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

• Published in: Parkinsonism & related disorders Vol. 30; pp. 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: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.09.2016
• 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; 123I-FP-CIT imaging; Parkinson's disease; Statistical parametric mapping; Functional covariance analysis; Impulse control disorders; Parkinson’s disease; I-FP-CIT imaging
• ISSN: 1353-8020; 1873-5126
• DOI: 10.1016/j.parkreldis.2016.05.028

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.