Parkinson's Disease and pathological gambling: Results from a functional MRI study

Abstract

Seven patients with a diagnosis of Parkinson's disease (PD) and pathological gambling (PG) and 7 PD patients without PG were investigated by functional MRI and a block-design experiment with gambling-related visual cues alternating with neutral stimuli and rest periods. Compared with PD/non-PG, in PD/PG patients, several areas of increased cue-related blood oxygen level dependent (BOLD)-response were observed including bilateral anterior cingulate cortex, medial and superior frontal gyri, and precuneus, right inferior parietal lobule, and ventral striatum. The over activation of cingulate cortex and ventral striatum in PD/PG patients after the craving task is similar to that reported in addicted patients, whereas the activation of the parietal structures is probably related to the attentional network.

Impulsivity and Parkinson's disease: More than just disinhibition

“…Neuroimaging studies have underlined the idea of a susceptibility to impulsivity. Indeed in the subpopulation of PD patients with PG compared to PD non-gamblers, there is an abnormal activation of cortical [68] and subcortical [69] areas implicated in impulse control during the task. In particular Steeves et al underlined the role of the striatum in a recent PET study [70].…”

Impulsive and Compulsive Behaviors in Parkinson's Disease

“…For example fMRI studies in PD patients with ICBs showed an increase in ventral striatal activity following reward after dopamine agonist medication (Frosini, Pesaresi et al 2010; Voon, Pessiglione et al 2010). Other studies have shown a significant correlation of sexual desire with enhanced activation in the ventral striatum, the anterior cingulate and the orbitofrontal cortex in PD patients with addictive behavours but not in a control patient group (Politis, Loane et al 2013).…”

The role of dopamine in risk taking: a specific look at Parkinson’s disease and gambling

“…Parkinson’s disease patients with pathological gambling show enhanced hemodynamic responses to gambling-related visual cues in the bilateral anterior cingulate cortex, left VStr, right precuneus and medial prefrontal cortex (Frosini et al, 2010). This is in line with similar experiments in pathological gambling without Parkinson’s disease (Crockford et al, 2005; Ko et al, 2009) and drug addiction (Wexler et al, 2001), supporting the view that impulse control disorders in Parkinson’s disease may be conceptualized as behavioral addictions.…”