Compulsive use of dopaminergic drug therapy in Parkinson's disease: Reward and anti‐reward
Identifieur interne : 001D73 ( Main/Exploration ); précédent : 001D72; suivant : 001D74Compulsive use of dopaminergic drug therapy in Parkinson's disease: Reward and anti‐reward
Auteurs : Andrew H. Evans [Australie, Royaume-Uni] ; Andrew D. Lawrence [Royaume-Uni] ; Silke Appel Cresswell [Canada] ; Regina Katzenschlager [Royaume-Uni, Autriche] ; Andrew Lees (neurologue) [Royaume-Uni]Source :
- Movement Disorders [ 0885-3185 ] ; 2010-05-15.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Affect (drug effects), Compulsive Behavior, Dopamine Agonists (adverse effects), Dopamine Agonists (therapeutic use), Drug Administration Schedule, Female, Humans, Levodopa (adverse effects), Levodopa (therapeutic use), Male, Middle Aged, Nervous system diseases, Parkinson Disease (drug therapy), Parkinson disease, Parkinson's disease, Questionnaires, Severity of Illness Index, Substance Withdrawal Syndrome (diagnosis), Substance Withdrawal Syndrome (epidemiology), Substance Withdrawal Syndrome (etiology), Treatment, Treatment Outcome, non‐motor, reward, withdrawal.
- MESH :
- chemical , adverse effects : Dopamine Agonists, Levodopa.
- diagnosis : Substance Withdrawal Syndrome.
- drug effects : Affect.
- drug therapy : Parkinson Disease.
- epidemiology : Substance Withdrawal Syndrome.
- etiology : Substance Withdrawal Syndrome.
- chemical , therapeutic use : Dopamine Agonists, Levodopa.
- Compulsive Behavior, Drug Administration Schedule, Female, Humans, Male, Middle Aged, Questionnaires, Severity of Illness Index, Treatment Outcome.
Abstract
A few Parkinson patients develop a disabling pattern of compulsive dopaminergic drug use (“dopamine dysregulation syndrome”—DDS). DDS patients commonly identify aversive dysphoric “OFF” mood‐states as a primary motivation to compulsively use their drugs. We compared motoric, affective, non‐motor symptoms and incentive arousal after overnight medication withdrawal and after levodopa in DDS and control PD patients. Twenty DDS patients were matched to 20 control PD patients for age, gender, and disease duration and underwent a standard levodopa challenge. Somatic symptomatology, positive and negative affective states, drug effects, reward responsivity, motor disability, and dyskinesias were tested in the “OFF”‐state after overnight withdrawal of medications, and then after a challenge with a standard dose of levodopa, after a full “ON”‐state was achieved. In the “OFF”‐state, DDS patients reported lower positive affect, and more motor and non‐motor disability. In the “ON”‐state, DDS patients had higher expressions of drug “wanting,” reward responsivity, and dyskinesias. Positive and negative affect, non‐motor symptomatology, and motor disability were comparable. These findings suggest that affective, motivational, and motoric disturbances in PD are associated with the transition to compulsive drug use in individuals who inappropriately overuse their dopaminergic medication. © 2010 Movement Disorder Society
Url:
DOI: 10.1002/mds.22898
Affiliations:
- Australie, Autriche, Canada, Royaume-Uni
- Angleterre, Grand Londres, Vienne (Autriche)
- Londres, Vienne (Autriche)
- National Hospital for Neurology and Neurosurgery
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Le document en format XML
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<front><div type="abstract" xml:lang="en">A few Parkinson patients develop a disabling pattern of compulsive dopaminergic drug use (“dopamine dysregulation syndrome”—DDS). DDS patients commonly identify aversive dysphoric “OFF” mood‐states as a primary motivation to compulsively use their drugs. We compared motoric, affective, non‐motor symptoms and incentive arousal after overnight medication withdrawal and after levodopa in DDS and control PD patients. Twenty DDS patients were matched to 20 control PD patients for age, gender, and disease duration and underwent a standard levodopa challenge. Somatic symptomatology, positive and negative affective states, drug effects, reward responsivity, motor disability, and dyskinesias were tested in the “OFF”‐state after overnight withdrawal of medications, and then after a challenge with a standard dose of levodopa, after a full “ON”‐state was achieved. In the “OFF”‐state, DDS patients reported lower positive affect, and more motor and non‐motor disability. In the “ON”‐state, DDS patients had higher expressions of drug “wanting,” reward responsivity, and dyskinesias. Positive and negative affect, non‐motor symptomatology, and motor disability were comparable. These findings suggest that affective, motivational, and motoric disturbances in PD are associated with the transition to compulsive drug use in individuals who inappropriately overuse their dopaminergic medication. © 2010 Movement Disorder Society</div>
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