Download PDF
Nervenheilkunde 2008; 27(08): 721-727
DOI: 10.1055/s-0038-1627134
Originaler Artikel
Schattauer GmbH

Störungen von Verhalten und Impulskontrolle beim Morbus Parkinson

Impulse control and related disorders in Parkinson's disease
R. Katzenschlager
1   Neurologische Abteilung, Donauspital, Wien
› Author Affiliations
Further Information

Publication History

Eingegangen am: 22 April 2008

angenommen am: 28 April 2008

Publication Date:
22 January 2018 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Ein kleiner Teil der Parkinsonpatienten entwickelt unter dopaminerger Therapie Verhaltensmuster, die mit einer Störung der Impulskontrolle zusammenhängen: Dazu zählen Impulskontrollstörungen im engeren Sinn, wie pathologisches Glücksspiel, Hypersexualität und impulsives Essen und Einkaufen, die eng mit Agonistentherapie assoziiert sind und bereits unter niedriger Dosierung auftreten können. Bei manchen prädisponierten Patienten mit fortgeschrittener Erkrankung und meist auch Wirkfluktuationen und Dyskinesien kann unter höher dosierter Therapie ein Medikamentenabhängigkeitssyndrom mit charakteristischen Verhaltensstörungen beobachtet werden (dopaminerges Dysregulationssyndrom) oder ein Syndrom repetitiver, stereotyper langdauernder Bewegungsmuster, das Punding. Alle diese Phänomene können isoliert oder gemeinsam auftreten.

Die Pathophysiologie der impulskontrollassoziierten Verhaltensstörungen ist nicht zur Gänze geklärt. Bei dysregulierenden Patienten konnte vermehrter Dopamin-Release im ventralen Striatum gezeigt werden, vereinbar mit der zentralen Rolle von Dopamin bei der Mediierung von motivationsgesteuertem Verhalten und im Belohnungssystem.

Summary

A small number of patients with Parkinson's disease (PD) develop characteristic behavioural abnormalities related to impulse control: This includes impulse control disorders in a strict sense, such as pathological gambling, hyper-sexuality and compulsive eating or shopping. These are closely associated with dopamine agonist treatment and may occur on low or medium doses. Some predisposed patients with more advanced disease, usually with motor fluctuations and dyskinesia and typically on higher dopaminergic doses, develop a drug dependency syndrome with characteristic behavioural changes (dopamine dysregulation syndrom), or a syndrome of repetitive, stereotyped motor patterns termed punding. These phenomena may occur in isolation or in any combination.

The pathophysiology of these impulse control associated behavioural abnormalities has not been fully determined. In dysregulating patients, increased ventral striatal dopamine release has been demonstrated, in keeping with the central role of dopamine in the mediation of motivation driven behaviour and reward.

Schlüsselwörter

M. Parkinson - Impulskontrollstörungen - dopaminerges Dysregulationssyndrom - Punding

Keywords

Parkinson's disease - impulse control and repetitive behavioural disorders - dopamine dysregulation syndrome - punding
 

  • Literatur

  • 1 American Psychiatric Association.. Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Press; 1994
    Google Scholar
  • 2 Ardouin C, Voon V, Worbe Y, Abouazar N, Czernecki V, Hosseini H, Pelissolo A, Moro E, Lhommee E, Lang AE, Agid Y, Benabid AL, Pollak P, Mallet L, Krack P. Pathological gambling in Parkinson’s disease improves on chronic subthalamic nucleus stimulation. Mov Disord 2006; 21: 1941-1946.
    CrossrefPubMedGoogle Scholar
  • 3 Avanzi M, Baratti M, Cabrini S, Uber E, Brighetti G, Bonfà F. Prevalence of pathological gambling in patients with Parkinson’s disease. Mov Disord 2006; 21: 2068-2072.
    CrossrefPubMedGoogle Scholar
  • 4 Berger Ch, Mehrhoff FW, Beier KM, Meinck HM. [Sexual delinquency and Parkinson’s disease]. Nervenarzt 2003; 74: 370-375.
    CrossrefPubMedGoogle Scholar
  • 5 Berke JD, Hyman SE. Addiction, dopamine, and the molecular mechanisms of memory. Neuron 2000; 25: 515-532.
    CrossrefPubMedGoogle Scholar
  • 6 Black KJ, Hershey T, Koller JM, Videen TO, Mintun MA, Price JL, Perlmutter JS. A possible substrate for dopamine-related changes in mood and behavior: prefrontal and limbic effects of a D3-preferring dopamine agonist. Proc Natl Acad Sci 2002; 99: 17113-17118.
    CrossrefPubMedGoogle Scholar
  • 7 Cohen JD, Braver TS, Brown JW. Computational perspectives on dopamine function in prefrontal cortex. Curr Opin Neurobiol 2002; 12: 223-229.
    CrossrefPubMedGoogle Scholar
  • 8 Courty E, Durif F, Zenut M, Courty P, Lavarenne J. Psychiatric and sexual disorders induced by apomorphine in Parkinson’s disease. Clin Neuropharmacol 1997; 20: 140-147.
    CrossrefPubMedGoogle Scholar
  • 9 Driver-Dunckley ED, Noble BN, Hentz JG, Evidente VG, Caviness JN, Parish J, Krahn L, Adler CH. Gambling and increased sexual desire with dopaminergic medications in restless legs syndrome. Clin Neuropharmacol 2007; 30: 249-255.
    CrossrefPubMedGoogle Scholar
  • 10 Evans AH, Katzenschlager R, Paviour D, O’Sullivan JD, Appel S, Lawrence AD, Lees AJ. Punding in Parkinson’s disease: its relation to the dopamine dysregulation syndrome. Mov Disord 2004; 19: 397-405.
    CrossrefPubMedGoogle Scholar
  • 11 Evans AH, Lawrence AD, Appel S, Lees AJ. Aversive off symptoms in parkinson patients compulsively using dopaminergic drugs: drug rewards can be punishing. Mov Disord 2006; 21 (Suppl. 01) S599.
    CrossrefPubMedGoogle Scholar
  • 12 Evans AH, Lawrence AD, Potts J, Appel S, Lees AJ. Factors influencing susceptibility to compulsive dopaminergic drug use in Parkinson disease. Neurology 2005; 65: 1570-1574.
    CrossrefPubMedGoogle Scholar
  • 13 Evans AH, Lees AJ. Dopamine dysregulation syndrome in Parkinson’s disease. Curr Opin Neurol 2004; 17: 393-398.
    CrossrefPubMedGoogle Scholar
  • 14 Evans AH, Pavese N, Lawrence AD, Tai YF, Appel S, Doder M, Brooks DJ, Lees AJ, Piccini P. Compulsive drug use linked to sensitized ventral striatal dopamine transmission. Ann Neurol 2006; 59: 852-858.
    CrossrefPubMedGoogle Scholar
  • 15 Evans AH, Lawrence AD, Potts J, MacGregor L, Katzenschlager R, Shaw K, Zijlmans J, Lees AJ. Relationship between impulsive sensation seeking traits, smoking, alcohol and caffeine intake, and Parkinson’s disease. J Neurol Neurosurg Psychiatry 2006; 77: 317-321.
    PubMedGoogle Scholar
  • 16 Everitt BJ, Dickinson A, Robbins TW. The neuropsychological basis of addictive behaviour. Brain Res Brain Res Rev 2001; 36: 129-138.
    CrossrefPubMedGoogle Scholar
  • 17 Fernandez HH, Durso R. Clozapine for dopaminergic- induced paraphilias in Parkinson’s disease. Mov Disord 1998; 13: 597-598.
    CrossrefPubMedGoogle Scholar
  • 18 Fiorillo CD, Tobler PN, Schultz W. Discrete coding of reward probability and uncertainty by dopamine neurons. Science 2003; 299: 1898-1902.
    CrossrefPubMedGoogle Scholar
  • 19 Gallagher DA, O’Sullivan SS, Evans AH, Lees AJ, Schrag A. Pathological gambling in Parkinson’s disease: risk factors and differences from dopamine dysregulation. An analysis of published case series. Mov Disord 2007; 22: 1757-1763.
    CrossrefPubMedGoogle Scholar
  • 20 Giladi N, Weitzman N, Schreiber S, Shabtai H, Peretz C. New onset heightened interest or drive for gambling, shopping, eating or sexual activity in patients with Parkinson’s disease: the role of dopa mine agonist treatment and age at motor symptoms onset. J Psychopharmacol 2007; 21: 501-506.
    CrossrefPubMedGoogle Scholar
  • 21 Giovannoni G, O’Sullivan JD, Turner K, Manson AJ, Lees AJ. Hedonistic homeostatic dysregulation in patients with Parkinson’s disease on dopamine replacement therapies. J Neurol Neurosurg Psychiatry 2000; 68: 423-428.
    CrossrefPubMedGoogle Scholar
  • 22 Grosset KA, Macphee G, Pal G, Stewart D, Watt A, Davie J, Grosset DG. Problematic gambling on dopamine agonists: Not such a rarity. Mov Disord 2006; 21: 2206-2208.
    CrossrefPubMedGoogle Scholar
  • 23 Hoehn MM. The natural history of Parkinson’s disease in the pre-levodopa and post-levodopa eras. Neurol Clin 1992; 10: 331-339.
    CrossrefPubMedGoogle Scholar
  • 24 Houeto JL, Mesnage V, Mallet L, Pillon B, Gargiulo M, du Moncel ST, Bonnet AM, Pidoux B, Dormont D, Cornu P, Agid Y. Behavioural disorders, Parkinson’s disease and subthalamic stimulation. J Neurol Neurosurg Psychiatry 2002; 72: 701-707.
    CrossrefPubMedGoogle Scholar
  • 25 Hutcheson DM, Everitt BJ, Robbins TW, Dickinson A. The role of withdrawal in heroin addiction: enhances reward or promotes avoidance?. Nat Neurosci 2001; 4: 943-947.
    CrossrefPubMedGoogle Scholar
  • 26 Jiménez-Jiménez FJ, Sayed Y, García-Soldevilla MA, Barcenilla B. Possible zoophilia associated with dopaminergic therapy in Parkinson disease. Ann Pharmacother 2002; 36: 1178-1179.
    CrossrefPubMedGoogle Scholar
  • 27 Kimber TE, Thompson PD, Kiley MA. Resolution of dopamine dysregulation syndrome following cessation of dopamine agonist therapy in Parkinson’s disease. J. Clin. Neurosci 2008; 15: 205-208.
    CrossrefPubMedGoogle Scholar
  • 28 Klos KJ, Bower JH, Josephs KA, Matsumoto JY, Ahlskog JE. Pathological hypersexuality predominantly linked to adjuvant dopamine agonist therapy in Parkinson’s disease and multiple system atrophy. Parkinsonism Relat Disord 2005; 11: 381-386.
    CrossrefPubMedGoogle Scholar
  • 29 Kurlan R. Disabling repetitive behaviors in Parkinson’s disease. Mov Disord 2004; 19: 433-437.
    CrossrefPubMedGoogle Scholar
  • 30 Lawrence AD, Evans AH, Lees AJ. Compulsive use of dopamine replacement therapy in Parkinson’s disease: reward systems gone awry?. Lancet Neurol 2003; 2: 595-604.
    CrossrefPubMedGoogle Scholar
  • 31 Lawrence AJ, Blackwell AD, Barker RA, Spagnolo F, Clark L, Aitken MR, Sahakian BJ. Predictors of punding in Parkinson’s disease: results from a questionnaire survey. Mov Disord 2007; 22: 2339-2345.
    CrossrefPubMedGoogle Scholar
  • 32 Lu C, Bharmal A, Suchowersky O. Gambling and Parkinson disease. Arch Neurol 2006; 63: 298.
    PubMedGoogle Scholar
  • 33 Machado AG, Hiremath GK, Salazar F, Rezai AR. Fracture of subthalamic nucleus deep brain stimulation hardware as a result of compulsive manipulation: case report. Neurosurgery 2005; 57: E1318.
    CrossrefPubMedGoogle Scholar
  • 34 Mamikonyan E, Siderowf AD, Duda JE, Potenza MN, Horn S, Stern MB, Weintraub D. Long-term follow-up of impulse control disorders in Parkinson’s disease. Mov Disord 2008; 23: 75-80.
    CrossrefPubMedGoogle Scholar
  • 35 Miyasaki JM, Al HK, Lang AE, Voon V. Punding prevalence in Parkinson’s disease. Mov Disord 2007; 22: 1179-1181.
    CrossrefPubMedGoogle Scholar
  • 36 Nirenberg MJ, Waters C. Compulsive eating and weight gain related to dopamine agonist use. Mov Disord 2005; 21: 524-529.
    Google Scholar
  • 37 Oh JD, Russell DS, Vaughan CL, Chase TN. Enhanced tyrosine phosphorylation of striatal NMDA receptor subunits: effect of dopaminergic denervation and L-DOPA administration. Brain Res 1998; 813: 150-159.
    CrossrefPubMedGoogle Scholar
  • 38 Ouchi Y, Yoshikawa E, Okada H, Futatsubashi M, Sekine Y, Iyo M, Sakamoto M. Alterations in binding site density of dopamine transporter in the striatum, orbitofrontal cortex, and amygdala in early Parkinson’s disease: compartment analysis for beta-CFT binding with positron emission tomography. Ann Neurol 1999; 45: 601-610.
    CrossrefPubMedGoogle Scholar
  • 39 Pezzella FR, Colosimo C, Vanacore N, Di Rezze S, Chianese M, Fabbrini G, Meco G. Prevalence and clinical features of hedonistic homeostatic dysregulation in Parkinson’s disease. Mov Disord 2005; 20: 77-81.
    CrossrefPubMedGoogle Scholar
  • 40 Pickering AD, Gray JA. Dopamine, Appetitive Reinforcement, and the Neuropsychology of Human Learning: An Individual Differences Approach. In Advances in Research on Temperament. ed. Eliasz A, and Angleitner A. 113-149. Lengerich: Pabst Science Publishers; 2001
    Google Scholar
  • 41 Quinn NP, Toone B, Lang AE, Marsden CD, Parkes JD. Dopa dose-dependent sexual deviation. Br J Psychiatry 1983; 142: 296-298.
    CrossrefPubMedGoogle Scholar
  • 42 Reuter J, Raedler T, Rose M, Hand I, Glascher J, Buchel C. Pathological gambling is linked to reduced activation of the mesolimbic reward system. Nat Neurosci 2005; 8: 147-148.
    CrossrefPubMedGoogle Scholar
  • 43 Robinson TE, Berridge KC. Addiction. Annu Rev Psychol 2000; 54: 25-53.
    Google Scholar
  • 44 Rylander G. Psychoses and the punding and choreiform syndromes in addiction to central stimulant drugs. Psychiatr Neurol Neurochir 1972; 75: 203-212.
    PubMedGoogle Scholar
  • 45 Sensi M, Eleopra R, Cavallo MA, Sette E, Milani P, Quatrale R, Capone JG, Tugnoli V, Tola MR, Granieri E. Data Pathological Gambling. Explosive- aggressive behavior related to bilateral subthalamic stimulation. Parkinsonism Relat Disord 2004; 10: 247-251.
    CrossrefPubMedGoogle Scholar
  • 46 Serrano-Duenas M. Chronic dopamimetic drug addiction and pathologic gambling in patients with Parkinson’s disease—presentation of four cases. Ger J Psychiatry 2002; 5: 62-66.
    Google Scholar
  • 47 Shapiro MA, Chang YL, Munson SK, Okun MS, Fernandez HH. Hypersexuality and paraphilia induced by selegiline in Parkinson’s disease: report of 2 cases. Parkinsonism Relat Disord 2006; 12: 392-395.
    CrossrefPubMedGoogle Scholar
  • 48 Silveira-Moriyama L, Evans AH, Katzenschlager R, Lees AJ. Punding and dyskinesias. Mov Disord 2006; 21: 2214-2217.
    CrossrefPubMedGoogle Scholar
  • 49 Thiel A, Hilker R, Kessler J, Habedank B, Herholz K, Heiss WD. Activation of basal ganglia loops in idiopathic Parkinson’s disease: a PET study. J Neural Transm 2003; 110: 1289-1301.
    CrossrefPubMedGoogle Scholar
  • 50 Tippmann-Peikert M, Park JG, Boeve BF, Shepard JW, Silber MH. Pathologic gambling in patients with restless legs syndrome treated with dopaminergic agonists. Neurology 2007; 68: 301-303.
    CrossrefPubMedGoogle Scholar
  • 51 Uitti RJ, Tanner CM, Rajput AH, Goetz CG, Klawans HL, Thiessen B. Hypersexuality with antiparkinsonian therapy. Clin Neuropharmacol 1989; 12: 375-383.
    CrossrefPubMedGoogle Scholar
  • 52 Volkow ND, Wang GJ, Ma Y, Fowler JS, Wong C, Ding YS, Hitzemann R, Swanson JM, Kalivas P. Activation of orbital and medial prefrontal cortex by methylphenidate in cocaine-addicted subjects but not in controls: relevance to addiction. J Neurosci 2005; 25: 3932-3939.
    CrossrefPubMedGoogle Scholar
  • 53 Voon V, Hassan K, Zurowski MSM, Thomsen T, Fox S, Lang AE, Miyasaki J. Prevalence of repetitive and reward-seeking behaviors in Parkinson disease. Neurology 2006; 67: 1254-1257.
    CrossrefPubMedGoogle Scholar
  • 54 Voon V, Potenza MN, Thomsen T. Medication-related impulse control and repetitive behaviors in Parkinson’s disease. Curr Opin Neurol 2007; 20: 484-492.
    CrossrefPubMedGoogle Scholar
  • 55 Voon V, Thomsen T, Miyasaki JM, Shafro A, Fox SH, Duff-Canning S, Lang AE, Zurowski M. Factors associated with dopaminergic drug-related pathological gambling in Parkinson disease. Arch Neurol 2007; 64: 212-216.
    CrossrefPubMedGoogle Scholar
  • 56 Weintraub D, Siderowf AD, Potenza MN, Goveas J, Morales KH, Duda JE, Moberg PJ, Stern MB. Association of dopamine agonist use with impulse control disorders in Parkinson disease. Arch Neurol 2006; 63: 969-973.
    CrossrefPubMedGoogle Scholar
  • 57 Katzenschlager R, Evans AH. Impulse dyscontrol and dopamine dysregulation syndrome. In: The Non-Motor Symptoms of Parkinson’s Disease. Schapira AHV, Tolosa E, Poewe W, Chaudhuri R. (eds). Oxford: Oxford University Press; (in press).
    Google Scholar