Chronic dopaminergic stimulation in Parkinson's disease: from dyskinesias to impulse control disorders.

Abstract

Dopamine is an essential neurotransmitter for many brain functions, and its dysfunction has been implicated in both neurological and psychiatric disorders. Parkinson's disease is an archetypal disorder of dopamine dysfunction characterised by motor, cognitive, behavioural, and autonomic symptoms. While effective for motor symptoms, dopamine replacement therapy is associated not only with motor side-effects, such as levodopa-induced dyskinesia, but also behavioural side-effects such as impulse control disorders (eg, pathological gambling and shopping, binge eating, and hypersexuality), punding (ie, abnormal repetitive non-goal oriented behaviours), and compulsive medication use. We review clinical features, overlapping molecular mechanisms, and a specific cognitive mechanism of habit learning that might underlie these behaviours. We integrate these mechanisms with the emerging view of the basal ganglia as a distributive system involved in the selection and facilitation of movements, acts, and emotions.

• Authors: Valerie Voon, Pierre-Olivier Fernagut, Jeff Wickens, Christelle Baunez, Manuel Rodriguez, Nancy Pavon, Jorge L Juncos, José A Obeso, Erwan Bezard
• Journal: The Lancet. Neurology (Lancet Neurol) Vol. 8 Issue 12 Pg. 1140-9 (Dec 2009) ISSN: 1474-4465 [Electronic] England
• PMID: 19909912 (Publication Type: Journal Article, Review)

Chemical References

• Antiparkinson Agents
• Dopamine Agents
• Levodopa
• Dopamine

Topics

• Antiparkinson Agents (adverse effects, therapeutic use)
• Automatism (physiopathology)
• Compulsive Behavior (chemically induced, psychology)
• Disruptive, Impulse Control, and Conduct Disorders (chemically induced, physiopathology)
• Dopamine (physiology)
• Dopamine Agents (adverse effects, therapeutic use)
• Dyskinesia, Drug-Induced (physiopathology)
• Gambling (psychology)
• Humans
• Levodopa (adverse effects, therapeutic use)
• Parkinson Disease (complications, drug therapy, psychology)
• Psychoses, Substance-Induced (psychology)
• Sexual Behavior