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Proficient motor impulse control in Parkinson disease patients with impulsive and compulsive behaviors.
Pharmacol Biochem Behav. 2015 Feb; 129:19-25.PB

Abstract

BACKGROUND

Parkinson disease (PD) patients treated with dopamine agonist therapy can develop maladaptive reward-driven behaviors, known as impulse control disorder (ICD). In this study, we assessed if ICD patients have evidence of motor-impulsivity.

METHODS

We used the stop-signal task in a cohort of patients with and without active symptoms of ICD to evaluate motor-impulsivity. Of those with PD, 12 were diagnosed with ICD symptoms (PD-ICD) and were assessed before clinical reduction of dopamine agonist medication; 12 were without symptoms of ICD [PD-control] and taking equivalent dosages of dopamine agonist. Levodopa, if present, was maintained in both settings. Groups were similar in age, duration, and severity of motor symptoms, levodopa co-therapy, and total levodopa daily dose. All were tested in the dopamine agonist medicated and acutely withdrawn (24 h) state, in a counterbalanced manner. Primary outcome measures were mean reaction time to correct go trials (go reaction time), and mean stop-signal reaction time (SSRT).

RESULTS

ICD patients produce faster SSRT than both Healthy Controls, and PD-Controls. Faster SSRT in ICD patients is apparent in both dopamine agonist medication states. Also, we show unique dopamine medication effects on Go Reaction time (GoRT). In dopamine agonist monotherapy patients, dopamine agonist administration speeds GoRT. Conversely, in those with levodopa co-therapy, dopamine agonist administration slows.

DISCUSSION

PD patients with active ICD symptoms are significantly faster at stopping initiated motor actions, and this is not altered by acute dopamine agonist withdrawal. In addition, the effect of dopamine agonist on GoRT is strongly influenced by the presence or absence of levodopa, even though levodopa co-therapy does not appear to influence SSRT. We discuss these findings as they pertain to the multifaceted definition of 'impulsivity,' the lack of evidence for motor-impulsivity in PD-ICD, and dopamine effects on motor-control in PD.

Authors+Show Affiliations

Department of Neurology, Vanderbilt University, Nashville, TN, United States. Electronic address: daniel.claassen@vanderbilt.edu.Department of Psychology, University of Amsterdam, Netherlands.Department of Neurology, University of Virginia, Charlottesville, VA, United States.Department of Neurology, Vanderbilt University, Nashville, TN, United States.Department of Neurology, Vanderbilt University, Nashville, TN, United States.Department of Neurosurgery, Vanderbilt University, Nashville, TN, United States.Department of Neurology, Vanderbilt University, Nashville, TN, United States.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25459105

Citation

Claassen, Daniel O., et al. "Proficient Motor Impulse Control in Parkinson Disease Patients With Impulsive and Compulsive Behaviors." Pharmacology, Biochemistry, and Behavior, vol. 129, 2015, pp. 19-25.
Claassen DO, van den Wildenberg WP, Harrison MB, et al. Proficient motor impulse control in Parkinson disease patients with impulsive and compulsive behaviors. Pharmacol Biochem Behav. 2015;129:19-25.
Claassen, D. O., van den Wildenberg, W. P., Harrison, M. B., van Wouwe, N. C., Kanoff, K., Neimat, J. S., & Wylie, S. A. (2015). Proficient motor impulse control in Parkinson disease patients with impulsive and compulsive behaviors. Pharmacology, Biochemistry, and Behavior, 129, 19-25. https://doi.org/10.1016/j.pbb.2014.11.017
Claassen DO, et al. Proficient Motor Impulse Control in Parkinson Disease Patients With Impulsive and Compulsive Behaviors. Pharmacol Biochem Behav. 2015;129:19-25. PubMed PMID: 25459105.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Proficient motor impulse control in Parkinson disease patients with impulsive and compulsive behaviors. AU - Claassen,Daniel O, AU - van den Wildenberg,Wery P M, AU - Harrison,Madaline B, AU - van Wouwe,Nelleke C, AU - Kanoff,Kristen, AU - Neimat,Joseph S, AU - Wylie,Scott A, Y1 - 2014/11/29/ PY - 2014/07/28/received PY - 2014/11/16/revised PY - 2014/11/22/accepted PY - 2014/12/3/entrez PY - 2014/12/3/pubmed PY - 2015/10/10/medline KW - Dopamine agonist KW - Impulse control disorder KW - Inhibition KW - Motor impulsivity KW - Parkinson disease KW - Reaction time SP - 19 EP - 25 JF - Pharmacology, biochemistry, and behavior JO - Pharmacol. Biochem. Behav. VL - 129 N2 - BACKGROUND: Parkinson disease (PD) patients treated with dopamine agonist therapy can develop maladaptive reward-driven behaviors, known as impulse control disorder (ICD). In this study, we assessed if ICD patients have evidence of motor-impulsivity. METHODS: We used the stop-signal task in a cohort of patients with and without active symptoms of ICD to evaluate motor-impulsivity. Of those with PD, 12 were diagnosed with ICD symptoms (PD-ICD) and were assessed before clinical reduction of dopamine agonist medication; 12 were without symptoms of ICD [PD-control] and taking equivalent dosages of dopamine agonist. Levodopa, if present, was maintained in both settings. Groups were similar in age, duration, and severity of motor symptoms, levodopa co-therapy, and total levodopa daily dose. All were tested in the dopamine agonist medicated and acutely withdrawn (24 h) state, in a counterbalanced manner. Primary outcome measures were mean reaction time to correct go trials (go reaction time), and mean stop-signal reaction time (SSRT). RESULTS: ICD patients produce faster SSRT than both Healthy Controls, and PD-Controls. Faster SSRT in ICD patients is apparent in both dopamine agonist medication states. Also, we show unique dopamine medication effects on Go Reaction time (GoRT). In dopamine agonist monotherapy patients, dopamine agonist administration speeds GoRT. Conversely, in those with levodopa co-therapy, dopamine agonist administration slows. DISCUSSION: PD patients with active ICD symptoms are significantly faster at stopping initiated motor actions, and this is not altered by acute dopamine agonist withdrawal. In addition, the effect of dopamine agonist on GoRT is strongly influenced by the presence or absence of levodopa, even though levodopa co-therapy does not appear to influence SSRT. We discuss these findings as they pertain to the multifaceted definition of 'impulsivity,' the lack of evidence for motor-impulsivity in PD-ICD, and dopamine effects on motor-control in PD. SN - 1873-5177 UR - https://www.unboundmedicine.com/medline/citation/25459105/Proficient_motor_impulse_control_in_Parkinson_disease_patients_with_impulsive_and_compulsive_behaviors_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-3057(14)00317-7 DB - PRIME DP - Unbound Medicine ER -