TY  - JOUR
PY  - 2015//
TI  - Apathy and impulsive control disorders: yin & yang of dopamine dependent behaviors
JO  - Journal of Parkinson's disease
A1  - Sierra, María
A1  - Carnicella, Sébastien
A1  - Strafella, Antonio P.
A1  - Bichon, Amélie
A1  - Lhommée, Eugénie
A1  - Castrioto, Anna
A1  - Chabardes, Stephan
A1  - Thobois, Stephane
A1  - Krack, Paul
SP  - 625
EP  - 636
VL  - 5
IS  - 3
N2  - Neuropsychiatric symptoms are common non-motor symptoms in Parkinson's disease (PD). Apathy and impulse control disorders (ICD) are two opposite motivational expressions of a continuous behavioural spectrum involving hypo- and hyperdopaminergia. Both syndromes share pathological (decreased vs increased) dopamine receptor stimulation states. Apathy belongs to the spectrum of hypodopaminergic symptoms together with anhedonia, anxiety and depression. Apathy is a key symptom of PD which worsens with disease progression. Animal models, imaging and pharmacological studies concur in pointing out dopaminergic denervation in the aetiology of parkinsonian apathy with a cardinal role of decreased tonic D2/D3 receptor stimulation. ICDs are part of the hyperdopaminergic behavioural spectrum, which also includes punding, and dopamine dysregulation syndrome (DDS), which are all related to non-physiological dopaminergic stimulation induced by antiparkinsonian drugs. According to clinical data tonic D2/D3 receptor stimulation can be sufficient to induce ICDs. Clinical observations in drug addiction and PD as well as data from studies in dopamine depleted rodents provide hints allowing to argue that both pulsatile D1 and D2 receptor stimulation and the severity of dopaminergic denervation are risk factors to develop punding behavior and DDS. Imaging studies have shown that the brain structures involved in drug addiction are also involved in hyperdopaminergic behaviours with increase of bottom-up appetitive drive and decrease in prefrontal top down behavioural control.<p />  <p>Language: en</p>
LA  - en
SN  - 1877-7171
UR  - http://dx.doi.org/10.3233/JPD-150535
ID  - ref1
ER  -