Unmasking neurobiological commonalities between addictive disorders and impulse control disorders in Parkinson’s disease
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Changes in reward circuitry have been studied extensively in substance and behavioural addictions. However, comparatively little is known about the neurobiology underlying impulse control disorders (ICDs) in Parkinson’s disease, which show roughly similar risk factors and behavioural presentations to both stimulant and behavioural addictions. ICDs occur in a subset of susceptible patients with Parkinson’s disease (PD) following intake of dopamine replacement therapy (DRT). These behavioural disorders often have debilitating effects on a patient’s quality of life and increase caregiver burden. This comprehensive review examined findings of 40 neuroimaging studies of ICDs in PD to determine (a) whether there are putative neurobiological commonalities between traditional substance and behavioural addictions and DRT-induced ICD in PD and (b) opportunities for future studies to advance current neurobiological understanding of the phenomenon. Results revealed that strikingly similar (a) deficits in dopaminergic receptor expression, (b) connectivity changes in corticostriatal circuitry and (c) neural responses to cue exposure are observed in both ICDs in PD and addictive disorders. These findings point to the value of adopting a transdiagnostic approach when studying addicted populations and pave the way for demystifying this peculiar, often-devastating phenomenon in PD that has so far proven extremely difficult to treat and predict with any precision.
KeywordsAddiction Dopamine Impulse control disorders Neuroimaging Parkinson’s disease
Swathi Ramdave and Andrew Dawson are supported by an Australian Government Research Training Program Scholarship. Adrian Carter is supported by an NHMRC Career Development Fellowship (ID: APP1123311). Nadeeka Dissanayaka is supported by the NHMRC and Lions Medical Research Fellowship.
SR wrote first draft. SR and AD did literature search. SR, AD, AC and ND reviewed and edited the manuscript. SR, AD, AC and ND approved final version.
This review was funded by the Australian Government in the form of a Research Training Program Scholarship (SR/AD), Australian Research Council Discovery Early Career Researcher Award (ID: DE140101097) (AC) and National Health and Medical Research Council Career Development Fellowship (ID: APP1123311) (AC). NHMRC Boosting Dementia Research Leadership fellowship and Lions Medical Research Fellowship (ND).
Compliance with ethical standards
Conflict of interest
SR declares that she has no conflict of interest. AD declares that he has no conflict of interest. AC declares that he has no conflict of interest. ND declares that she has no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
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