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Mov Disord. 2017 Dec;32(12):1710-1719. doi: 10.1002/mds.27139. Epub 2017 Sep 26.

Intrinsic brain connectivity predicts impulse control disorders in patients with Parkinson's disease.

Author information

1
Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy.
2
MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Napoli, Italy.
3
Neuropsychology Laboratory, Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy.
4
Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi (SA), Italy.

Abstract

BACKGROUND:

Impulse control disorders can be triggered by dopamine replacement therapies in patients with PD. Using resting-state functional MRI, we investigated the intrinsic brain network connectivity at baseline in a cohort of drug-naive PD patients who successively developed impulse control disorders over a 36-month follow-up period compared with patients who did not.

METHODS:

Baseline 3-Tesla MRI images of 30 drug-naive PD patients and 20 matched healthy controls were analyzed. The impulse control disorders' presence and severity at follow-up were assessed by the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease Rating Scale. Single-subject and group-level independent component analysis was used to investigate functional connectivity differences within the major resting-state networks. We also compared internetwork connectivity between patients. Finally, a multivariate Cox regression model was used to investigate baseline predictors of impulse control disorder development.

RESULTS:

At baseline, decreased connectivity in the default-mode and right central executive networks and increased connectivity in the salience network were detected in PD patients with impulse control disorders at follow-up compared with those without. Increased default-mode/central executive internetwork connectivity was significantly associated with impulse control disorders development (P < 0.05).

CONCLUSIONS:

Our findings demonstrated that abnormal brain connectivity in the three large-scale networks characterizes drug-naive PD patients who will eventually develop impulse control disorders while on dopaminergic treatment. We hypothesize that these divergent cognitive and limbic network connectivity changes could represent a potential biomarker and an additional risk factor for the emergence of impulse control disorders. © 2017 International Parkinson and Movement Disorder Society.

KEYWORDS:

Parkinson's disease; drug naive; impulse control disorders; resting-state connectivity; reward system

PMID:
28949049
DOI:
10.1002/mds.27139
[Indexed for MEDLINE]

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