Impulsivity and Parkinson's disease: More than just disinhibition

Antonelli, Francesca; Ray, Nicola; Strafella, Antonio P.

doi:10.1016/j.jns.2011.06.006

Cited by 47 publications

(41 citation statements)

References 95 publications

(121 reference statements)

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“…In these patients, the correlation analysis revealed that our medicated patients with higher k ‐values (i.e., more impulsive) had less rCBF changes in “reward‐areas” as compared to the less impulsive patients (i.e., lower k ‐value). Thus, from our observations, it appears obvious that failure of inhibition and impulsivity incorporates a number of dissociable components [Antonelli et al, ; Chamberlain and Sahakian, ]. One component is related to the ability of processing decision‐making information useful to make a proper choice.…”

Section: Discussionmentioning

confidence: 80%

Dopamine‐agonists and impulsivity in Parkinson's disease: Impulsive choices vs. impulsive actions

Antonelli

Miyasaki

et al. 2013

Human Brain Mapping

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The control of impulse behavior is a multidimensional concept subdivided into separate subcomponents, which are thought to represent different underlying mechanisms due to either disinhibitory processes or poor decision-making. In patients with Parkinson's disease (PD), dopamine-agonist (DA) therapy has been associated with increased impulsive behavior. However, the relationship among these different components in the disease and the role of DA is not well understood. In this imaging study, we investigated in PD patients the effects of DA medication on patterns of brain activation during tasks testing impulsive choices and actions. Following overnight withdrawal of antiparkinsonian medication, PD patients were studied with a H2 ((15)) O PET before and after administration of DA (1 mg of pramipexole), while they were performing the delay discounting task (DDT) and the GoNoGo Task (GNG). We observed that pramipexole augmented impulsivity during DDT, depending on reward magnitude and activated the medial prefrontal cortex and posterior cingulate cortex and deactivated ventral striatum. In contrast, the effect of pramipexole during the GNG task was not significant on behavioral performance and involved different areas (i.e., lateral prefrontal cortex). A voxel-based correlation analysis revealed a significant negative correlation between the discounting value (k) and the activation of medial prefrontal cortex and posterior cingulate suggesting that more impulsive patients had less activation in those cortical areas. Here we report how these different subcomponents of inhibition/impulsivity are differentially sensitive to DA treatment with pramipexole influencing mainly the neural network underlying impulsive choices but not impulsive action.

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Section: Discussionmentioning

confidence: 80%

Dopamine‐agonists and impulsivity in Parkinson's disease: Impulsive choices vs. impulsive actions

Antonelli

Miyasaki

et al. 2013

Human Brain Mapping

Self Cite

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“…As a consequence, movement initiation disorders are not easily alleviated by standard therapies [4][5][6]. Even worse, they can be aggravated by the treatments, for example worsened akinesia [7] or induced impulsivity [8][9][10]. A prerequisite for current therapeutic strategies is to understand the complexity of the basic mechanisms involved in movement initiation and related dysfunctions.…”

Section: Introductionmentioning

confidence: 99%

Deep Brain Stimulation of the Subthalamic Nucleus, but not Dopaminergic Medication, Improves Proactive Inhibitory Control of Movement Initiation in Parkinson's Disease

et al. 2013

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Slowness in movement initiation is a cardinal feature of Parkinson's disease (PD) that is still poorly understood and unsuccessfully alleviated by standard therapies. Here, we raise this major clinical issue within the framework of a novel theoretical model that allows a better understanding of the basic mechanisms involved in movement initiation. This model assumes that movement triggering is inhibited by default to prevent automatic responses to unpredictable events. We investigated to which extent the top-down control necessary to release this locking state before initiating actions is impaired in PD and restored by standard therapies. We used a cue-target reaction time task to test both the ability to initiate fast responses to targets and the ability to refrain from reacting to cues. Fourteen patients with dopaminergic (DA) medication and 11 with subthalamic nucleus (STN) stimulation were tested on and off treatment, and compared with 14 healthy controls. We found evidence that patients withdrawn from treatment have trouble voluntarily releasing proactive inhibitory control; while DA medication broadly reduces movement initiation latency, it does not reinstate a normal pattern of movement initiation; and stimulation of the STN specifically re-establishes the efficiency of the top-down control of proactive inhibition. These results suggest that movement initiation disorders that resist DA medication are due to executive, not motor, dysfunctions. This conclusion is discussed with regard to the role the STN may play as an interface between non-DA executive and DA motor systems in cortico-basal ganglia loops.

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“…However, "impulsivity" is a complex and multifaceted construct; Antonelli et al (2011) distinguished between cognitive impulsivity-which is characterized by altered decision-making (e.g. risk-taking, altered time-perception, and avoidance of waiting) and motor impulsivity-which is associated with a relative inability to inhibit prepotent responses.…”

Section: Introductionmentioning

confidence: 99%

Continuous force measurements reveal no inhibitory control deficits in Parkinson’s disease

et al. 2020

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Suppression of unwanted motor responses can be disrupted by Parkinson's disease. People with Parkinson's (PwP) can show maladaptive reward-driven behaviours in the form of impulse control behaviours, which are associated with the use of the dopaminergic treatments used to alleviate the motor symptoms of the disease. However, the effects of Parkinson's itself on impulsive behaviour and control are unclear-empirical studies have yielded mixed findings, and some imaging studies have shown a functional deficit in the absence of a measurable change in behaviour. Here, we investigated the effects of Parkinson's on response activation and control by studying the dynamics of response in standard inhibitory control tasks-the Stop Signal and Simon tasks-using a continuous measure of response force. Our results are largely in favour of the conclusion that response inhibition appears to be intact in PwP, even when using a more sensitive measure of behavioural control relative to traditional button-press measures. Our findings provide some clarity as to the effects of Parkinson's on response inhibition and show continuous response force measurement can provide a sensitive means of detecting erroneous response activity in PwP, which could also be generalised to studying related processes in other populations.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Impulsivity and Parkinson's disease: More than just disinhibition

Cited by 47 publications

References 95 publications

Dopamine‐agonists and impulsivity in Parkinson's disease: Impulsive choices vs. impulsive actions

Dopamine‐agonists and impulsivity in Parkinson's disease: Impulsive choices vs. impulsive actions

Deep Brain Stimulation of the Subthalamic Nucleus, but not Dopaminergic Medication, Improves Proactive Inhibitory Control of Movement Initiation in Parkinson's Disease

Continuous force measurements reveal no inhibitory control deficits in Parkinson’s disease

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