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Parkinsonism Relat Disord. 2015 Nov;21(11):1336-41. doi: 10.1016/j.parkreldis.2015.09.042. Epub 2015 Sep 25.

Psychogenic and neural visual-cue response in PD dopamine dysregulation syndrome.

Author information

1
Division of Brain Sciences, Department of Medicine, Hammersmith Hospital, Imperial College London, UK; Neurodegeneration Imaging Group, Department of Clinical Neuroscience, King's College London, UK.
2
Division of Brain Sciences, Department of Medicine, Hammersmith Hospital, Imperial College London, UK.
3
Reta Lila Weston Institute of Neurological Studies, University College London, UK; Department of Neurology, University College Cork, Cork, Ireland.
4
School of Psychology, Cardiff University, UK.
5
Wellcome Trust Centre for Neuroimaging, University College London, UK.
6
Reta Lila Weston Institute of Neurological Studies, University College London, UK.
7
Division of Brain Sciences, Department of Medicine, Hammersmith Hospital, Imperial College London, UK; Neurodegeneration Imaging Group, Department of Clinical Neuroscience, King's College London, UK. Electronic address: marios.politis@kcl.ac.uk.

Abstract

INTRODUCTION:

Dopamine dysregulation syndrome (DDS) in Parkinson's disease (PD) patients refers to the compulsive use of dopaminergic replacement therapy and has serious psycho-social consequences. Mechanisms underlying DDS are not clear although has been linked to dysfunctional brain reward networks.

METHODS:

With fMRI, we investigate behavioral and neural response to drug-cues in six PD DDS patients and 12 PD control patients in both the ON and OFF medication state. Behavioral measures of liking, wanting and subjectively 'feeling ON medication' were also collected.

RESULTS:

Behaviorally, PD DDS patients feel less ON and want their drugs more at baseline compared to PD controls. Following drug-cue exposure, PD DDS patients feel significantly more ON medication, which correlates with significant increases in reward related regions.

CONCLUSIONS:

The results demonstrate that exposure to drug-cues increases the subjective feeling of being 'ON' medication which corresponds to dysfunctional activation in reward related regions in PD DDS patients. These findings should be extended in future studies. Visual stimuli being sufficient to elicit behavioral response through neuroadaptations could have direct implications to the management of addictive behavior.

KEYWORDS:

Addiction; Dopamine dyregulation syndrome; Parkinson's disease; Psychiatry; Reward; fMRI

[Indexed for MEDLINE]

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