Functional Abnormalities Underlying Pathological Gambling in Parkinson Disease

Cilia, Roberto; Siri, Chiara; Marotta, Giorgio; Isaias, Ioannis U.; Gaspari, Danilo De; Canesi, Margherita; Pezzoli, Gianni; Antonini, Angelo

doi:10.1001/archneur.65.12.1604

Cited by 131 publications

(104 citation statements)

References 32 publications

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“…Thus, in our case, it may be possible that the parahippocampal gyrus may contribute to the emotional salience associated with the decision making process. This is also consistent with previous studies demonstrating the involvement of this region in impulsive behaviour (Völlm et al 2007;Soloff et al 2008;Carmona et al 2005;Cilia et al 2008). …”

Section: Discussionsupporting

confidence: 93%

Morphometric Correlation of Impulsivity in Medial Prefrontal Cortex

et al. 2012

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Impulsivity is a complex behaviour composed of different domains encompassing behavioural disinhibition, risky decision-making and delay discounting abnormalities. To investigate regional brain correlates between levels of individual impulsivity and grey matter volume, we performed voxel-based morphometric correlation analysis in 34 young, healthy subjects using impulsivity scores measured with Barratt Impulsivity Scale-11 and computerized Kirby's delay discounting task. The VBM analysis showed that impulsivity appears to be reliant on a network of cortical (medial prefrontal cortex and dorsolateral prefrontal cortex) and subcortical (ventral striatum) structures emphasizing the importance of brain networks associated with reward related decisionmaking in daily life as morphological biomarkers for impulsivity in a normal healthy population. While our results in healthy volunteers may not directly extend to pathological conditions, they provide an insight into the mechanisms of impulsive behaviour in patients with abnormalities in prefrontal/frontal-striatal connections, such as in drug abuse, pathological gambling, ADHD and Parkinson's disease.

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Section: Discussionsupporting

confidence: 93%

Morphometric Correlation of Impulsivity in Medial Prefrontal Cortex

et al. 2012

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“…Moreover, age correlates with the line bisection errors found in the current study were consistent with many previous reports [17], implying an age-related and right-(facial decision task) hemispheric dominant tasks [41]. Right hemisphere dominance is also found in over-eating behavior [42][43][44], which is considered a behavioral addiction [45,46]. This pattern of hemispheric dominance is also depicted in patients with Parkinson's disease and pathological gambling, by perfusion single-photon emission computed tomography [47].…”

Section: Discussionsupporting

confidence: 92%

“…Right hemisphere dominance is also found in over-eating behavior [42][43][44], which is considered a behavioral addiction [45,46]. This pattern of hemispheric dominance is also depicted in patients with Parkinson's disease and pathological gambling, by perfusion single-photon emission computed tomography [47]. Further, the obsessive-compulsive trait represents a major risk of headache chronification and drug dependence [48,49].…”

Section: Discussionmentioning

confidence: 99%

Line bisection in medication-overuse and chronic tension-type headaches

Zhang

Gao

Fan

et al. 2014

Translational Neuroscience

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Background: Both medication-overuse headache (MOH) and drug dependence share similar clinical features and the latter displays some deficits in visuospatial attention. The line bisection performance might help to indicate whether there is also a disruption in the visuospatial attention in MOH. Methods: We administered the line bisection test and measured anxiety and depression levels in 21 patients with MOH, 26 patients with chronic tension-type headaches (CTTH) and in 22 healthy volunteers. Results: On average, MOH patients significantly bisected leftward when referring to both frequency and magnitude, whereas the healthy volunteers and CTTH patients bisected slightly rightward. The levels of anxiety and depression were elevated in both MOH and CTTH patients compared to healthy volunteers, but the anxiety / depression levels were not correlated with the line bisection errors in all participants. Conclusions: We found a pronounced pseudoneglect in MOH, which might indicate a relatively hyperactive right or hypoactive left hemisphere, or both, suggesting the disorder's neuropsychological mechanism might overlap with that of drug dependence.

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“…However, one cannot rule out that the individual vulnerability to develop behavioral addictions also stems from neurobehavioral mechanisms that are not related to mesolimbic dopamine. In the absence of an external task (ie freely fluctuating brain activity), PD patients experiencing heavy PG symptoms at the time of study showed increased brain perfusion in dopaminergic mesolimbic structures, but also in the insula, the hippocampus, and the amygdala (Cilia et al, 2008). More studies are needed in this area to distinguish traits that predict vulnerability from an abnormal neurobehavioral pattern that may evolve once PG consolidates as a behavior.…”

Section: Discussionmentioning

confidence: 99%

Dopamine Agonists Diminish Value Sensitivity of the Orbitofrontal Cortex: A Trigger for Pathological Gambling in Parkinson's Disease?

Eimeren¹,

Ballanger²,

Pellecchia³

et al. 2009

Neuropsychopharmacology

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The neurobehavioral underpinnings of pathological gambling are not well understood. Insight might be gained by understanding pharmacological effects on the reward system in patients with Parkinson's disease (PD). Treatment with dopamine agonists (DAs) has been associated with pathological gambling in PD patients. However, how DAs are involved in the development of this form of addiction is unknown. We tested the hypothesis that tonic stimulation of dopamine receptors specifically desensitizes the dopaminergic reward system by preventing decreases in dopaminergic transmission that occurs with negative feedback. Using functional magnetic resonance imaging, we studied PD patients during three sessions of a probabilistic reward task in random order: off medication, after levodopa (LD) treatment, and after an equivalent dose of DA (pramipexole). For each trial, a reward prediction error value was computed using outcome, stake, and probability. Pramipexole specifically changed activity of the orbitofrontal cortex (OFC) in two ways that were both associated with increased risk taking in an out-of-magnet task. Outcomeinduced activations were generally higher with pramipexole compared with LD or off medication. In addition, only pramipexole greatly diminished trial-by-trial correlation with reward prediction error values. Further analysis yielded that this resulted mainly from impaired deactivation in trials with negative errors in reward prediction. We propose that DAs prevent pauses in dopamine transmission and thereby impair the negative reinforcing effect of losing. Our findings raise the question of whether pathological gambling may in part stem from an impaired capacity of the OFC to guide behavior when facing negative consequences.

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Functional Abnormalities Underlying Pathological Gambling in Parkinson Disease

Cited by 131 publications

References 32 publications

Morphometric Correlation of Impulsivity in Medial Prefrontal Cortex

Morphometric Correlation of Impulsivity in Medial Prefrontal Cortex

Line bisection in medication-overuse and chronic tension-type headaches

Dopamine Agonists Diminish Value Sensitivity of the Orbitofrontal Cortex: A Trigger for Pathological Gambling in Parkinson's Disease?

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