scholarly journals Should impulse control disorders and dopamine dysregulation syndrome be indications for deep brain stimulation and intestinal levodopa?

2013 ◽  
Vol 28 (14) ◽  
pp. 1915-1919 ◽  
Author(s):  
Michael S. Okun ◽  
Daniel Weintraub
PLoS ONE ◽  
2012 ◽  
Vol 7 (1) ◽  
pp. e29768 ◽  
Author(s):  
Sarah J. Moum ◽  
Catherine C. Price ◽  
Natlada Limotai ◽  
Genko Oyama ◽  
Herbert Ward ◽  
...  

2020 ◽  
Vol 77 (9) ◽  
pp. 1000-1002 ◽  
Author(s):  
Mehmet Şenol ◽  
Hakan Şimşek

Introduction. Parkinson's disease patients with impulse control disorders and dopamine dysregulation syndrome is increasingly recognized. There are reports that such disorders can sometimes be improved by using deep brain stimulation, but sometimes they can get worse. Case report. Our patient was a 30-year-old man with Parkinson's disease since the age of 23. The patient had motor fluctuations on the right with marked bradykinesia, bradymimia and rigidities in the off-periods. The patient's paraphilia and sexual indiscretions against women were apparent in the on-periods. The patient's eating habits were also changed. The patient underwent subthalamic nucleus-deep brain stimulation (STNDBS). Significant improvements were seen in the motor and behavior signs of the patient after this procedure had been performed. Conclusion. STN-DBS may be a reasonable option in patients with Parkinson's disease when unwanted dopaminergic side effects occur, and motor disorders and impulse control disorders cannot be improved with drugs.


2019 ◽  
Vol 10 ◽  
Author(s):  
Robert S. Eisinger ◽  
Adolfo Ramirez-Zamora ◽  
Samuel Carbunaru ◽  
Brandon Ptak ◽  
Zhongxing Peng-Chen ◽  
...  

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Polyvios Demetriades ◽  
Hugh Rickards ◽  
Andrea Eugenio Cavanna

Parkinson's disease (PD) has been associated with the development of impulse control disorders (ICDs), possibly due to overstimulation of the mesolimbic system by dopaminergic medication. Preliminary reports have suggested that deep brain stimulation (DBS), a neurosurgical procedure offered to patients with treatment-resistant PD, affects ICD in a twofold way. Firstly, DBS allows a decrease in dopaminergic medication and hence causes an improvement in ICDs. Secondly, some studies have proposed that specific ICDs may develop after DBS. This paper addresses the effects of DBS on ICDs in patients with PD. A literature search identified four original studies examining a total of 182 patients for ICDs and nine case reports of 39 patients that underwent DBS and developed ICDs at some point. Data analysis from the original studies did not identify a significant difference in ICDs between patients receiving dopaminergic medication and patients on DBS, whilst the case reports showed that 56% of patients undergoing DBS had poor outcome with regards to ICDs. We discuss these ambivalent findings in the light of proposed pathogenetic mechanisms. Longitudinal, prospective studies with larger number of patients are required in order to fully understand the role of DBS on ICDs in patients with PD.


2016 ◽  
Vol 28 (10) ◽  
pp. 1597-1614 ◽  
Author(s):  
Susan Zhang ◽  
Nadeeka N. Dissanayaka ◽  
Andrew Dawson ◽  
John D. O'Sullivan ◽  
Philip Mosley ◽  
...  

ABSTRACTBackground:Impulse control disorders (ICDs) have become a widely recognized non-motor complication of Parkinson's disease (PD) in patients taking dopamine replacement therapy (DRT). There are no current evidence-based recommendations for their treatment, other than reducing their dopaminergic medication.Methods:This study reviews the current literature of the treatment of ICDs including pharmacological treatments, deep brain stimulation, and psychotherapeutic interventions.Results:Dopamine agonist withdrawal is the most common and effective treatment, but may lead to an aversive withdrawal syndrome or motor symptom degeneration in some individuals. There is insufficient evidence for all other pharmacological treatments in treating ICDs in PD, including amantadine, serotonin selective reuptake inhibitors, antipsychotics, anticonvulsants, and opioid antagonists (e.g. naltrexone). Large randomized control trials need to be performed before these drugs can be routinely used for the treatment of ICDs in PD. Deep brain stimulation remains equivocal because ICD symptoms resolve in some patients after surgery but may appearde novoin others. Cognitive behavioral therapy has been shown to improve ICD symptoms in the only published study, although further research is urgently needed.Conclusions:Further research will allow for the development of evidence-based guidelines for the management of ICDs in PD.


2020 ◽  
pp. 149-154
Author(s):  
Adolfo Ramirez-Zamora

Neuropsychiatric symptoms, including impulse control disorders and mood changes, are common nonmotor features across all Parkinson disease (PD) stages. Subthalamic nucleus (STN) deep brain stimulation (DBS) is a safe and well-established treatment for the management of refractory motor fluctuations in PD; however, it has been associated with worsening neuropsychiatric symptoms in the short and long term. Recognizing the occurrence of stimulation-induced behavioral symptoms is critical to implement effective and timely treatment. Most reports indicate that stimulation of the ventral and medial region within the STN and surrounding structures, including the substantia nigra, might account for the occurrence of acute impulsive behaviors and hypomania, requiring adopting different programming strategies aimed at limiting behavioral side effects while reducing parkinsonism. Stimulation of the most dorsal and lateral contacts can mitigate behavioral side effects after STN DBS, but specific treatment needs to be applied based on the patient’s individual neuropsychiatric and motor presentations and specific imaging-based brain localization of DBS lead contacts.


2020 ◽  
Vol 19 (8) ◽  
pp. 611-617
Author(s):  
Deborah Amstutz ◽  
Steffen Paschen ◽  
Martin Lenard Lachenmayer ◽  
Marie Elise Maradan-Gachet ◽  
Günther Deuschl ◽  
...  

Impulse Control Disorders (ICDs) and related disorders are common side effects of dopaminergic treatment in Parkinson’s Disease (PD) and are associated with negative effects on mental and physical health, quality of life and interpersonal relationships. Current management options are limited, as a reduction of dopaminergic medication often leads to worsening of motor symptoms or dopamine agonist withdrawal syndrome. The aim of this review was to investigate if ICDs improve, worsen, or remain stable after Subthalamic Nucleus Deep Brain Stimulation (STN-DBS). We reviewed retrospective, prospective and randomized-controlled studies published between 2000 and 2019 examining the effect of STN-DBS on one or more ICDs. The number of participants, time of follow-up, methods used to measure ICDs, type of ICDs, the incidence of ICDs before STN-DBS, the incidence of improvement (remission or reduction) of ICDs after STN-DBS, the incidence of de novo ICDs after STN-DBS, stimulation parameters, lead position, change in motor score and change in medication are reported for each study. Available studies suggest that ICDs improve after STN-DBS in most patients and that persisting new-onset ICDs induced by STN-DBS are rare. However, more randomized-controlled studies are needed to confirm the findings and to further investigate the underlying mechanisms.


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