Callesen Mette Buhl, Hansen K V, Gjedde A, Linnet J, Møller A
Department of Nuclear Medicine and PET-Centre, Aarhus University Hospital , Aarhus , Denmark ; Centre of Functionally Integrative Neuroscience, Aarhus University , Aarhus , Denmark.
Front Behav Neurosci. 2013 Jul 29;7:95. doi: 10.3389/fnbeh.2013.00095. eCollection 2013.
Dopaminergic medication for motor symptoms in Parkinson's disease (PD) recently has been linked with impulse control disorders, including pathological gambling (PG), which affects up to 8% of patients. PG often is considered a behavioral addiction associated with disinhibition, risky decision-making, and altered striatal dopaminergic neurotransmission. Using [(11)C]raclopride with positron emission tomography, we assessed dopaminergic neurotransmission during Iowa Gambling Task performance. Here we present data from a single patient with PD and concomitant PG. We noted a marked decrease in [(11)C]raclopride binding in the left ventral striatum upon gambling, indicating a gambling-induced dopamine release. The results imply that PG in PD is associated with a high dose of dopaminergic medication, pronounced motor symptomatology, young age at disease onset, high propensity for sensation seeking, and risky decision-making. Overall, the findings are consistent with the hypothesis of medication-related PG in PD and underscore the importance of taking clinical variables, such as age and personality, into account when patients with PD are medicated, to reduce the risk of PG.
帕金森病（PD）中用于治疗运动症状的多巴胺能药物最近被认为与冲动控制障碍有关，包括病态赌博（PG），高达8%的患者受其影响。PG通常被认为是一种与去抑制、冒险决策和纹状体多巴胺能神经传递改变相关的行为成瘾。我们使用[（11）C]雷氯必利正电子发射断层扫描技术，评估了爱荷华赌博任务执行过程中的多巴胺能神经传递。在此，我们展示了一名患有PD并伴有PG的患者的数据。我们注意到赌博时左腹侧纹状体中[（11）C]雷氯必利结合显著减少，表明赌博诱导多巴胺释放。结果表明，PD中的PG与高剂量多巴胺能药物、明显的运动症状、疾病发病年龄较轻、寻求刺激的高倾向以及冒险决策有关。总体而言，这些发现与PD中与药物相关的PG假说一致，并强调在PD患者用药时考虑年龄和性格等临床变量以降低PG风险的重要性。
