Dopamine agonists and risk: impulse control disorders in Parkinson's; disease

Voon, Valerie; Gao, Jennifer; Brezing, Christina; Symmonds, Mkael; Ekanayake, Vindhya; Fernandez, Hubert; Dolan, Raymond J.; Hallett, Mark

doi:10.1093/brain/awr080

Cited by 192 publications

(189 citation statements)

References 25 publications

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“…Indeed, on one hand, the use of STN DBS has been proposed to allow improvement in dopamine dysregulation syndrome, impulse control disorders or other behavioural addictions made possible by postoperative reductions in dopamine replacement therapy, based on clinical outcomes in retrospective studies (Witjas et al, 2005;Ardouin et al, 2006;Bandini et al, 2007;Knobel et al, 2008). Impulse control disorders and other behavioural addictions in Parkinson's disease are clearly linked to dopamine replacement therapy (Weintraub et al, 2010;Ambermoon et al, 2011;Voon et al, 2011b), and reduction of dopamine replacement therapy, and in particular of dopamine agonists, can improve impulse control disorder in the context of surgery (Kimber et al, 2008;Mamikonyan et al, 2008;Sohtaoglu et al, 2010). On the other hand, several studies have reported no improvement, worsening of pre-existing behavioural addictions (Lim et al, 2009) Lim et al, 2009;De la Casa-Fages and Grandas, 2011).…”

Section: Improvement Of Dopamine Dysregulation Syndrome Behavioural mentioning

confidence: 99%

Subthalamic stimulation in Parkinson’s disease: restoring the balance of motivated behaviours

Lhommée

Klinger

Thobois

et al. 2012

Brain

251

287

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Addictions to dopaminergic drugs or to pleasant behaviours are frequent and potentially devastating neuropsychiatric disorders observed in Parkinson's disease. They encompass impulse control disorders, punding and dopamine dysregulation syndrome. A relationship with dopaminergic treatment is strongly suggested. Subthalamic stimulation improves motor complications and allows for drastic reductions in medication. This treatment might, therefore, be considered for patients with behavioural addictions, when attempts to reduce dopaminergic medication have failed. However, conflicting data have reported suppression, alleviation, worsening or new onset of behavioural addictions after subthalamic stimulation. Non-motor fluctuations are also a disabling feature of the disease. We prospectively investigated behaviour in a cohort of 63 patients with Parkinson's disease, before and 1 year after subthalamic stimulation using the Ardouin scale, with systematic evaluation of functioning in overall appetitive or apathetic modes, non-motor fluctuations, dopaminergic dysregulation syndrome, as well as behavioural addictions (including impulse control disorders and punding) and compulsive use of dopaminergic medication. Defined drug management included immediate postoperative discontinuation of dopamine agonists and reduction in levodopa. Motor and cognitive statuses were controlled (Unified Parkinson's Disease Rating Scale, Mattis Dementia Rating Scale, frontal score). After surgery, the OFF medication motor score improved ( À 45.2%), allowing for a 73% reduction in dopaminergic treatment, while overall cognitive evaluation was unchanged. Preoperative dopamine dysregulation syndrome had disappeared in 4/4, behavioural addictions in 17/17 and compulsive dopaminergic medication use in 9/9 patients. New onset of levodopa abuse occurred in one patient with surgical failure. Non-motor fluctuations were significantly reduced with improvements in off-dysphoria (P 4 0.001) and reduction in on-euphoria (P 4 0.001). There was an inversion in the number of patients functioning in an overall appetitive mode (29 before versus 2 after surgery, P 4 0.0001) to an overall apathetic mode (3 before versus 13 after surgery, P 5 0.05). Two patients attempted suicide. Improvement in motor fluctuations is linked to the direct effect of stimulation on the sensory-motor subthalamic territory, while improvement in dyskinesias is mainly explained by an indirect effect related to the decrease in dopaminergic drugs. Our data suggest that non-motor fluctuations could similarly be directly alleviated through stimulation of the non-motor subthalamic territories, and hyperdopaminergic side effects might improve mainly due to the decrease in dopaminergic medication. We show an overall improvement in neuropsychiatric symptomatology and propose that disabling non-motor fluctuations, dopaminergic treatment abuse and drug-induced behavioural addictions in Parkinson's disease may be considered as new indications for subthalamic stimulation.

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Section: Improvement Of Dopamine Dysregulation Syndrome Behavioural mentioning

confidence: 99%

Subthalamic stimulation in Parkinson’s disease: restoring the balance of motivated behaviours

Lhommée

Klinger

Thobois

et al. 2012

Brain

251

287

View full text Add to dashboard Cite

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“…Interestingly, studies tend to show that DAs are molecules that influence the neuronal processes involved in reinforcement. A study conducted among 14 people with PD taking a DA and 14 control subjects who participated in an experimental gambling task showed that the former group presented a positive bias toward risk taking when positive reinforcements were presented to them and that this bias was explained by DA intake (Voon et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

“…Little data are available on the subject. In fact, many studies that aimed to understand the development of problem gambling among this population did not evaluate the types of games played or the amounts spent (see Callesen, Scheel-Kruger, Kringelbach, & Moller, 2013;Callesen et al, 2014;Voon et al, 2011;Weintraub et al, 2010).…”

Section: Characteristics and Types Of Gambling Activitiesmentioning

confidence: 99%

Gambling Habits of People With Parkinson’s Disease: An Exploratory Study

Nadeau¹,

Giroux²,

Simard³

et al. 2017

JGI

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The development of pathological gambling (PG) among people with Parkinson's disease (PD) is increasingly reported. The intake of dopamine agonists is most often associated with the emergence of this addiction. Although it is known that gambling habits contribute to the onset of gambling problems in the general population, these habits have not yet been studied in individuals with PD. Thus, this study aimed to explore gambling habits in people with PD. Twenty-five individuals with PD and 8 caregivers participated. Thirteen gamblers took part in a semi-structured interview regarding their gambling habits and the presence of a gambling problem and other impulse-control disorders. The results show that gamblers mainly play lotteries and slot machines. Most gamble for pleasure, but some reported wanting to win money to finance a cure for their PD. None of the gamblers involved a caregiver in their gambling activities and no gambler currently presented a gambling problem. However, 2 at-risk gamblers reported having developed a gambling problem in the past. This study sheds light on factors that may contribute to the development of PG among patients with PD, namely, the emergence of new reasons for gambling after a PD diagnosis, erroneous beliefs about gambling, and discretion about gambling habits. Prevention strategies are discussed in view of these results. However, given the small sample size, further studies examining the gambling habits of people with PD are required.Keywords: Parkinson's disease, pathological gambling, gambling habits RésuméDe plus en plus, on observe le développement du jeu pathologique (JP) chez les personnes atteintes de la maladie de Parkinson (MP). La prise d'agonistes de la

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“…[34][35][36][37] Recently, our group looked at DAA-induced alterations to reward and risk processing in patients with active ICD symptoms. 38 We used a version of the Balloon Analogue Risk task in patients both Off in the ventral striatum, and this region shows a differential response to rewarding stimuli.…”

Section: Mesocorticolimbic Function In Patients With Impulse Control mentioning

confidence: 99%

Dopamine Agonists and Impulse Control Disorders in Parkinson’s Disease

Claassen¹,

Kanoff²,

Wylie³

2013

US Neurology

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The widespread clinical use of dopamine agonists (DAAs) was influenced largely by clinical trials comparing levodopa to DAAs (Ropinirole and Pramipexole) for the treatment of early Parkinson's disease (PD). Parkinson's Disease Impulse Control DisordersThe earliest reports of DAA-induced behavioral changes were about the same time as the completion of the DAA versus levodopa trials. Dopamine Agonists and Impulse Control Disorders in Parkinson's Disease AbstractThe emergence of the behavioral syndrome known as impulse control disorder (ICD) in Parkinson's disease (PD) has increasingly been associated with dopamine agonist (DAA) use. Clinical reports emphasize the presence of excessive, disruptive, and 'atypical' behaviors in PD patients that resolve after discontinuation or reductions of DAA therapy. The severity of these behaviors has resulted in a heightened clinical vigilance, especially in patients prescribed DAA. This review will discuss the historical rationale for the clinical use of DAA in PD, highlighting the increased association of ICD in patients prescribed DAA therapy. The association between DAA and the emergence of ICD supports the hypothesis that altered mesocorticolimbic function, further emphasized in behavioral and imaging studies, may account for the distinct compulsive hedonic behaviors that characterize the clinical features of this disorder. While the first-line treatment option is reduction and discontinuation of DAA therapy, other therapeutic options are discussed.

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Dopamine agonists and risk: impulse control disorders in Parkinson's; disease

Cited by 192 publications

References 25 publications

Subthalamic stimulation in Parkinson’s disease: restoring the balance of motivated behaviours

Subthalamic stimulation in Parkinson’s disease: restoring the balance of motivated behaviours

Gambling Habits of People With Parkinson’s Disease: An Exploratory Study

Dopamine Agonists and Impulse Control Disorders in Parkinson’s Disease

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