Amantadine and cognitive flexibility: decision making in Parkinson's patients with severe pathological gambling and other impulse control disorders

• Published in: Neuropsychiatric disease and treatment 2014-01, Vol.10 (default), p.1093-1101
• Main Authors: Cera, Nicoletta, Bifolchetti, Stefania, Martinotti, Giovanni, Gambi, Francesco, Sepede, Gianna, Onofrj, Marco, Di Giannantonio, Massimo, Thomas, Astrid
• Format: Article
• Language: English
• Subjects: Addictive behaviors; Amantadine; Behavior; Decision making; Dopamine; Dosage and administration; Drug addiction; Drug therapy; emotion; Emotions; Executive function; executive functions; Expenditures; Gambling; Gaming machines; Impulsive personality; Impulsivity; Original Research; Parkinson's disease; Psychiatry; Quality of life; Studies
• ISSN: 1176-6328; 1178-2021; 1178-2021
• DOI: 10.2147/NDT.S54423

Dopamine replacement therapy for Parkinson's disease (PD) was recently linked to the development of impulse control disorders such as pathological gambling (PG), hypersexuality, compulsive shopping, and binge or compulsive eating. Antiglutamatergic agents including amantadine (Ama) reduce these behaviors in PD and non-PD patients. The aim of our study is to evaluate the changes in executive functions, emotions, and reward/loss processing during Ama treatment in PD patients. Thirty-three patients affected by idiopathic PD were selected from a cohort of 1,096 PD patients and categorized in three different groups: ten affected by PG (PD-PG); nine PD patients with other impulse control disorder (PD-ICD); and 14 PD patient without any psychiatric disorder (PD-CTR-controls). For the neuropsychological evaluation, the following behavioral tasks where administered: the Stroop, the emotional Stroop, and the monetary reward/loss risk-taking tasks. During Ama treatment, PD-PGs showed a decrease in risky choices and an increase in non-risky choices (t(9)=-2.40, P