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Motivational and myopic mechanisms underlying dopamine medication-induced impulsive-compulsive behaviors in Parkinson's disease
Dawson, Andrew Ortelli, Paola Carter, Adrian Ferrazzoli, Davide Dissanayaka, Nadeeka N. Evans, Andrew Chye, Yann Lorenzetti, Valentina Frazzitta, Giuseppe Yucel, Murat
Dawson, Andrew
Ortelli, Paola
Carter, Adrian
Ferrazzoli, Davide
Dissanayaka, Nadeeka N.
Evans, Andrew
Chye, Yann
Lorenzetti, Valentina
Frazzitta, Giuseppe
Yucel, Murat
Abstract
Introduction: Dopaminergic medications can trigger impulsive-compulsive behaviors (ICBs) in pre-disposed patients with Parkinson's disease (PD), but what this implies on a neurocognitive level is unclear. Previous findings highlighted potentially exacerbated incentive motivation (willingness to work for rewards) and choice impulsivity (preferring smaller, immediate rewards over larger, delayed rewards) in PD patients with ICBs (PD + ICBs).
Methods: To deeply understand this evidence, we studied 24 PD + ICBs and 28 PD patients without ICBs (PD-ICBs). First of all, patients underwent the assessment of impulsivity traits, mood, anxiety, and addiction condition. We further administered robust objective and subjective measures of specific aspects of motivation. Finally, we explored whether these processes might link to any heightened antisocial behavior (aggression and risky driving) in PD + ICBs.
Results: High levels of positive urgency trait characterized PD + ICBs. They choose to exert more effort for rewards under the conditions of low and medium reward probability and as reward magnitude increases. Findings on choice impulsivity show a great tendency to delay discounting in PD + ICBs, other than a high correlation between delay and probability discounting. In addition, we found what appears to be the first evidence of heightened reactive aggression in PD patients with ICBs. Exacerbated incentive motivation and delay discounting trended toward positively predicting reactive aggression in PD + ICBs.
Discussion: Our promising results suggest that there might be immense value in future large-scale studies adopting a transdiagnostic neurocognitive endophenotype approach to understanding and predicting the addictive and aggressive behaviors that can arise from dopaminergic medication in PD.
Keywords
Parkinson’s disease, dopamine replacement therapy, addiction, motivation, impulsivity, aggression
Date
2023
Type
Journal article
Journal
Frontiers in Behavioral Neuroscience
Book
Volume
16
Issue
Page Range
1-11
Article Number
Article 949406
ACU Department
School of Behavioural and Health Sciences
Faculty of Health Sciences
Faculty of Health Sciences
Relation URI
Source URL
Event URL
Open Access Status
Published as ‘gold’ (paid) open access
License
CC BY 4.0
File Access
Open