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Gan C, Zhang H, Sun H, Cao X, Wang L, Zhang K, Yuan Y. Aberrant brain topological organization and granger causality connectivity in Parkinson's disease with impulse control disorders. Front Aging Neurosci 2024; 16:1364402. [PMID: 38725535 PMCID: PMC11079187 DOI: 10.3389/fnagi.2024.1364402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/03/2024] [Indexed: 05/12/2024] Open
Abstract
Introduction Impulse control disorders (ICDs) refer to the common neuropsychiatric complication of Parkinson's disease (PD). The white matter (WM) topological organization and its impact on brain networks remain to be established. Methods A total of 17 PD patients with ICD (PD-ICD), 17 without ICD (PD-NICD), and 18 healthy controls (HCs) were recruited. Graph theoretic analyses and Granger causality analyses were combined to investigate WM topological organization and the directional connection patterns of key regions. Results Compared to PD-NICD, ICD patients showed abnormal global properties, including decreased shortest path length (Lp) and increased global efficiency (Eg). Locally, the ICD group manifested abnormal nodal topological parameters predominantly in the left middle cingulate gyrus (MCG) and left superior cerebellum. Decreased directional connectivity from the left MCG to the right medial superior frontal gyrus was observed in the PD-ICD group. ICD severity was significantly correlated with Lp and Eg. Discussion Our findings reflected that ICD patients had excessively optimized WM topological organization, abnormally strengthened nodal structure connections within the reward network, and aberrant causal connectivity in specific cortical- limbic circuits. We hypothesized that the aberrant reward and motor inhibition circuit could play a crucial role in the emergence of ICDs.
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Affiliation(s)
- Caiting Gan
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Heng Zhang
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Huimin Sun
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xingyue Cao
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Lina Wang
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Kezhong Zhang
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yongsheng Yuan
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Key Laboratory of Neurodegeneration, Nanjing Medical University, Nanjing, China
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Staubo SC, Fuskevåg OM, Toft M, Lie IH, Alvik KMJ, Jostad P, Tingvoll SH, Lilleng H, Rosqvist K, Størset E, Odin P, Dietrichs E, Dietrichs ES. Dopamine agonist serum concentrations and impulse control disorders in Parkinson's disease. Eur J Neurol 2024; 31:e16144. [PMID: 37955562 DOI: 10.1111/ene.16144] [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: 08/03/2023] [Revised: 10/18/2023] [Accepted: 10/26/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND AND PURPOSE Impulse control disorders (ICDs) are common among Parkinson's disease patients using dopamine agonists. We wanted to determine whether ICD patients have higher dopamine agonist serum concentrations than those without any sign of ICD. METHODS Patients who used either pramipexole or ropinirole depot once daily were screened for ICDs using the validated Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale. Those who scored above the cut-off for one or more of the four defined ICDs (gambling, compulsive sexual behavior, compulsive shopping, and binge-eating) were compared in a case-control study to patients who scored zero points (no evidence of ICD) on the same items. They were examined clinically and evaluated using relevant scales. Three blood samples were taken on the same day: before daily dose, and then 6 and 12 h later. RESULTS Forty-six patients were included: 19 ICD-positive and 27 controls. Ropinirole serum concentrations 6 h after daily intake (Cmax ) were higher in the case group compared to the control group, as was the daily ropinirole dosage. No differences were observed in serum concentrations, dosage or total drug exposure for pramipexole. Disease duration and length of dopamine agonist treatment was significantly longer among ICD patients for ropinirole, but not for pramipexole. CONCLUSIONS The use of pramipexole may in itself confer high ICD risk, whereas ICDs among ropinirole users depend more on serum concentration and drug exposure. The pharmacokinetic properties of ropinirole make it challenging to predict its effects on patients, which supports the need for therapeutic drug monitoring to reduce risk of ICD.
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Affiliation(s)
- Sara C Staubo
- Department of Neurology, Oslo University Hospital, Oslo, Norway
- Department of Neurology, Akershus University Hospital, Nordbyhagen, Norway
| | - Ole Martin Fuskevåg
- Experimental and Clinical Pharmacology, Institute of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Laboratory Medicine, Division of Diagnostic Services, University Hospital of Northern Norway, Tromsø, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Mathias Toft
- Department of Neurology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingeborg H Lie
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | | | - Pål Jostad
- Ringen Rehabilitation Centre, Moelv, Norway
| | | | - Hallvard Lilleng
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Neurology, University Hospital of Northern Norway, Tromsø, Norway
| | - Kristina Rosqvist
- Division of Neurology, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - Elisabet Størset
- Center for Psychopharmacology, Diakonhjemmet Hospital, Oslo, Norway
| | - Per Odin
- Division of Neurology, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - Espen Dietrichs
- Department of Neurology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Erik Sveberg Dietrichs
- Experimental and Clinical Pharmacology, Institute of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Laboratory Medicine, Division of Diagnostic Services, University Hospital of Northern Norway, Tromsø, Norway
- Center for Psychopharmacology, Diakonhjemmet Hospital, Oslo, Norway
- Institute of Oral Biology, University of Oslo, Oslo, Norway
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Mata-Marín D, Pineda-Pardo JÁ, Michiels M, Pagge C, Ammann C, Martínez-Fernández R, Molina JA, Vela-Desojo L, Alonso-Frech F, Obeso I. A circuit-based approach to modulate hypersexuality in Parkinson's disease. Psychiatry Clin Neurosci 2022; 77:223-232. [PMID: 36579893 DOI: 10.1111/pcn.13523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 12/30/2022]
Abstract
AIM Impulse-control disorder is a common neuropsychiatric complication in Parkinson's disease (PD) under dopamine replacement therapy. Prior studies tested the balance between enhanced desire towards reward and cognitive control deficits, hypothesized to be biased towards the former in impulse control disorders. We provide evidence for this hypothesis by measuring behavioral and neural patterns behind the influence of sexual desire over response inhibition and tools towards functional restoration using repetitive transcranial stimulation in patients with hypersexuality as predominant impulsive disorder. METHODS The effect of sexual cues on inhibition was measured with a novel erotic stop-signal task under on and off dopaminergic medication. Task-related functional and anatomical connectivity models were estimated in 16 hypersexual and 17 nonhypersexual patients with PD as well as in 17 healthy controls. Additionally, excitatory neuromodulation using intermittent theta-burst stimulation (sham-controlled) was applied over the pre-supplementary motor area in 20 additional hypersexual patients with PD aiming to improve response inhibition. RESULTS Compared with their nonhypersexual peers, patients with hypersexuality recruited caudate, pre-supplementary motor area, ventral tegmental area, and anterior cingulate cortex while on medication. Reduced connectivity was found between pre-supplementary motor area and caudate nucleus in hypersexual compared with nonhypersexual patients (while medicated), a result paralleled by compensatory enhanced anatomical connectivity. Furthermore, stimulation over the pre-supplementary motor area improved response inhibition in hypersexual patients with PD when exposed to sexual cues. CONCLUSION This study, therefore, has identified a specific fronto-striatal and mesolimbic circuitry underlying uncontrolled sexual responses in medicated patients with PD where cortical neuromodulation halts its expression.
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Affiliation(s)
- David Mata-Marín
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain.,PhD program in Neuroscience, Autonoma University of Madrid, Madrid, Spain
| | - José Ángel Pineda-Pardo
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
| | - Mario Michiels
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain.,PhD program in Neuroscience, Autonoma University of Madrid, Madrid, Spain
| | - Cristina Pagge
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,PhD program in Neuroscience, Autonoma University of Madrid, Madrid, Spain
| | - Claudia Ammann
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain
| | - Raúl Martínez-Fernández
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
| | | | | | | | - Ignacio Obeso
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain.,Department of Psychobiology & Methods for the Behavioral Sciences Department, Complutense University of Madrid, Madrid, Spain
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Takeshige-Amano H, Hatano T, Kamagata K, Andica C, Uchida W, Abe M, Ogawa T, Shimo Y, Oyama G, Umemura A, Ito M, Hori M, Aoki S, Hattori N. White matter microstructures in Parkinson's disease with and without impulse control behaviors. Ann Clin Transl Neurol 2022; 9:253-263. [PMID: 35137566 PMCID: PMC8935280 DOI: 10.1002/acn3.51504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 11/20/2021] [Accepted: 12/28/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Impulse control behaviors (ICBs) in Parkinson's disease (PD) are thought to be caused by an overdose of dopaminergic therapy in the relatively spared ventral striatum, or by hypersensitivity of this region to dopamine. Alterations in brain networks are now also thought to contribute to the development of ICBs. OBJECTIVE To comprehensively assess white matter microstructures in PD patients with ICBs using advanced diffusion MRI and magnetization transfer saturation (MT-sat) imaging. METHODS This study included 19 PD patients with ICBs (PD-ICBs), 18 PD patients without ICBs (PD-nICBs), and 20 healthy controls (HCs). Indices of diffusion tensor imaging (DTI), diffusion kurtosis imaging, neurite orientation dispersion and density imaging, and MT-sat imaging were evaluated using tract-based spatial statistics (TBSS), regions of interest (ROIs), and tract-specific analysis (TSA). RESULTS Compared with HCs, PD-nICBs had significant alterations in many major white matter tracts in most parameters. In contrast, PD-ICBs had only partial changes in several parameters. Compared with PD-ICBs, TBSS, ROI, and TSA analyses revealed that PD-nICBs had lower axial kurtosis, myelin volume fraction, and orientation dispersion index in the uncinate fasciculus and external capsule, as well as in the retrolenticular part of the internal capsule. These are components of the reward system and the visual and emotional perception areas, respectively. INTERPRETATION Myelin and axonal changes in fibers related to the reward system and visual emotional recognition might be more prominent in PD-nICBs than in PD-ICBs.
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Affiliation(s)
- Haruka Takeshige-Amano
- Department of Neurology, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 1138421, Japan.,Department of Neurology, Juntendo University Nerima Hospital, 3-1-10 Takanodai Nerima-ku, Tokyo, 1778521, Japan
| | - Taku Hatano
- Department of Neurology, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 1138421, Japan
| | - Koji Kamagata
- Department of Radiology, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 1138421, Japan
| | - Christina Andica
- Department of Radiology, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 1138421, Japan
| | - Wataru Uchida
- Department of Radiology, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 1138421, Japan
| | - Masahiro Abe
- Department of Radiology, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 1138421, Japan
| | - Takashi Ogawa
- Department of Neurology, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 1138421, Japan
| | - Yasushi Shimo
- Department of Neurology, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 1138421, Japan.,Department of Neurology, Juntendo University Nerima Hospital, 3-1-10 Takanodai Nerima-ku, Tokyo, 1778521, Japan
| | - Genko Oyama
- Department of Neurology, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 1138421, Japan
| | - Atsushi Umemura
- Department of Neurosurgery, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 1138421, Japan
| | - Masanobu Ito
- Department of Psychiatry, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 1138421, Japan
| | - Masaaki Hori
- Department of Radiology, Toho University Omori Medical Center, 6-11-1 Omorinishi, Ota-ku, Tokyo, 1438540, Japan
| | - Shigeki Aoki
- Department of Radiology, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 1138421, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 1138421, Japan
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