Aracil-Bolaños I, Strafella A P
Morton and Gloria Shulman Movement Disorder Unit & Edmond J. Safra Program in Parkinson Disease, Toronto Western Hospital, UHN, University of Toronto, Ontario, Canada; Research Imaging Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada; Division of Brain, Imaging and Behaviour - Systems Neuroscience, Toronto Western Research Institute, UHN, University of Toronto, Ontario, Canada.
Morton and Gloria Shulman Movement Disorder Unit & Edmond J. Safra Program in Parkinson Disease, Toronto Western Hospital, UHN, University of Toronto, Ontario, Canada; Research Imaging Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada; Division of Brain, Imaging and Behaviour - Systems Neuroscience, Toronto Western Research Institute, UHN, University of Toronto, Ontario, Canada.
Parkinsonism Relat Disord. 2016 Jan;22 Suppl 1(Suppl 1):S101-5. doi: 10.1016/j.parkreldis.2015.08.003. Epub 2015 Aug 12.
Impulse control disorders (ICDs) may arise in Parkinson's disease (PD) in relation to the use of dopamine agonists (DA). A dysfunction of reward circuits is considered the main underlying mechanism. Neuroimaging has been largely used in this setting to understand the structure of the reward system and its abnormalities brought by exogenous stimulation in PD. Dopaminergic changes, such as increased dopamine release, reduced dopamine transporter activity and other changes, have been shown to be a consistent feature of ICDs in PD. Beyond the striatum, alterations of prefrontal cortical function may also impact an individuals' propensity for impulsivity. Neuroimaging is advancing our knowledge of the mechanisms involved in the development of these behavioral addictions. An increased understanding of these disorders may lead to the discovery of new therapeutic targets, or the identification of risk factors for the development of these disorders.
冲动控制障碍(ICD)可能在帕金森病(PD)中与多巴胺激动剂(DA)的使用有关。奖励回路功能障碍被认为是主要的潜在机制。在这种情况下,神经影像学已被广泛用于了解奖励系统的结构及其在PD中外源性刺激所带来的异常。多巴胺能变化,如多巴胺释放增加、多巴胺转运体活性降低和其他变化,已被证明是PD中ICD的一个一致特征。除纹状体之外,前额叶皮质功能的改变也可能影响个体的冲动倾向。神经影像学正在增进我们对这些行为成瘾发展所涉及机制的认识。对这些障碍的更多了解可能会导致发现新的治疗靶点,或识别这些障碍发展的风险因素。