Impulse control disorder in PD: A lateralized monoaminergic frontostriatal disconnection syndrome?

Abstract Background Impulse Control Disorder symptoms (ICD) in Parkinson's disease (PD) has been recently associated by magnetic Resonance imaging with impaired cortico-striatal connectivity, especially between left putamen and frontal associative areas. Methods 84 patients entered the study (2...

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Published in:Parkinsonism & related disorders 2016-09, Vol.30, p.62-66
Main Authors: Premi, E, Pilotto, A, Garibotto, V, Bigni, B, Turrone, R, Alberici, A, Cottini, E, Poli, L, Bianchi, M, Formenti, A, Cosseddu, M, Gazzina, S, Magoni, M, Bertoli, M, Paghera, B, Borroni, B, Padovani, A
Format: Article
Language:English
Subjects:
123I-FP-CIT imaging
Adult
Aged
Aged, 80 and over
Brain Mapping - methods
Corpus Striatum - pathology
Corpus Striatum - physiopathology
Disruptive, Impulse Control, and Conduct Disorders - complications
Female
Functional covariance analysis
Humans
Image Processing, Computer-Assisted - methods
Impulse control disorders
Magnetic Resonance Imaging - methods
Male
Middle Aged
Neural Pathways - physiopathology
Neurology
Parkinson Disease - complications
Parkinson’s disease
Statistical parametric mapping
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Summary:Abstract Background Impulse Control Disorder symptoms (ICD) in Parkinson's disease (PD) has been recently associated by magnetic Resonance imaging with impaired cortico-striatal connectivity, especially between left putamen and frontal associative areas. Methods 84 patients entered the study (21 PD-ICD+ and 64 PD-ICD-) and underwent DATSCAN imaging. The striatal tracer uptake was evaluated using BRASS software (Hermes, Sweden). The whole-brain analysis was performed with Statistical Parametric Mapping (SPM). Results PD-ICD + showed a significant reduction of left putaminal and left inferior frontal gyrus tracer uptake compared to PD-ICD-. Functional covariance analysis using left putamen as the seed point showed that, in contrast to ICD-patients, ICD + patients had no functional covariance with contralateral basal ganglia and ipsilateral cingulate cortex, as index of an impaired inter- and intra-hemispheric dopamine binding in PD-ICD+. Discussion the results support and expand the concept of a functional disconnection syndrome linked to ICD symptoms in PD patients through an asymmetric molecular frontostriatal network breakdown with left basal ganglia as central hub.
ISSN:1353-8020
1873-5126
DOI:10.1016/j.parkreldis.2016.05.028