Benoit Delpont1, Eugénie Lhommée1,2, Hélène Klinger3,4, Emmanuelle Schmitt1,2, Amélie Bichon1,2, Valérie Fraix1,2, Anna Castrioto1,2, Jean-Louis Quesada5, Pierre Pélissier1, Andrea Kistner1, Sébastien Carnicella2, Christian Lüscher6, Emmanuel Broussolle3,4, Pierre Pollak6, Stéphane Thobois3,4, Paul Krack1,2,6. 1. Movement Disorders Unit, Neurology Department, CHU Grenoble Alpes and Université Grenoble Alpes, Grenoble, France. 2. Grenoble Institut des Neurosciences, Inserm, U1216, Grenoble, France. 3. Service de Neurologie C, Université Lyon I, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Lyon, France. 4. CNRS, UMR 5229, Centre de Neurosciences Cognitives, Lyon, France. 5. Unité Scientifique de la DRCI et Centre d'Investigation Clinique, CHU de Grenoble, Grenoble, France. 6. Department of Basic Neurosciences, Medical Faculty, University of Geneva, Geneva, Switzerland; Clinic of Neurology, Department of Clinical Neurosciences, Geneva University Hospital, Geneva, Switzerland.
Abstract
BACKGROUND: Dopamine replacement therapy in PD has been associated with both behavioral addictions and dopamine addiction. OBJECTIVES: To investigate potential association between l-dopa induced neuropsychiatric fluctuations and addictions in PD. METHODS: A cohort of 102 patients with PD suffering from motor complications of l-dopa treatment was prospectively analyzed. We evaluated dopamine addiction, behavioral addictions, and neuropsychiatric fluctuations using the Ardouin scale of behavior in PD. RESULTS: Patients with (n = 51) or without (n = 51) neuropsychiatric fluctuations did not differ in age, disease duration, medication, or UPDRS III motor score during on and off drug condition. Patients with neuropsychiatric fluctuations had a higher H & Y stage in off-drug condition. A multivariate model showed that dopamine addiction (odds ratio: 8.9; P = 0.02) and behavioral addictions (odds ratio: 3.76; P = 0.033) were more frequent in the presence of neuropsychiatric fluctuations. Behavioral addictions and dopamine addiction were more frequent in the presence than in the absence of on-drug euphoria (46% vs. 13.9%; P < 0.001 and 27% vs 6.2 %; P = 0.003), while conversely, no association emerged between dopamine or behavioral addictions and presence of off-drug dysphoria. Patients with neuropsychiatric fluctuations had a poorer quality of life and a more frequent history of anxiety disorder. CONCLUSIONS: The psychostimulant effects of dopamine treatment during on-drug euphoria, rather than avoidance of off-drug dysphoria, appear to drive both behavioral addictions and abuse of medication.
BACKGROUND:Dopamine replacement therapy in PD has been associated with both behavioral addictions and dopamine addiction. OBJECTIVES: To investigate potential association between l-dopa induced neuropsychiatric fluctuations and addictions in PD. METHODS: A cohort of 102 patients with PD suffering from motor complications of l-dopa treatment was prospectively analyzed. We evaluated dopamine addiction, behavioral addictions, and neuropsychiatric fluctuations using the Ardouin scale of behavior in PD. RESULTS:Patients with (n = 51) or without (n = 51) neuropsychiatric fluctuations did not differ in age, disease duration, medication, or UPDRS III motor score during on and off drug condition. Patients with neuropsychiatric fluctuations had a higher H & Y stage in off-drug condition. A multivariate model showed that dopamine addiction (odds ratio: 8.9; P = 0.02) and behavioral addictions (odds ratio: 3.76; P = 0.033) were more frequent in the presence of neuropsychiatric fluctuations. Behavioral addictions and dopamine addiction were more frequent in the presence than in the absence of on-drug euphoria (46% vs. 13.9%; P < 0.001 and 27% vs 6.2 %; P = 0.003), while conversely, no association emerged between dopamine or behavioral addictions and presence of off-drug dysphoria. Patients with neuropsychiatric fluctuations had a poorer quality of life and a more frequent history of anxiety disorder. CONCLUSIONS: The psychostimulant effects of dopamine treatment during on-drug euphoria, rather than avoidance of off-drug dysphoria, appear to drive both behavioral addictions and abuse of medication.
Authors: R Depoortère; J Bergman; P M Beardsley; R I Desai; C A Paronis; D M Walentiny; M A Varney; A Newman-Tancredi Journal: Neuropharmacology Date: 2022-03-09 Impact factor: 5.250
Authors: Emmanuelle Schmitt; Paul Krack; Anna Castrioto; Helene Klinger; Amelie Bichon; Eugénie Lhommée; Pierre Pelissier; Valerie Fraix; Stephane Thobois; Elena Moro; Pablo Martinez-Martin Journal: Mov Disord Clin Pract Date: 2018-03-23