BACKGROUND: Pathological gambling (PG) may develop in patients with Parkinson disease (PD) during dopamine replacement therapy, but the underlying neural correlates are still unclear. OBJECTIVE: To investigate resting state brain perfusion in PD patients with active PG compared with matched PD controls and healthy controls. DESIGN: Case-control study. SETTING: Outpatient tertiary clinic. PARTICIPANTS: Eleven right-handed PD patients with active PG according to Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) criteria, 40 matched PD controls, and 29 age-matched healthy controls. INTERVENTION: All the participants underwent resting state brain perfusion single-photon emission computed tomography using technetium TC 99m ethylcysteinate dimer bicisate. All PD subjects were taking dopaminergic medication. MAIN OUTCOME MEASURE: Statistical Parametric Mapping was used for data analysis (P<.005, false discovery rate corrected). RESULTS: PD patients with PG showed resting state overactivity in a right hemisphere network that included the orbitofrontal cortex, the hippocampus, the amygdala, the insula, and the ventral pallidum. No areas of perfusion reduction were detected. CONCLUSIONS: We found that PD patients with PG have abnormal resting state dysfunction of the mesocorticolimbic network possibly associated with a drug-induced overstimulation of relatively preserved reward-related neuronal systems. These findings support the concept that PG is a "behavioral" addictive disorder.
BACKGROUND: Pathological gambling (PG) may develop in patients with Parkinson disease (PD) during dopamine replacement therapy, but the underlying neural correlates are still unclear. OBJECTIVE: To investigate resting state brain perfusion in PDpatients with active PG compared with matched PD controls and healthy controls. DESIGN: Case-control study. SETTING:Outpatient tertiary clinic. PARTICIPANTS: Eleven right-handed PDpatients with active PG according to Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) criteria, 40 matched PD controls, and 29 age-matched healthy controls. INTERVENTION: All the participants underwent resting state brain perfusion single-photon emission computed tomography using technetium TC 99m ethylcysteinate dimer bicisate. All PD subjects were taking dopaminergic medication. MAIN OUTCOME MEASURE: Statistical Parametric Mapping was used for data analysis (P<.005, false discovery rate corrected). RESULTS:PDpatients with PG showed resting state overactivity in a right hemisphere network that included the orbitofrontal cortex, the hippocampus, the amygdala, the insula, and the ventral pallidum. No areas of perfusion reduction were detected. CONCLUSIONS: We found that PDpatients with PG have abnormal resting state dysfunction of the mesocorticolimbic network possibly associated with a drug-induced overstimulation of relatively preserved reward-related neuronal systems. These findings support the concept that PG is a "behavioral" addictive disorder.
Authors: Hengyi Rao; Eugenia Mamikonyan; John A Detre; Andrew D Siderowf; Matthew B Stern; Marc N Potenza; Daniel Weintraub Journal: Mov Disord Date: 2010-08-15 Impact factor: 10.338
Authors: Theodore D Satterthwaite; Daniel H Wolf; Amy E Pinkham; Kosha Ruparel; Mark A Elliott; Jeffrey N Valdez; Eve Overton; Janina Seubert; Raquel E Gur; Ruben C Gur; James Loughead Journal: Brain Cogn Date: 2011-05-19 Impact factor: 2.310
Authors: Hans-Jochen Heinze; Marcus Heldmann; Jürgen Voges; Hermann Hinrichs; Josep Marco-Pallares; Jens-Max Hopf; Ulf J Müller; Imke Galazky; Volker Sturm; Bernard Bogerts; Thomas F Münte Journal: Front Hum Neurosci Date: 2009-09-02 Impact factor: 3.169