Mojtahed Zadeh Mahtab, Ashraf-Ganjouei Amir, Ghazi Sherbaf Farzaneh, Haghshomar Maryam, Aarabi Mohammad Hadi
Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Front Neurol. 2018 Mar 20;9:163. doi: 10.3389/fneur.2018.00163. eCollection 2018.
Impulse control disorders (ICDs) are relatively frequent in patients with Parkinson's disease (PD), although it is still unclear whether an underlying pathological process plays a significant role in the development of ICD in PD apart from dopaminergic replacement therapy. In this study, we have investigated alterations of white matter tract in drug-naïve PD patients with ICDs diffusion MRI connectometry. Our results showed that disrupted connectivity in the complex network of dynamic connections between cerebellum, basal ganglia, cortex, and its spinal projections serves as the underlying neuropathology of ICD in PD not interfered with the contribution of dopaminergic replacement therapy. These findings provide the first evidence on involved white matter tracts in the neuropathogenesis of ICD in drug-naïve PD population, supporting the hypothesis that neural disturbances intrinsic to PD may confer an increased risk for ICDs. Future studies are needed to validate the attribution of the impaired corticocerebellar network to impulsivity in PD.
冲动控制障碍（ICDs）在帕金森病（PD）患者中相对常见，尽管除多巴胺能替代疗法外，尚不清楚潜在的病理过程在PD患者ICD的发生发展中是否起重要作用。在本研究中，我们采用扩散磁共振成像连接ometry技术，研究了未接受过药物治疗的患有ICDs的PD患者白质束的改变。我们的结果表明，小脑、基底神经节、皮层及其脊髓投射之间动态连接的复杂网络中的连接中断，是未受多巴胺能替代疗法影响的PD患者ICD的潜在神经病理学基础。这些发现首次证明了未接受过药物治疗的PD患者群体中，ICD神经发病机制中涉及的白质束，支持了PD内在的神经紊乱可能增加ICD风险的假说。未来需要进一步研究来验证皮质小脑网络受损与PD患者冲动性之间的关系。
