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Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation
Published on: July 16, 2014
Dopamine agonists rather than deep brain stimulation cause reflection impulsivity in Parkinson's disease
Atbin Djamshidian1, Sean S O'Sullivan, Thomas Foltynie
1Department of Molecular Neuroscience and Reta Lila Weston Institute for Neurological Studies, University of London, London, UK.
Journal of Parkinson'S Disease
|August 14, 2013
Summary
Dopamine agonist therapy, not deep brain stimulation, increases "reflection impulsivity" in Parkinson's disease (PD) patients. This therapy leads to poorer decision-making and information gathering in individuals with PD.
Area of Science:
- Neuroscience
- Neurology
- Psychiatry
Background:
- Dopamine agonist therapy is a known risk factor for impulse control disorders in Parkinson's disease (PD).
- The impact of subthalamic nucleus deep brain stimulation (DBS) on decision-making in PD remains unclear.
Purpose of the Study:
- To investigate the effects of dopamine agonist therapy and subthalamic nucleus DBS on reflection impulsivity in non-demented PD patients.
Main Methods:
- 61 PD patients were categorized based on treatment: L-dopa with dopamine agonist, L-dopa monotherapy, DBS with L-dopa and dopamine agonist, or DBS with L-dopa only.
- 18 healthy controls were included for comparison.
- Reflection impulsivity was assessed using the validated beads task, excluding patients with existing impulsive-compulsive behaviors.
Main Results:
- Patients receiving dopamine agonist therapy (with or without DBS) exhibited significantly reduced information gathering.
- These patients also made more irrational decisions compared to all other groups.
- Subthalamic nucleus DBS did not appear to influence reflection impulsivity.
Conclusions:
- Dopamine agonist therapy is implicated as a cause of "reflection impulsivity" in Parkinson's disease.
- Deep brain stimulation of the subthalamic nucleus does not appear to induce this specific type of impulsivity.
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