scholarly journals Impulse Control Disorders Following Deep Brain Stimulation of the Subthalamic Nucleus in Parkinson's Disease: Clinical Aspects

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Polyvios Demetriades ◽  
Hugh Rickards ◽  
Andrea Eugenio Cavanna
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Impulse Control ◽  
Case Reports ◽  
Impulse Control Disorders ◽  
Clinical Aspects ◽  
Dopaminergic Medication ◽  
Deep Brain

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.

scholarly journals Medications, Deep Brain Stimulation, and Other Factors Influencing Impulse Control Disorders in Parkinson's Disease

2019 ◽  
Vol 10 ◽  
Author(s):  
Robert S. Eisinger ◽  
Adolfo Ramirez-Zamora ◽  
Samuel Carbunaru ◽  
Brandon Ptak ◽  
Zhongxing Peng-Chen ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Impulse Control ◽  
Impulse Control Disorders ◽  
Factors Influencing ◽  
Deep Brain

Management of impulse control disorders in Parkinson's disease

2016 ◽  
Vol 28 (10) ◽  
pp. 1597-1614 ◽  
Author(s):  
Susan Zhang ◽  
Nadeeka N. Dissanayaka ◽  
Andrew Dawson ◽  
John D. O'Sullivan ◽  
Philip Mosley ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Impulse Control ◽  
Impulse Control Disorders ◽  
Current Evidence ◽  
Evidence Based ◽  
Pharmacological Treatments ◽  
Deep Brain

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.

scholarly journals To do or don’t, to take or don’t take: STN-DBS therapy in young PD patient

2020 ◽  
Vol 77 (9) ◽  
pp. 1000-1002 ◽  
Author(s):  
Mehmet Şenol ◽  
Hakan Şimşek
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Impulse Control ◽  
Eating Habits ◽  
Impulse Control Disorders ◽  
Dopamine Dysregulation Syndrome ◽  
Stn Dbs ◽  
Deep Brain

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.

P100 Deep brain stimulation and medication in Parkinson’s Disease: Changes in impulse control

Basal Ganglia ◽  
2011 ◽  
Vol 1 (1) ◽  
pp. 19
Author(s):  
D. Lulé ◽  
J. Heimrath ◽  
A.C. Ludolph ◽  
I. Uttner ◽  
J. Kassubek
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Impulse Control ◽  
Deep Brain

scholarly journals A Systematic Review of the Biological Processes Involved in Deep-Brain Stimulation for Parkinson's disease: A Focus on the Potential Disease-Modifying Effects

2021 ◽  
Vol 05 (02) ◽  
pp. 1-1
Author(s):  
Francesco Sciancalepore ◽  
◽  
Giulia Remoli ◽  
Leonardo Tariciotti ◽  
Giulia Sarti ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Early Stage ◽  
Case Reports ◽  
Biological Processes ◽  
Inclusion Criteria ◽  
Disease Modifying ◽  
Deep Brain

Deep-Brain Stimulation (DBS) is an important treatment option for the management of Parkinson’s disease (PD) and is a common symptomatic treatment. However, an increasing number of studies have examined the biological processes to assess if DBS can also modify the natural history of PD by acting on its pathophysiological mechanisms. Relevant literature published up to November 2020 was systematically searched on databases such as PubMed, ISI Web of Knowledge, Academic Search Index, and Science Citation Index. The following predefined inclusion criteria were applied to the full-text versions of the selected articles: i) recruiting and monitoring of PD subjects that were previously treated with DBS and ii) investigating the electrophysiological, biochemical, epigenetic, or neuroimaging effects of DBS. Studies focusing exclusively on motor and clinical changes were excluded. Reviews, case reports, studies on animal models, and computational studies were also not considered. Out of 2,960 records screened, 43 studies met the inclusion criteria. Only three studies described a potential disease-modifying effect of DBS. However, a wide heterogeneity was observed in the investigated biomarkers, and the design and methodological issues of several studies limited their ability to find potential disease-modifying features. Specifically, 60.4% of the trials followed-up subjects for no more than 1 year from the surgical intervention, and 67.4% observed patients with PD only once after DBS. Moreover, 64.2% of the studies enrolled late-stage PD patients. Most of the studies (88.4%) reported that DBS only had a symptomatic effect, with several of them showing some limitations in the study design and recruitment of patients. Further studies using shared biomarkers are encouraged to assess if and how DBS might affect the progression of PD. Based on the existing preclinical literature, prospective clinical trials examining the course of PD in early-stage patients are needed.

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