dopamine release in the ventral striatum when engaged in reward-related stimuli/gambling tasks. This dopaminergic imbalance might represent a biological substrate for ICD in PD. Adequately powered longitudinal studies with drug naïve patients are needed to understand whether these changes may represent biomarkers of premorbid vulnerability to ICD.
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Affiliation(s)
- Alice Martini
- School of Psychology, Keele University, Newcastle-under-Lyme, United Kingdom
| | - Denise Dal Lago
- School of Psychology, Keele University, Newcastle-under-Lyme, United Kingdom
| | - Nicola M J Edelstyn
- School of Psychology, Keele University, Newcastle-under-Lyme, United Kingdom
| | - Matteo Salgarello
- Department of Nuclear Medicine, Ospedale Sacro Cuore Don Calabria, Verona, Italy
| | - Fabio Lugoboni
- Addiction Unit, Department of Internal Medicine, University Hospital of Verona, Verona, Italy
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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27
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Köhler S, Schumann A, de la Cruz F, Wagner G, Bär KJ. Towards response success prediction: An integrative approach using high-resolution fMRI and autonomic indices. Neuropsychologia 2018; 119:182-190. [DOI: 10.1016/j.neuropsychologia.2018.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 07/28/2018] [Accepted: 08/03/2018] [Indexed: 12/14/2022]
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28
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Martini A, Dal Lago D, Edelstyn NMJ, Grange JA, Tamburin S. Impulse Control Disorder in Parkinson's Disease: A Meta-Analysis of Cognitive, Affective, and Motivational Correlates. Front Neurol 2018; 9:654. [PMID: 30233478 PMCID: PMC6127647 DOI: 10.3389/fneur.2018.00654] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Accepted: 07/23/2018] [Indexed: 01/08/2023] Open
Abstract
Background: In Parkinson's disease (PD), impulse control disorders (ICDs) develop as side-effect of dopaminergic replacement therapy (DRT). Cognitive, affective, and motivational correlates of ICD in medicated PD patients are debated. Here, we systematically reviewed and meta-analyzed the evidence for an association between ICD in PD and cognitive, affective, and motivational abnormalities. Methods: A systematic review and meta-analysis was performed on PubMed, Science Direct, ISI Web of Science, Cochrane, EBSCO for studies published between 1-1-2000 and 8-3-2017 comparing cognitive, affective, and motivational measures in PD patients with ICD (ICD+) vs. those without ICD (ICD-). Exclusion criteria were conditions other than PD, substance and/or alcohol abuse, dementia, drug naïve patients, cognition assessed by self-report tools. Standardized mean difference (SMD) was used, and random-effect model applied. Results: 10,200 studies were screened (title, abstract), 79 full-texts were assessed, and 25 were included (ICD+: 625 patients; ICD-: 938). Compared to ICD-, ICD+ showed worse performance reward-related decision-making (0.42 [0.02, 0.82], p = 0.04) and set-shifting tasks (SMD = -0.49 [95% CI -0.78, -0.21], p = 0.0008). ICD in PD was also related to higher self-reported rate of depression (0.35 [0.16, 0.54], p = 0.0004), anxiety (0.43 [0.18, 0.68], p = 0.0007), anhedonia (0.26 [0.01, 0.50], p = 0.04), and impulsivity (0.79 [0.50, 1.09], p < 0.00001). Heterogeneity was low to moderate, except for depression (I2 = 61%) and anxiety (I2 = 58%). Conclusions: ICD in PD is associated with worse set-shifting and reward-related decision-making, and increased depression, anxiety, anhedonia, and impulsivity. This is an important area for further studies as ICDs have negative impact on the quality of life of patients and their caregivers.
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Affiliation(s)
- Alice Martini
- School of Psychology, Keele University, Newcastle-under-Lyme, United Kingdom
| | - Denise Dal Lago
- School of Psychology, Keele University, Newcastle-under-Lyme, United Kingdom
| | - Nicola M J Edelstyn
- School of Psychology, Keele University, Newcastle-under-Lyme, United Kingdom
| | - James A Grange
- School of Psychology, Keele University, Newcastle-under-Lyme, United Kingdom
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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29
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Petersen K, Van Wouwe N, Stark A, Lin YC, Kang H, Trujillo-Diaz P, Kessler R, Zald D, Donahue MJ, Claassen DO. Ventral striatal network connectivity reflects reward learning and behavior in patients with Parkinson's disease. Hum Brain Mapp 2017; 39:509-521. [PMID: 29086460 DOI: 10.1002/hbm.23860] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 10/16/2017] [Indexed: 12/24/2022] Open
Abstract
A subgroup of Parkinson's disease (PD) patients treated with dopaminergic therapy develop compulsive reward-driven behaviors, which can result in life-altering morbidity. The mesocorticolimbic dopamine network guides reward-motivated behavior; however, its role in this treatment-related behavioral phenotype is incompletely understood. Here, mesocorticolimbic network function in PD patients who develop impulsive and compulsive behaviors (ICB) in response to dopamine agonists was assessed using BOLD fMRI. The tested hypothesis was that network connectivity between the ventral striatum and the limbic cortex is elevated in patients with ICB and that reward-learning proficiency reflects the extent of mesocorticolimbic network connectivity. To evaluate this hypothesis, 3.0T BOLD-fMRI was applied to measure baseline functional connectivity on and off dopamine agonist therapy in age and sex-matched PD patients with (n = 19) or without (n = 18) ICB. An incentive-based task was administered to a subset of patients (n = 20) to quantify positively or negatively reinforced learning. Whole-brain voxelwise analyses and region-of-interest-based mixed linear effects modeling were performed. Elevated ventral striatal connectivity to the anterior cingulate gyrus (P = 0.013), orbitofrontal cortex (P = 0.034), insula (P = 0.044), putamen (P = 0.014), globus pallidus (P < 0.01), and thalamus (P < 0.01) was observed in patients with ICB. A strong trend for elevated amygdala-to-midbrain connectivity was found in ICB patients on dopamine agonist. Ventral striatum-to-subgenual cingulate connectivity correlated with reward learning (P < 0.01), but not with punishment-avoidance learning. These data indicate that PD-ICB patients have elevated network connectivity in the mesocorticolimbic network. Behaviorally, proficient reward-based learning is related to this enhanced limbic and ventral striatal connectivity. Hum Brain Mapp 39:509-521, 2018. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Kalen Petersen
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Nelleke Van Wouwe
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Adam Stark
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ya-Chen Lin
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Hakmook Kang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Paula Trujillo-Diaz
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Robert Kessler
- Department of Radiology, University of Alabama School of Medicine, Birmingham, Alabama
| | - David Zald
- Department of Psychology, Vanderbilt University, Nashville, Tennessee
| | - Manus J Donahue
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Daniel O Claassen
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee
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