Impulse control disorders in Parkinson’s disease

Marques A(1)(2), Durif F(1)(2), Fernagut PO(3)(4)(5)(6).

Author information:
(1)EA 7280, Université Clermont Auvergne, Clermont-Ferrand, France.
(2)Department of Neurology, CHU Clermont-Ferrand, Clermont-Ferrand, France.
(3)Institut des Maladies Neurodégénératives, UMR 5293, Université de Bordeaux,
Bordeaux, France. .
(4)CNRS, UMR 5293, Institute of Neurodegenerative Diseases, Université de
Bordeaux, 146 rue Léo Saignat, 33076, Bordeaux Cedex, France.
.
(5)Laboratoire de Neurosciences Expérimentales et Cliniques, INSERM U1084,
Poitiers, France. .
(6)Laboratoire de Neurosciences Expérimentales et Cliniques, Université de
Poitiers, Poitiers, France. .

Impulse control disorders (ICD) are frequent side effects of dopamine
replacement therapy (DRT) used in Parkinson’s disease (PD) with devastating
consequences on the patients and caregivers. ICD are behavioural addictions
including compulsive gambling, shopping, sexual behaviour, and binge eating that
are mainly associated with dopamine D2/D3 agonists. Their management is a real
clinical challenge due to the lack of therapeutic alternative. Clinical studies
have identified demographic and clinical risk factors for ICD such as younger
age at disease onset, male gender, prior history of depression or substance
abuse, REM sleep behaviour disorders and higher rate of dyskinesia. PD patients
with ICD may also have a specific pattern of dopaminergic denervation in the
ventral striatum. Specific evaluation tools have now been designed to better
evaluate the severity and impact of ICD in PD. Patients with ICD display altered
processing of reward and loss, and decisional bias associated with altered
activity in cortical and subcortical areas such as the orbitofrontal cortex,
amygdala, insula, anterior cingular cortex, and ventral striatum. Preclinical
studies have demonstrated that D2/D3 agonists induce impairments in behavioural
processes likely relevant to ICD such as risk-taking behaviour, preference for
uncertainty, perseverative responding and sustained drive to engage in
gambling-like behaviour. Whether interactions between dopamine denervation and
DRT significantly contribute to the pathogenesis of ICD remains poorly
understood so far, although features unique to PD have been identified in
patients with ICD. Large-scale longitudinal studies are needed to better
identify subjects with increased risk to develop ICD and develop therapeutic
options.

DOI: 10.1007/s00702-018-1870-8
PMID: 29511827 [Indexed for MEDLINE]

Auteurs Bordeaux Neurocampus