期刊
NEUROLOGY
卷 75, 期 19, 页码 1711-1716出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0b013e3181fc27fa
关键词
-
资金
- Ontario Problem Gambling Research Centre
- Canadian Institutes of Health Research (CIHR) [MOP-64423]
- Fondazione Grigioni per il Morbo di Parkinson
- Bioscan
- Ontario Ministry of Research and Innovation
- Canada Foundation for Innovation
- CIHR
- Teva Pharmaceutical Industries Ltd.
- Boehringer Ingelheim
- Solvay Pharmaceuticals, Inc.
- Solstice Neurosciences, Inc.
- Impax Laboratories
- Neurogen
- Medivation, Inc.
- National Parkinson Foundation
- Parkinson Society Canada
- Michael J. Fox Foundation
- Huntington Study Group
- Taro Pharma
- Dystonia Medical Research Foundation
- Parkinson's Disease Foundation
Objective: Some patients with Parkinson disease (PD) develop pathological gambling when treated with dopamine agonists (DAs). However, little is known about DA-induced changes in neuronal networks that may underpin this drug-induced change in behavior in vulnerable individuals. In this case-control study, we aimed to investigate DA-induced changes in brain activity that may differentiate patients with PD with DA-induced pathological gambling (gamblers) from patients with PD without such a history (controls). Methods: Following overnight withdrawal of antiparkinsonian medication, patients were studied with (H2O)-O-15 PET before and after administration of DA (3 mg apomorphine) to measure changes in regional cerebral blood flow as an index of regional brain activity during a card selection game with probabilistic feedback. Results: We observed that the direction of DA-related activity change in brain areas that are implicated in impulse control and response inhibition (lateral orbitofrontal cortex, rostral cingulate zone, amygdala, external pallidum) distinguished gamblers from controls. DA significantly increased activity in these areas in controls, while gamblers showed a significant DA-induced reduction of activity. Conclusions: We propose that in vulnerable patients with PD, DAs produce an abnormal neuronal pattern that resembles those found in nonparkinsonian pathological gambling and drug addiction. DA-induced disruption of inhibitory key functions-outcome monitoring (rostral cingulate zone), acquisition and retention of negative action-outcome associations (amygdala and lateral orbitofrontal cortex)-together with restricted access of those areas to executive control (external pallidum)-may well explain loss of impulse control and response inhibition in vulnerable patients with PD, thereby fostering the development of pathological gambling. Neurology(R) 2010;75:1711-1716
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据