Journal Article

Increased striatal dopamine release in Parkinsonian patients with pathological gambling: a [<sup>11</sup>C] raclopride PET study

T. D. L. Steeves, J. Miyasaki, M. Zurowski, A. E. Lang, G. Pellecchia, T. Van Eimeren, P. Rusjan, S. Houle and A. P. Strafella

in Brain

Published on behalf of The Guarantors of Brain

Volume 132, issue 5, pages 1376-1385
Published in print May 2009 | ISSN: 0006-8950
Published online April 2009 | e-ISSN: 1460-2156 | DOI: http://dx.doi.org/10.1093/brain/awp054
Increased striatal dopamine release in Parkinsonian patients with pathological gambling: a [11C] raclopride PET study

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Pathological gambling is an impulse control disorder reported in association with dopamine agonists used to treat Parkinson's disease. Although impulse control disorders are conceptualized as lying within the spectrum of addictions, little neurobiological evidence exists to support this belief. Functional imaging studies have consistently demonstrated abnormalities of dopaminergic function in patients with drug addictions, but to date no study has specifically evaluated dopaminergic function in Parkinson's disease patients with impulse control disorders. We describe results of a [11C] raclopride positron emission tomography (PET) study comparing dopaminergic function during gambling in Parkinson's disease patients, with and without pathological gambling, following dopamine agonists. Patients with pathological gambling demonstrated greater decreases in binding potential in the ventral striatum during gambling (13.9%) than control patients (8.1%), likely reflecting greater dopaminergic release. Ventral striatal bindings at baseline during control task were also lower in patients with pathological gambling. Although prior imaging studies suggest that abnormality in dopaminergic binding and dopamine release may be markers of vulnerability to addiction, this study presents the first evidence of these phenomena in pathological gambling. The emergence of pathological gambling in a number of Parkinson's disease patients may provide a model into the pathophysiology of this disorder.

Keywords: Parkinson's disease; dopamine; impulse control disorders; pathological gambling, PET, functional imaging

Journal Article.  5966 words.  Illustrated.

Subjects: Neurology ; Neuroscience

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