Neurology Department, Miguel Servet University Hospital, Zaragoza, Spain.
Servet Neuroscience Group, Institute of Health Research of Aragon (IIS Aragón), Zaragoza, Spain.
Ann Neurol. 2022 Dec;92(6):974-984. doi: 10.1002/ana.26486. Epub 2022 Sep 9.
This study was undertaken to evaluate whether the feedback-related negativity (FRN)-a neurophysiological marker of incentive processing-can be used to predict the development of impulse control disorders (ICDs) in Parkinson disease (PD).
The longitudinal cohort consisted of consecutive nondemented PD patients with no ICD history. We recorded FRN signals while they performed a gambling task. We calculated the mean amplitude difference between losses and gains (FRNdiff) to be used as a predictor of future ICD development. We performed prospective biannual follow-up assessments for 30 months to detect incident ICDs. Finally, we evaluated how basal FRNdiff was associated with posterior development of ICDs using survival models.
Between October 7, 2015 and December 16, 2016, we screened 120 patients. Among them, 94 patients performed the gambling and 92 completed the follow-up. Eighteen patients developed ICDs during follow-up, whereas 74 remained free of ICDs. Baseline FRNdiff was greater in patients who developed ICDs than in those who did not (-2.33μV vs -0.84μV, p = 0.001). No other significant baseline differences were found. The FRNdiff was significantly associated with ICD development in the survival models both when not adjusted (hazard ratio [HR] = 0.73, 95% confidence interval [CI] = 0.58-0.91, p = 0.006) and when controlling for dopamine replacement therapy, sex, and age (HR = 0.74, 95% CI = 0.55-0.97, p = 0.035). None of the impulsivity measures evaluated was related to ICD development.
Reward-processing differences measured by FRN signals precede ICD development in PD. This neurophysiological marker permits identification of patients with high risk of ICD development. ANN NEUROL 2022;92:974-984.
本研究旨在评估反馈相关负波（FRN）——一种激励加工的神经生理标志物，是否可用于预测帕金森病（PD）中冲动控制障碍（ICD）的发展。
该纵向队列由无 ICD 病史的连续非痴呆 PD 患者组成。我们在他们进行赌博任务时记录 FRN 信号。我们计算了损失和收益之间的平均振幅差（FRNdiff），作为未来 ICD 发展的预测指标。我们进行了为期 30 个月的前瞻性每半年一次的随访评估，以发现新的 ICD。最后，我们使用生存模型评估了基础 FRNdiff 与 ICD 后发展的关系。
2015 年 10 月 7 日至 2016 年 12 月 16 日，我们筛查了 120 名患者。其中，94 名患者进行了赌博，92 名完成了随访。18 名患者在随访期间发生了 ICD，而 74 名患者没有 ICD。与未发生 ICD 的患者相比，发生 ICD 的患者的基线 FRNdiff 更大（-2.33μV 与-0.84μV，p=0.001）。没有发现其他显著的基线差异。在生存模型中，FRNdiff 与 ICD 的发展显著相关，既没有调整时（危险比[HR]0.73，95%置信区间[CI]0.58-0.91，p=0.006），也没有调整多巴胺替代疗法、性别和年龄时（HR 0.74，95%CI 0.55-0.97，p=0.035）。评估的任何冲动性指标都与 ICD 的发展无关。
由 FRN 信号测量的奖励处理差异先于 PD 中的 ICD 发展。这种神经生理标志物可识别具有 ICD 发展高风险的患者。
