Pathological gambling in Parkinson's disease improves on chronic subthalamic nucleus stimulation
Pathological gambling (PG) related to dopaminergic treatment in Parkinson's disease (PD) is part of a spectrum of behavioral disorders called the dopamine dysregulation syndrome (DDS). We describe a series of PD patients with preoperative active PG due to dopaminergic treatment from a total of...
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| Veröffentlicht in: | Movement disorders 2006-11, Vol.21 (11), p.1941-1946 |
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| creator | Ardouin, Claire Voon, Valerie Worbe, Yulia Abouazar, Nehman Czernecki, Virginie Hosseini, Hassan Pelissolo, Antoine Moro, Elena Lhommée, Eugénie Lang, Anthony E. Agid, Yves Benabid, Alim-Louis Pollak, Pierre Mallet, Luc Krack, Paul |
| description | Pathological gambling (PG) related to dopaminergic treatment in Parkinson's disease (PD) is part of a spectrum of behavioral disorders called the dopamine dysregulation syndrome (DDS). We describe a series of PD patients with preoperative active PG due to dopaminergic treatment from a total of 598 patients who have undergone surgery for subthalamic nucleus stimulation for disabling motor fluctuations. The patients had systematic open assessment of behavioral symptoms and standardized assessments of motor symptoms, mood, and apathy. Seven patients (6 men, 1 woman; age, 54 ± 9 years; levodopa equivalent dose, 1,390 ± 350 mg/day) had preoperative PG over a mean of 7 years, intolerant to reduction in medication. Six had nonmotor fluctuations and four had other behavioral symptoms consistent with a diagnosis of the DDS. After surgery, motor symptoms improved, allowing for 74% reduction of dopaminergic treatment, below the dosage of gambling onset. In all patients, PG resolved postoperatively after 18 months on average (range, 0–48), although transient worsening occurred in two. Improvement paralleled the time course and degree of reduction in dopaminergic treatment. Nonmotor fluctuations, off period dysphoria, and other symptoms of the DDS improved. Two patients developed persistent apathy. In conclusion, PG and other symptoms of the DDS‐associated dopaminergic treatment improved in our patients following surgery. Dopaminergic dysregulation commonly attributed to pulsatile overstimulation of the limbic dopaminergic system may be subject to desensitization on chronic subthalamic stimulation, which has a relative motor selectivity and allows for decrease in dopaminergic treatment. © 2006 Movement Disorder Society |
| doi_str_mv | 10.1002/mds.21098 |
| format | Article |
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We describe a series of PD patients with preoperative active PG due to dopaminergic treatment from a total of 598 patients who have undergone surgery for subthalamic nucleus stimulation for disabling motor fluctuations. The patients had systematic open assessment of behavioral symptoms and standardized assessments of motor symptoms, mood, and apathy. Seven patients (6 men, 1 woman; age, 54 ± 9 years; levodopa equivalent dose, 1,390 ± 350 mg/day) had preoperative PG over a mean of 7 years, intolerant to reduction in medication. Six had nonmotor fluctuations and four had other behavioral symptoms consistent with a diagnosis of the DDS. After surgery, motor symptoms improved, allowing for 74% reduction of dopaminergic treatment, below the dosage of gambling onset. In all patients, PG resolved postoperatively after 18 months on average (range, 0–48), although transient worsening occurred in two. Improvement paralleled the time course and degree of reduction in dopaminergic treatment. Nonmotor fluctuations, off period dysphoria, and other symptoms of the DDS improved. Two patients developed persistent apathy. In conclusion, PG and other symptoms of the DDS‐associated dopaminergic treatment improved in our patients following surgery. Dopaminergic dysregulation commonly attributed to pulsatile overstimulation of the limbic dopaminergic system may be subject to desensitization on chronic subthalamic stimulation, which has a relative motor selectivity and allows for decrease in dopaminergic treatment. © 2006 Movement Disorder Society</description><identifier>ISSN: 0885-3185</identifier><identifier>EISSN: 1531-8257</identifier><identifier>DOI: 10.1002/mds.21098</identifier><identifier>PMID: 16972268</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Adult ; Biological and medical sciences ; deep brain stimulation ; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases ; dopamine ; Dose-Response Relationship, Radiation ; Electric Stimulation Therapy ; Female ; Follow-Up Studies ; Gambling ; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy ; Humans ; Male ; Medical sciences ; Middle Aged ; Nervous system (semeiology, syndromes) ; Neurology ; Neuropsychological Tests ; Neuropsychological Tests - statistics & numerical data ; Parkinson Disease ; Parkinson Disease - pathology ; Parkinson Disease - psychology ; Parkinson Disease - surgery ; Parkinson's disease ; pathological gambling ; Severity of Illness Index ; Subthalamic Nucleus ; Subthalamic Nucleus - physiopathology ; Subthalamic Nucleus - radiation effects</subject><ispartof>Movement disorders, 2006-11, Vol.21 (11), p.1941-1946</ispartof><rights>Copyright © 2006 Movement Disorder Society</rights><rights>2007 INIST-CNRS</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5608-d66e652945d942e90355ee1934d5c65cd2071ad95c9de9aa68964423ee2cbbb83</citedby><cites>FETCH-LOGICAL-c5608-d66e652945d942e90355ee1934d5c65cd2071ad95c9de9aa68964423ee2cbbb83</cites><orcidid>0000-0001-5903-9370 ; 0000-0001-8061-1167</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fmds.21098$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fmds.21098$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,315,781,785,886,1418,27929,27930,45579,45580</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18319364$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16972268$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://inserm.hal.science/inserm-00385497$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Ardouin, Claire</creatorcontrib><creatorcontrib>Voon, Valerie</creatorcontrib><creatorcontrib>Worbe, Yulia</creatorcontrib><creatorcontrib>Abouazar, Nehman</creatorcontrib><creatorcontrib>Czernecki, Virginie</creatorcontrib><creatorcontrib>Hosseini, Hassan</creatorcontrib><creatorcontrib>Pelissolo, Antoine</creatorcontrib><creatorcontrib>Moro, Elena</creatorcontrib><creatorcontrib>Lhommée, Eugénie</creatorcontrib><creatorcontrib>Lang, Anthony E.</creatorcontrib><creatorcontrib>Agid, Yves</creatorcontrib><creatorcontrib>Benabid, Alim-Louis</creatorcontrib><creatorcontrib>Pollak, Pierre</creatorcontrib><creatorcontrib>Mallet, Luc</creatorcontrib><creatorcontrib>Krack, Paul</creatorcontrib><title>Pathological gambling in Parkinson's disease improves on chronic subthalamic nucleus stimulation</title><title>Movement disorders</title><addtitle>Mov. Disord</addtitle><description>Pathological gambling (PG) related to dopaminergic treatment in Parkinson's disease (PD) is part of a spectrum of behavioral disorders called the dopamine dysregulation syndrome (DDS). We describe a series of PD patients with preoperative active PG due to dopaminergic treatment from a total of 598 patients who have undergone surgery for subthalamic nucleus stimulation for disabling motor fluctuations. The patients had systematic open assessment of behavioral symptoms and standardized assessments of motor symptoms, mood, and apathy. Seven patients (6 men, 1 woman; age, 54 ± 9 years; levodopa equivalent dose, 1,390 ± 350 mg/day) had preoperative PG over a mean of 7 years, intolerant to reduction in medication. Six had nonmotor fluctuations and four had other behavioral symptoms consistent with a diagnosis of the DDS. After surgery, motor symptoms improved, allowing for 74% reduction of dopaminergic treatment, below the dosage of gambling onset. In all patients, PG resolved postoperatively after 18 months on average (range, 0–48), although transient worsening occurred in two. Improvement paralleled the time course and degree of reduction in dopaminergic treatment. Nonmotor fluctuations, off period dysphoria, and other symptoms of the DDS improved. Two patients developed persistent apathy. In conclusion, PG and other symptoms of the DDS‐associated dopaminergic treatment improved in our patients following surgery. Dopaminergic dysregulation commonly attributed to pulsatile overstimulation of the limbic dopaminergic system may be subject to desensitization on chronic subthalamic stimulation, which has a relative motor selectivity and allows for decrease in dopaminergic treatment. © 2006 Movement Disorder Society</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>deep brain stimulation</subject><subject>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</subject><subject>dopamine</subject><subject>Dose-Response Relationship, Radiation</subject><subject>Electric Stimulation Therapy</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gambling</subject><subject>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Neuropsychological Tests</subject><subject>Neuropsychological Tests - statistics & numerical data</subject><subject>Parkinson Disease</subject><subject>Parkinson Disease - pathology</subject><subject>Parkinson Disease - psychology</subject><subject>Parkinson Disease - surgery</subject><subject>Parkinson's disease</subject><subject>pathological gambling</subject><subject>Severity of Illness Index</subject><subject>Subthalamic Nucleus</subject><subject>Subthalamic Nucleus - physiopathology</subject><subject>Subthalamic Nucleus - radiation effects</subject><issn>0885-3185</issn><issn>1531-8257</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU9v1DAQxSMEotvCgS-AcgGERFr_iR37WFrYghYoAsTROM7srsGxSyYp9NvjkqU9cRoffvPevOeieETJISWEHfUdHjJKtLpTLKjgtFJMNHeLBVFKVJwqsVfsI34nhFJB5f1ij0rdMCbVovh2bsdtCmnjnQ3lxvZt8HFT-lie2-GHj5jiMyw7j2ARSt9fDOkSsEyxdNshRe9KnNpxa4Pt8ztOLsCEJY6-n4IdfYoPintrGxAe7uZB8eX1q88nZ9Xqw_LNyfGqckISVXVSghRM16LTNQNNuBAAVPO6E04K1zHSUNtp4XQH2lqptKxrxgGYa9tW8YPixaybbzEXg-_tcGWS9ebseGVyDhh6QwhXotbNJc340xnPgX5OgKPpPToIwUZIExpGaSMaVWfw-Qy6ISEOsL4Rp8Rct29y--Zv-5l9vBOd2h66W3JXdwae7ACLue_1YKPzeMspnhPLa9OjmfvlA1z939G8O_30z7qaNzyO8PtmI_-hkQ1vhPn6fmnqj285kS-pWfI_ew6q8A</recordid><startdate>200611</startdate><enddate>200611</enddate><creator>Ardouin, Claire</creator><creator>Voon, Valerie</creator><creator>Worbe, Yulia</creator><creator>Abouazar, Nehman</creator><creator>Czernecki, Virginie</creator><creator>Hosseini, Hassan</creator><creator>Pelissolo, Antoine</creator><creator>Moro, Elena</creator><creator>Lhommée, Eugénie</creator><creator>Lang, Anthony E.</creator><creator>Agid, Yves</creator><creator>Benabid, Alim-Louis</creator><creator>Pollak, Pierre</creator><creator>Mallet, Luc</creator><creator>Krack, Paul</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0001-5903-9370</orcidid><orcidid>https://orcid.org/0000-0001-8061-1167</orcidid></search><sort><creationdate>200611</creationdate><title>Pathological gambling in Parkinson's disease improves on chronic subthalamic nucleus stimulation</title><author>Ardouin, Claire ; Voon, Valerie ; Worbe, Yulia ; Abouazar, Nehman ; Czernecki, Virginie ; Hosseini, Hassan ; Pelissolo, Antoine ; Moro, Elena ; Lhommée, Eugénie ; Lang, Anthony E. ; Agid, Yves ; Benabid, Alim-Louis ; Pollak, Pierre ; Mallet, Luc ; Krack, Paul</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5608-d66e652945d942e90355ee1934d5c65cd2071ad95c9de9aa68964423ee2cbbb83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>deep brain stimulation</topic><topic>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</topic><topic>dopamine</topic><topic>Dose-Response Relationship, Radiation</topic><topic>Electric Stimulation Therapy</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gambling</topic><topic>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Neuropsychological Tests</topic><topic>Neuropsychological Tests - statistics & numerical data</topic><topic>Parkinson Disease</topic><topic>Parkinson Disease - pathology</topic><topic>Parkinson Disease - psychology</topic><topic>Parkinson Disease - surgery</topic><topic>Parkinson's disease</topic><topic>pathological gambling</topic><topic>Severity of Illness Index</topic><topic>Subthalamic Nucleus</topic><topic>Subthalamic Nucleus - physiopathology</topic><topic>Subthalamic Nucleus - radiation effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ardouin, Claire</creatorcontrib><creatorcontrib>Voon, Valerie</creatorcontrib><creatorcontrib>Worbe, Yulia</creatorcontrib><creatorcontrib>Abouazar, Nehman</creatorcontrib><creatorcontrib>Czernecki, Virginie</creatorcontrib><creatorcontrib>Hosseini, Hassan</creatorcontrib><creatorcontrib>Pelissolo, Antoine</creatorcontrib><creatorcontrib>Moro, Elena</creatorcontrib><creatorcontrib>Lhommée, Eugénie</creatorcontrib><creatorcontrib>Lang, Anthony E.</creatorcontrib><creatorcontrib>Agid, Yves</creatorcontrib><creatorcontrib>Benabid, Alim-Louis</creatorcontrib><creatorcontrib>Pollak, Pierre</creatorcontrib><creatorcontrib>Mallet, Luc</creatorcontrib><creatorcontrib>Krack, Paul</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Movement disorders</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ardouin, Claire</au><au>Voon, Valerie</au><au>Worbe, Yulia</au><au>Abouazar, Nehman</au><au>Czernecki, Virginie</au><au>Hosseini, Hassan</au><au>Pelissolo, Antoine</au><au>Moro, Elena</au><au>Lhommée, Eugénie</au><au>Lang, Anthony E.</au><au>Agid, Yves</au><au>Benabid, Alim-Louis</au><au>Pollak, Pierre</au><au>Mallet, Luc</au><au>Krack, Paul</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pathological gambling in Parkinson's disease improves on chronic subthalamic nucleus stimulation</atitle><jtitle>Movement disorders</jtitle><addtitle>Mov. Disord</addtitle><date>2006-11</date><risdate>2006</risdate><volume>21</volume><issue>11</issue><spage>1941</spage><epage>1946</epage><pages>1941-1946</pages><issn>0885-3185</issn><eissn>1531-8257</eissn><abstract>Pathological gambling (PG) related to dopaminergic treatment in Parkinson's disease (PD) is part of a spectrum of behavioral disorders called the dopamine dysregulation syndrome (DDS). We describe a series of PD patients with preoperative active PG due to dopaminergic treatment from a total of 598 patients who have undergone surgery for subthalamic nucleus stimulation for disabling motor fluctuations. The patients had systematic open assessment of behavioral symptoms and standardized assessments of motor symptoms, mood, and apathy. Seven patients (6 men, 1 woman; age, 54 ± 9 years; levodopa equivalent dose, 1,390 ± 350 mg/day) had preoperative PG over a mean of 7 years, intolerant to reduction in medication. Six had nonmotor fluctuations and four had other behavioral symptoms consistent with a diagnosis of the DDS. After surgery, motor symptoms improved, allowing for 74% reduction of dopaminergic treatment, below the dosage of gambling onset. In all patients, PG resolved postoperatively after 18 months on average (range, 0–48), although transient worsening occurred in two. Improvement paralleled the time course and degree of reduction in dopaminergic treatment. Nonmotor fluctuations, off period dysphoria, and other symptoms of the DDS improved. Two patients developed persistent apathy. In conclusion, PG and other symptoms of the DDS‐associated dopaminergic treatment improved in our patients following surgery. Dopaminergic dysregulation commonly attributed to pulsatile overstimulation of the limbic dopaminergic system may be subject to desensitization on chronic subthalamic stimulation, which has a relative motor selectivity and allows for decrease in dopaminergic treatment. © 2006 Movement Disorder Society</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>16972268</pmid><doi>10.1002/mds.21098</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0001-5903-9370</orcidid><orcidid>https://orcid.org/0000-0001-8061-1167</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Biological and medical sciences deep brain stimulation Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases dopamine Dose-Response Relationship, Radiation Electric Stimulation Therapy Female Follow-Up Studies Gambling Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Humans Male Medical sciences Middle Aged Nervous system (semeiology, syndromes) Neurology Neuropsychological Tests Neuropsychological Tests - statistics & numerical data Parkinson Disease Parkinson Disease - pathology Parkinson Disease - psychology Parkinson Disease - surgery Parkinson's disease pathological gambling Severity of Illness Index Subthalamic Nucleus Subthalamic Nucleus - physiopathology Subthalamic Nucleus - radiation effects |
| title | Pathological gambling in Parkinson's disease improves on chronic subthalamic nucleus stimulation |
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