Journal of Neurology

, Volume 262, Issue 6, pp 1504–1514 | Cite as

Single versus multiple impulse control disorders in Parkinson’s disease: an 11C-raclopride positron emission tomography study of reward cue-evoked striatal dopamine release

  • Kit Wu
  • Marios Politis
  • Sean S. O’Sullivan
  • Andrew D. Lawrence
  • Sarah Warsi
  • Subrata Bose
  • Andrew J. Lees
  • Paola Piccini
Original Communication


Impulse control disorders (ICDs) are reported in Parkinson’s disease (PD) in association with dopaminergic treatment. Approximately 25 % of patients with ICDs have multiple co-occurring ICDs (i.e. more than one diagnosed ICD). The extent to which dopaminergic neurotransmission in PD patients with multiple ICDs differs from those with only one diagnosed ICD is unknown. The aims of this study are: (1) to investigate dopamine neurotransmission in PD patients diagnosed with multiple ICDs, single ICDs and non-ICD controls in response to reward-related visual cues using positron emission tomography with 11C-raclopride. (2) to  compare clinical features of the above three groups. PD individuals with mulitple ICDs (n = 10), single ICD (n = 7) and no ICDs (n = 9) were recruited and underwent two positron emission tomography (PET) scans with 11C-raclopride: one where they viewed neutral visual cues and the other where they viewed a range of visual cues related to different rewards. Individuals with both multiple ICDs and single ICDs showed significantly greater ventral striatal dopamine release compared to non-ICD PD individuals in response to reward cues, but the two ICD groups did not differ from each other in the extent of dopamine release. Subjects with multiple ICDs were, however, significantly more depressed, and had higher levels of impulsive sensation-seeking compared to subjects with single ICDs and without ICDs. This is the first study to compare dopamine neurotransmission using PET neuroimaging in PD subjects with multiple vs. single ICDs. Our results suggest that striatal dopamine neurotransmission is not directly related to the co-occurrence of ICDs in PD, potentially implicating non-dopaminergic mechanisms linked to depression; and suggest that physicians should be vigilant in managing depression in PD patients with ICDs.


Parkinson’s disease Impulse control disorders PET Comorbidity Neuroimaging Addiction 



This work was supported by funding from Parkinson’s UK and the Reta Lila Weston Institute for Neurological studies. The authors wish to thank all participants for taking part in this study.

Conflicts of interest

This work was supported by funding from Parkinson’s UK and the Reta Lila Weston Institute for Neurological studies. We confirm that all authors have read the manuscript, the paper has not been previously published, and it is not under simultaneous consideration by another journal. There has been no ghost writing by anyone not named on the author list. We confirm that there is no potential conflict of interest with this research study.

Ethical standard

This study has been approved by the appropriate ethics committee and has therefore been performed in the accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Kit Wu
    • 1
  • Marios Politis
    • 1
    • 4
  • Sean S. O’Sullivan
    • 1
    • 2
  • Andrew D. Lawrence
    • 3
  • Sarah Warsi
    • 1
  • Subrata Bose
    • 1
  • Andrew J. Lees
    • 2
  • Paola Piccini
    • 1
  1. 1.Centre for Neuroinflammation and NeurodegenerationImperial College London, Hammersmith Hospital CampusLondonUK
  2. 2.Reta Lila Weston Institute of Neurological StudiesUniversity College LondonLondonUK
  3. 3.Cardiff University Brain Research Imaging Centre and School of PsychologyCardiff UniversityCardiffUK
  4. 4.Neurodegeneration Imaging Group, Department of Clinical NeuroscienceKing’s College LondonLondonUK

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