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

Parkinsonism Relat Disord. 2016 Sep:30:62-6. doi: 10.1016/j.parkreldis.2016.05.028. Epub 2016 May 27.

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.

Keywords: (123)I-FP-CIT imaging; Functional covariance analysis; Impulse control disorders; Parkinson’s disease; Statistical parametric mapping.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Mapping / methods
  • Corpus Striatum / pathology
  • Corpus Striatum / physiopathology*
  • Disruptive, Impulse Control, and Conduct Disorders / complications*
  • Female
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Neural Pathways / physiopathology*
  • Parkinson Disease / complications*