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Impulse control disorders in Parkinson's disease: decreased striatal dopamine transporter levels

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posted on 2023-06-08, 17:15 authored by Valerie Voon, Alexandra Rizos, Riddhika Chakravartty, Nicola Mulholland, Stephanie Robinson, Nicholas A Howell, Neil Harrison, Gill Vivian, K Ray Chaudhuri
Objective Impulse control disorders are commonly associated with dopaminergic therapy in Parkinson's disease (PD). PD patients with impulse control disorders demonstrate enhanced dopamine release to conditioned cues and a gambling task on [11C]raclopride positron emission tomography (PET) imaging and enhanced ventral striatal activity to reward on functional MRI. We compared PD patients with impulse control disorders and age-matched and gender-matched controls without impulse control disorders using [123I]FP-CIT (2ß-carbomethoxy-3ß-(4-iodophenyl)tropane) single photon emission computed tomography (SPECT), to assess striatal dopamine transporter (DAT) density. Methods The [123I]FP-CIT binding data in the striatum were compared between 15 PD patients with and 15 without impulse control disorders using independent t tests. Results Those with impulse control disorders showed significantly lower DAT binding in the right striatum with a trend in the left (right: F(1,24)=5.93, p=0.02; left: F(1,24)=3.75, p=0.07) compared to controls. Conclusions Our findings suggest that greater dopaminergic striatal activity in PD patients with impulse control disorders may be partly related to decreased uptake and clearance of dopamine from the synaptic cleft. Whether these findings are related to state or trait effects is not known. These findings dovetail with reports of lower DAT levels secondary to the effects of methamphetamine and alcohol. Although any regulation of DAT by antiparkinsonian medication appears to be modest, PD patients with impulse control disorders may be differentially sensitive to regulatory mechanisms of DAT expression by dopaminergic medications.

History

Publication status

  • Published

File Version

  • Published version

Journal

Journal of Neurology, Neurosurgery and Psychiatry

ISSN

0022-3050

Publisher

BMJ Publishing Group

Issue

2

Volume

85

Page range

148-152

Department affiliated with

  • Clinical and Experimental Medicine Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2014-05-13

First Open Access (FOA) Date

2014-07-31

First Compliant Deposit (FCD) Date

2014-07-31

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