Objective: Evaluating through meta-analysis brain activations associated with impulse control disorder in patients with and without Parkinson ’s disease.

Background: Impulse control disorders (ICDs) in the general population also known as “behavioral addictions” may share some clinical features with substance addictions.  Parkinson’s disease (PD) patients receiving dopaminergic therapy are susceptible to develop similar pathological behaviors. Imaging studies have showed that frontal and striatal areas are involved in the pathophysiology of these disorders in different populations. There are no known studies directly comparing brain activation in PD-ICD versus non PD-ICD.

Methods: We searched the literature through “Pubmed” and “Web of sciences” from 1.2000-1.2016, for imaging studies involving PD-ICD patients or non-PD ICD subjects.  fMRI, SPECT (Tc⁹⁹), and PET (H₂O¹⁵) studies were considered. Clinical and demographical data including cognitive state were extracted. For the PD patients we collected UPDRS scores, Levodopa equivalent daily dose.  A coordinate-based quantitative meta-analysis (“activation likelihood estimation”) was performed. 

Results: A total of 56 experiments and 384 foci were included. For the PD group, we found 16 experiments with 117 significant foci. For the non-PD group, we found 40 experiments with384 significant foci. PD subjects were older than the non-PD subjects, but most experiments included a normal control group age matched to the study group, thus controlling for the “age effect”. Cluster analysis demonstrated activation of the Lt. Insula, Lt. Putamen, Bil.Pallidum in the Non-PD ICD group. Additional significant clusters were found in the PD-ICD group including: Lt. Caudate, Anterior Orbital gyrus, Rt. Posterior and Inferior orbital gyri.

Conclusions: This study suggests that several brain circuits are shared between non-PD patients with ICD and PD patients associated ICD .However, activation of frontal brain areas was exclusively seen in PD-ICD patients. Our results contribute to a better understanding of PD associated ICD pathophysiology, which may differ from the one among ICD non-PD patients.

« Back to 2017 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/a-quantitative-meta-analysis-study-of-impulse-control-disorders-in-patients-with-and-without-parkinsons-disease/