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Overlapping and distinct neural metabolic patterns related to impulsivity and hypomania in Parkinson’s disease


Impulsivity and hypomania are common non-motor features in Parkinson’s disease (PD). The aim of this study was to find the overlapping and distinct neural correlates of these symptoms in PD. Symptoms of impulsivity and hypomania were assessed in 24 PD patients using the Barratt Impulsiveness Scale (BIS-11) and Self-Report Manic Inventory (SRMI), respectively. In addition, fluorodeoxyglucose positron emission tomography (FDG-PET) imaging for each individual was performed. We conducted two separate multiple regression analyses for BIS-11 and SRMI scores with FDG-PET data to identify the brain regions that are associated with both impulsivity and hypomania scores, as well as those exclusive to each symptom. Then, seed-based functional connectivity analyses on healthy subjects identified the areas connected to each of the exclusive regions and the overlapping region, used as seeds. We observed a positive association between BIS-11 and SRMI scores and neural metabolism only in the prefrontal areas. Conjunction analysis revealed an overlapping region in the middle frontal gyrus. Regions exclusive to impulsivity were found in the medial part of the right superior frontal gyrus and regions exclusive to hypomania were in the right superior frontal gyrus, right precentral gyrus and right paracentral lobule. Connectivity patterns of seeds exclusively related to impulsivity were different from those for hypomania in healthy brains. These results provide evidence of both overlapping and distinct regions linked with impulsivity and hypomania scores in PD. The exclusive regions for each characteristic are connected to specific intrinsic functional networks.

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We would like to thank all patients for their participation in the study. Moreover, we wish to thank the staff of the Departments of Neurology, University Hospital of Cologne, as well as Max Planck institute for Metabolism Research for their help in data collection.


This study was supported by the German Research Foundation (KFO 219 (TP10) and EI 892 3-1).

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Correspondence to Masoud Tahmasian.

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The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Registration and ethical approval conforming to Human Research Committee guidelines was obtained by the medical ethics board of the University Hospital of Cologne (EK 10-278).

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Written informed consent was obtained from all participants included in this study.

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Schwartz, F., Tahmasian, M., Maier, F. et al. Overlapping and distinct neural metabolic patterns related to impulsivity and hypomania in Parkinson’s disease. Brain Imaging and Behavior 13, 241–254 (2019).

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  • Impulsivity
  • Hypomania
  • Parkinson’s disease
  • Functional connectivity