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Journal of Neurology

, Volume 257, Issue 2, pp 247–252 | Cite as

Cognitive status of patients with Parkinson’s disease and pathological gambling

  • Chiara Siri
  • Roberto Cilia
  • Danilo De Gaspari
  • Margherita Canesi
  • Nicoletta Meucci
  • Anna Lena Zecchinelli
  • Gianni Pezzoli
  • Angelo Antonini
Original Communication

Abstract

The cognitive status of patients with Parkinson’s disease (PD) who developed pathological gambling (PG) during dopamine replacement therapy has been poorly explored. We compared clinical and cognitive features of 21 consecutive PD patients with active PG (PD–PG) versus 42 PD controls of similar disease duration without any impulse control disorder. All patients underwent full neuropsychological testing to evaluate executive and other frontal lobe-related functions, attention, learning and memory, language, visuospatial abilities and neuropsychiatric status [using Geriatric Depression Scale (GDS) and Neuropsychiatric Inventory (NPI)] as well as the South Oaks Gambling Screen Scale (SOGS). PD–PG were younger (60.4 vs. 64.9, p = 0.01) and more frequently of male gender (85 vs. 57%, p = 0.02). The two groups did not differ in medication dosages and kind of dopamine agonist. PD–PG had higher MMSE (29.1 vs. 27.4, p = 0.02) and performed better at Rey Auditory Verbal learning Test (45.9 vs. 40.4, p = 0.04), verbal phonemic fluencies (38.7 vs. 31.8, p = 0.02), verbal semantic fluencies (44.9 vs. 37.4, p = 0.01) and attentive matrices (47.6 vs. 43.5, p = 0.05) while the remaining cognitive performances were comparable to controls. Moreover, based on the NPI, PD–PG had higher aggressiveness, irritability, disinhibition and eating disorders than controls. In conclusion the occurrence of PG in our cohort of patients with PD was associated with preserved executive functions.

Keywords

Parkinson’s disease Pathological gambling Cognitive functions Impulse control disorders 

References

  1. 1.
    Weintraub D (2009) Dopamine and impulse control disorders in Parkinson’s disease. Ann Neurol 64(S2):S93–S100CrossRefGoogle Scholar
  2. 2.
    Weintraub D, Koester J, Potenza M, Siderowf A, Stacy M, Whetteckey J, Wunderlich GR, Lang AE, FRCPC, for the DOMINION Study Group (2008) Dopaminergic therapy and impulse control disorders in Parkinson’s disease: top line results of a Cross-Sectional Study of over 3,000 patients. Mov Disord Suppl. LB4Google Scholar
  3. 3.
    Lu C, Bharmal A, Suchowersky O (2006) Gambling and Parkinson’s disease. Arch Neurol 63:298CrossRefPubMedGoogle Scholar
  4. 4.
    Grosset KA, Macphee G, Pal G, Stewart D, Watt A, Davie J, Grosset DG (2006) Problematic gambling on dopamine agonists: not such a rarity. Mov Disord 21:2206–2208CrossRefPubMedGoogle Scholar
  5. 5.
    American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders fourth edition: DSM-IV-TR. American Psychiatric Association, Washington, DCCrossRefGoogle Scholar
  6. 6.
    Voon V, Fox SH (2007) Medication-related impulse control and repetitive behaviors in Parkinson disease. Arch Neurol 64(8):1089–1096CrossRefPubMedGoogle Scholar
  7. 7.
    Potenza MN, Voon V, Weintraub D (2007) Drug insight: impulse control disorders and dopamine therapies in Parkinson’s disease. Nat Clin Pract Neurol 3(12):664–672CrossRefPubMedGoogle Scholar
  8. 8.
    Isaias IU, Siri C, Cilia R, De Gaspari D, Pezzoli G, Antonini A (2008) The relationship between impulsivity and impulse control disorders in Parkinson’s disease. Mov Disord 23(3):411–415CrossRefPubMedGoogle Scholar
  9. 9.
    Voon V, Hassan K, Zurowski M, de Souza M, Thomsen T, Fox S, Lang AE, Miyasaki J (2006) Prevalence of repetitive and reward-seeking behaviors in Parkinson disease. Neurology 67(7):1254–1257CrossRefPubMedGoogle Scholar
  10. 10.
    Gallagher DA, O’Sullivan SS, Evans AH, Lees AJ, Schrag A (2007) Pathological gambling in Parkinson’s disease: risk factors and differences from dopamine dysregulation. An analysis of published case series. Mov Disord 22(12):1757–1763CrossRefPubMedGoogle Scholar
  11. 11.
    Santangelo G, Vitale C, Trojano L, Verde F, Grossi D, Barone P (2009) Cognitive dysfunctions and pathological gambling in patients with Parkinson’s disease. Mov Disord 9 (Epub ahead of print)Google Scholar
  12. 12.
    Cilia R, Siri C, Marotta G, Isaias IU, De Gaspari D, Canesi M, Pezzoli G, Antonini A (2008) Functional abnormalities underlying pathological gambling in Parkinson disease. Arch Neurol 65(12):1604–1611CrossRefPubMedGoogle Scholar
  13. 13.
    Hughes AJ, Daniel SE, Kilford L, Lees AJ (1992) Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinicopathologic study of 100 cases. J Neurol Neurosurg Psychiatry 55:181–184CrossRefPubMedGoogle Scholar
  14. 14.
    Gelb DJ, Oliver E, Gilman S (1999) Diagnostic criteria for Parkinson’s disease. Arch Neurol 56:33–39CrossRefPubMedGoogle Scholar
  15. 15.
    Lesieur HR, Blume SB (1987) The South Oaks Gambling Screen (SOGS): a new instrument for the identification of pathological gamblers. Am J Psychiatry 144(9):1184–1188PubMedGoogle Scholar
  16. 16.
    Battersby MW, Thomas LJ, Tolchard B, Esterman A (2002) The South Oaks Gambling Screen: a review with reference to Australian use. J Gambl Stud 18(3):257–271CrossRefPubMedGoogle Scholar
  17. 17.
    Folstein MF, Folstein SE, McHugh PR (1975) ‘Mini-mental state’. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198CrossRefPubMedGoogle Scholar
  18. 18.
    Heaton RK, Pendleton MG (1981) Use of neuropsychological tests to predict adult patients’ everyday functioning. J Consult Clin Psychol 49:807–821CrossRefPubMedGoogle Scholar
  19. 19.
    Novelli P, Capitani L, Vallar G, Cappa S (1986) Test di fluenza verbale. Archivio di Psicologia, Neurologia e Psichiatria 47(4)Google Scholar
  20. 20.
    Basso A, Capitani E, Laiacona M (1987) Raven’s coloured progressive matrices: normative values on 305 adult normal controls. Funct Neurol 2(2):189–194PubMedGoogle Scholar
  21. 21.
    De Renzi E, Nichelli P (1975) Verbal and non verbal short term memory impairment following hemispheric damage. Cortex 11:33–41Google Scholar
  22. 22.
    Dubois B, Slaechevsky A, Litvan I, Pillon B (2000) The FAB: a frontal assessment battery at bedside. Neurology 55:1621–1626PubMedGoogle Scholar
  23. 23.
    Appollonio I, Leone M, Isella V, Piamarta F, Consoli T, Villa ML, Forapani E, Russo A, Nichelli P (2005) The frontal assessment battery (FAB): normative values in an Italian population sample. Neurol Sci 26:108–116CrossRefPubMedGoogle Scholar
  24. 24.
    Wechsler D (1981) Wechsler Adult Intelligence scale. The Psychological Corporation, New YorkGoogle Scholar
  25. 25.
    Carlesimo GA, Caltagirone C, Gainotti G (1996) The Mental Deterioration Battery: normative data, diagnostic reliability and qualitative analyses of cognitive impairment. The Group for the Standardization of the Mental Deterioration Battery. Eur Neurol 36(6):378–384CrossRefPubMedGoogle Scholar
  26. 26.
    Spinnler H, Tognoni G (1987) Standardizzazione e taratura italiana di test neuropsicologici. Italian J of Neurol Sci 6(Suppl. 8):47–50Google Scholar
  27. 27.
    Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO (1983) Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 17:37–49CrossRefGoogle Scholar
  28. 28.
    Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J (1994) The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology 44:2308–2314PubMedGoogle Scholar
  29. 29.
    Singh A, Kandimala G, Dewey RB, O’Suilleabhain P (2007) Risk factors for pathologic gambling and other compulsions among Parkinson’s disease patients taking dopamine agonists. J Clin Neurosci 14:1178–1181CrossRefPubMedGoogle Scholar
  30. 30.
    Petry N, Stinson F, Grant B (2005) Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: results from the national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry 66:564–574CrossRefPubMedGoogle Scholar
  31. 31.
    Hoeft F, Watson CL, Kesler SR, Bettinger KE, Reiss AL (2008) Gender differences in the mesocorticolimbic system during computer game-play. J Psychiatr Res 42(4):253–258CrossRefPubMedGoogle Scholar
  32. 32.
    Munro CA, McCaul ME, Wong DF, Oswald LM, Zhou Y, Brasic J, Kuwabara H, Kumar A, Alexander M, Ye W, Wand GS (2006) Sex differences in striatal dopamine release in healthy adults. Biol Psychiatry 59(10):966–974CrossRefPubMedGoogle Scholar
  33. 33.
    Voon V, Thomsen T, Miyasaki JM, de Souza M, Shafro A, Fox SH, Duff-Canning S, Lang AE, Zurowski M (2007) Factors associated with dopaminergic drug-related pathological gambling in Parkinson disease. Arch Neurol 64:212–216CrossRefPubMedGoogle Scholar
  34. 34.
    Pagonabarraga J, Kulisevsky J, Llebaria G, García-Sánchez C, Pascual-Sedano B, Gironell A (2008) Parkinson’s disease-cognitive rating scale: a new cognitive scale specific for Parkinson’s disease. Mov Disord 23(7):998–1005CrossRefPubMedGoogle Scholar
  35. 35.
    Caviness JN, Driver-Dunckley E, Connor DJ et al (2007) Defining mild cognitive impairment in Parkinson’s disease. Mov Disord 22(9):1272–1277CrossRefPubMedGoogle Scholar
  36. 36.
    Kobayakawa M, Koyama S, Mimura M, Kawamura M (2008) Decision making in Parkinson’s disease: analysis of behavioral and physiological patterns in the Iowa gambling task. Mov Disord 23(4):547–552CrossRefPubMedGoogle Scholar
  37. 37.
    Brand M, Labudda K, Kalbe E, Hilker R, Emmans D, Fuchs G, Kessler J, Markowitsch HJ (2004) Decision-making impairments in patients with Parkinson’s disease. Behav Neurol 15:77–85PubMedGoogle Scholar
  38. 38.
    Künig G, Leenders KL, Martin-Sölch C, Missimer J, Magyar S, Schultz W (2000) Reduced reward processing in the brains of Parkinsonian patients. Neuroreport 11(17):3681–3687PubMedGoogle Scholar
  39. 39.
    Fujii C, Harada S, Ohkoshi N, Hayashi A, Yoshizawa K (2000) Cross-cultural traits for personality of patients with Parkinson’s disease in Japan. Am J Med Genet 96(1):1–3CrossRefPubMedGoogle Scholar
  40. 40.
    Dagher A, Robbins TW (2009) Personality, addiction, dopamine: insights from Parkinson’s disease. Neuron 61(4):502–510CrossRefPubMedGoogle Scholar
  41. 41.
    Dodd ML, Klos KJ, Bower JH, Geda YE, Josephs KA, Ahlskog JE (2005) Pathological gambling caused by drugs used to treat Parkinson disease. Arch Neurol 62(9):1377–1381CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Chiara Siri
    • 1
  • Roberto Cilia
    • 1
    • 2
  • Danilo De Gaspari
    • 1
  • Margherita Canesi
    • 1
  • Nicoletta Meucci
    • 1
  • Anna Lena Zecchinelli
    • 1
  • Gianni Pezzoli
    • 1
  • Angelo Antonini
    • 1
  1. 1.Parkinson InstituteIstituti Clinici di PerfezionamentoMilanItaly
  2. 2.Department of NeurologyUniversity of Milan-Bicocca, San Gerardo HospitalMonzaItaly

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