Pathological gambling in Parkinson's disease improves on chronic subthalamic nucleus stimulation
Identifieur interne : 001909 ( PascalFrancis/Corpus ); précédent : 001908; suivant : 001910Pathological gambling in Parkinson's disease improves on chronic subthalamic nucleus stimulation
Auteurs : Claire Ardouin ; Valerie Voon ; Yulia Worbe ; Nehman Abouazar ; Virginie Czernecki ; Hassan Hosseini ; Antoine Pelissolo ; Elena Moro ; Eugénie Lhommee ; Anthony E. Lang ; Yves Agid ; Alim-Louis Benabid ; Pierre Pollak ; Luc Mallet ; Paul KrackSource :
- Movement disorders [ 0885-3185 ] ; 2006.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
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.
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Pour connaître la documentation sur le format Inist Standard.
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Format Inist (serveur)
NO : | PASCAL 07-0021722 INIST |
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ET : | Pathological gambling in Parkinson's disease improves on chronic subthalamic nucleus stimulation |
AU : | ARDOUIN (Claire); VOON (Valerie); WORBE (Yulia); ABOUAZAR (Nehman); CZERNECKI (Virginie); HOSSEINI (Hassan); PELISSOLO (Antoine); MORO (Elena); LHOMMEE (Eugénie); LANG (Anthony E.); AGID (Yves); BENABID (Alim-Louis); POLLAK (Pierre); MALLET (Luc); KRACK (Paul) |
AF : | Département de Neurologie, CHU Grenoble, INSERM U318, Université Joseph Fourier/Grenoble/France (1 aut., 4 aut., 9 aut., 13 aut., 15 aut.); Toronto Western Hospital, University of Toronto/Toronto, Ontario/Canada (2 aut., 8 aut., 10 aut.); Centre d'Investigation Clinique 9503, INSERM U679, CHU Pitié-Salpêtrière, Université Pierre et Marie Curie/Paris/France (3 aut., 5 aut., 11 aut., 14 aut.); Service de Neurologie, Hôpital Henri Mondor/Créteil/France (6 aut.); Psychiatrie UMR7593, Pitié-Salpêtrière/Paris/France (7 aut., 14 aut.); Service de Neurochirurgie, CHU Grenoble, INSERM U318, Université Joseph Fourier/Grenoble/France (12 aut.) |
DT : | Publication en série; Niveau analytique |
SO : | Movement disorders; ISSN 0885-3185; Etats-Unis; Da. 2006; Vol. 21; No. 11; Pp. 1941-1946; Bibl. 44 ref. |
LA : | Anglais |
EA : | 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. |
CC : | 002B17; 002B17G; 002B17A03 |
FD : | Système nerveux pathologie; Jeu pathologique; Parkinson maladie; Chronique; Noyau sousthalamique; Dopamine; Stimulation cérébrale profonde |
FG : | Trouble contrôle impulsion; Encéphale pathologie; Extrapyramidal syndrome; Maladie dégénérative; Système nerveux central pathologie; Système nerveux central; Catécholamine; Neurotransmetteur |
ED : | Nervous system diseases; Pathological gambling; Parkinson disease; Chronic; Subthalamic nucleus; Dopamine; Deep brain stimulation |
EG : | Impulse control disorder; Cerebral disorder; Extrapyramidal syndrome; Degenerative disease; Central nervous system disease; Central nervous system; Catecholamine; Neurotransmitter |
SD : | Sistema nervioso patología; Juego patológico; Parkinson enfermedad; Crónico; Núcleo subtalámico; Dopamina |
LO : | INIST-20953.354000158935070190 |
ID : | 07-0021722 |
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Pascal:07-0021722Le document en format XML
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Pathological gambling in Parkinson's disease improves on chronic subthalamic nucleus stimulation</title>
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<front><div type="abstract" xml:lang="en">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.</div>
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<fA08 i1="01" i2="1" l="ENG"><s1>Pathological gambling in Parkinson's disease improves on chronic subthalamic nucleus stimulation</s1>
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<server><NO>PASCAL 07-0021722 INIST</NO>
<ET>Pathological gambling in Parkinson's disease improves on chronic subthalamic nucleus stimulation</ET>
<AU>ARDOUIN (Claire); VOON (Valerie); WORBE (Yulia); ABOUAZAR (Nehman); CZERNECKI (Virginie); HOSSEINI (Hassan); PELISSOLO (Antoine); MORO (Elena); LHOMMEE (Eugénie); LANG (Anthony E.); AGID (Yves); BENABID (Alim-Louis); POLLAK (Pierre); MALLET (Luc); KRACK (Paul)</AU>
<AF>Département de Neurologie, CHU Grenoble, INSERM U318, Université Joseph Fourier/Grenoble/France (1 aut., 4 aut., 9 aut., 13 aut., 15 aut.); Toronto Western Hospital, University of Toronto/Toronto, Ontario/Canada (2 aut., 8 aut., 10 aut.); Centre d'Investigation Clinique 9503, INSERM U679, CHU Pitié-Salpêtrière, Université Pierre et Marie Curie/Paris/France (3 aut., 5 aut., 11 aut., 14 aut.); Service de Neurologie, Hôpital Henri Mondor/Créteil/France (6 aut.); Psychiatrie UMR7593, Pitié-Salpêtrière/Paris/France (7 aut., 14 aut.); Service de Neurochirurgie, CHU Grenoble, INSERM U318, Université Joseph Fourier/Grenoble/France (12 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>Movement disorders; ISSN 0885-3185; Etats-Unis; Da. 2006; Vol. 21; No. 11; Pp. 1941-1946; Bibl. 44 ref.</SO>
<LA>Anglais</LA>
<EA>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.</EA>
<CC>002B17; 002B17G; 002B17A03</CC>
<FD>Système nerveux pathologie; Jeu pathologique; Parkinson maladie; Chronique; Noyau sousthalamique; Dopamine; Stimulation cérébrale profonde</FD>
<FG>Trouble contrôle impulsion; Encéphale pathologie; Extrapyramidal syndrome; Maladie dégénérative; Système nerveux central pathologie; Système nerveux central; Catécholamine; Neurotransmetteur</FG>
<ED>Nervous system diseases; Pathological gambling; Parkinson disease; Chronic; Subthalamic nucleus; Dopamine; Deep brain stimulation</ED>
<EG>Impulse control disorder; Cerebral disorder; Extrapyramidal syndrome; Degenerative disease; Central nervous system disease; Central nervous system; Catecholamine; Neurotransmitter</EG>
<SD>Sistema nervioso patología; Juego patológico; Parkinson enfermedad; Crónico; Núcleo subtalámico; Dopamina</SD>
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