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Dysfunctional inhibitory control in Parkinson’s disease patients with levodopa-induced dyskinesias

  • Silvia Picazio
  • Viviana Ponzo
  • Carlo Caltagirone
  • Livia Brusa
  • Giacomo Koch
Original Communication

Abstract

Introduction

Chronic dopamine replacement therapies in Parkinson’s disease can induce side effects, such as levodopa-induced dyskinesias and impulse control disorders. A dysfunction of inhibitory brain networks has been related to both disorders; however, there is no clear behavioral evidence supporting this hypothesis. We aimed to determine whether PD patients with levodopa-induced dyskinesias show features of increased impulsivity in parallel with altered motor inhibition.

Methods

Two matched samples of Parkinson’s disease patients with (n = 14) or without (n = 14) levodopa-induced dyskinesias and a control group (n = 10) participated in the study. All groups were evaluated by the Barratt Impulsiveness Scale-11 to assess impulsivity traits. Furthermore, participants performed a stop signal task to evaluate reactive-motor inhibition and a Go/NoGo task to evaluate proactive-inhibitory control. PD patients were tested both in OFF and ON levodopa medication.

Results

Parkinson’s disease patients with levodopa-induced dyskinesias showed higher impulsivity scores than PD patients without levodopa-induced dyskinesias. Dyskinetic patients presented also delayed stop signal reaction times indicating a worse performance in reactive inhibition. The slowness in inhibiting a motor command correlated with the impulsiveness scores. Furthermore, in the dyskinetic group, a positive correlation was found between stop reaction times and the severity of involuntary movements. Under the effect of levodopa, all patients were faster but dyskinetic patients were significantly less accurate in proactive inhibition.

Conclusion

Inhibitory control is compromised in dyskinetic patients in parallel with increased impulsivity, revealing an impairment of motor and behavioral inhibitory control in Parkinson’s disease patients with levodopa-induced dyskinesias.

Keywords

Parkinson’s disease Levodopa-induced dyskinesia Motor inhibition Impulsivity Go/NoGo Stop-signal task 

Notes

Acknowledgements

Sincere thanks to Gianluigi Rubino, Marilena Minei and to Prof. Fabio Ferlazzo for their essential contribution in reviewing the manuscript.

Compliance with ethical standards

Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

The Local Ethics Committee of the IRCCS “Santa Lucia” Foundation according to the Helsinki Declaration approved the study.

Informed consent

Written consent was obtained from all participants.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Silvia Picazio
    • 1
  • Viviana Ponzo
    • 1
  • Carlo Caltagirone
    • 1
    • 2
  • Livia Brusa
    • 3
  • Giacomo Koch
    • 1
    • 4
  1. 1.Non-Invasive Brain Stimulation UnitIRCCS Santa Lucia FoundationRomeItaly
  2. 2.Department of System MedicineUniversity of Rome Tor VergataRomeItaly
  3. 3.UOC Neurologia, Ospedale S. EugenioRomeItaly
  4. 4.Stroke Unit, Department of NeurosciencePoliclinic Tor VergataRomeItaly

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