Codling David, Shaw Philip, David Anthony S
South London and Maudsley NHS Foundation Trust London United Kingdom.
Child Psychiatry Branch National Institute of Mental Health Bethesda Maryland USA.
Mov Disord Clin Pract. 2015 Apr 30;2(2):116-126. doi: 10.1002/mdc3.12155. eCollection 2015 Jun.
Hypersexuality (HS) was one of the earliest examples of an impulse control disorder (ICD) or behavior to be associated with treatment for Parkinson's disease (PD), with an estimated prevalence of approximately 3.5%. Here, we report on a systematic review of the published literature of HS in PD with a view to uncovering evidence as to whether it is distinct from other ICDs. In addition, we report on 7 new cases that had broad neuropsychological testing, including a gambling test, which taps into reward and inhibitory mechanisms. The review uncovered a number of case series and cohorts that comment on the prevalence of HS, but very few made systematic comparisons with other ICDs, although younger onset and male sex are usually noted. A few studies have begun to map out a neuropsychological profile for HS, and our own cases show particular deficits in learning from negative outcomes, but, overall, there are insufficient data to draw firm conclusions. Functional imaging has shown patterns of increased content-specific activation in response to sexual material and this might relate to increased dopamine release. We conclude with a brief survey of the neurobiology of sexuality, which suggests possible avenues for further research and treatment of HS.
性欲亢进（HS）是最早与帕金森病（PD）治疗相关的冲动控制障碍（ICD）或行为之一，估计患病率约为3.5%。在此，我们报告一项对已发表的关于PD患者HS的文献的系统综述，旨在揭示其是否与其他ICD不同的证据。此外，我们报告7例新病例，这些病例接受了广泛的神经心理学测试，包括一项涉及奖励和抑制机制的赌博测试。该综述发现了一些评论HS患病率的病例系列和队列，但很少与其他ICD进行系统比较，不过通常会提到发病年龄较轻和男性。一些研究已开始勾勒HS的神经心理学概况，我们自己的病例显示在从负面结果中学习方面存在特定缺陷，但总体而言，数据不足以得出确凿结论。功能成像显示，对性相关材料的反应中存在特定内容激活增加的模式，这可能与多巴胺释放增加有关。我们最后简要综述了性的神经生物学，这为HS的进一步研究和治疗提示了可能的途径。
