In patients with Parkinson's disease, aberrant or excessive dopaminergic stimulation is commonly indicated as the trigger factor in unmasking impulse control disorders (ICDs) such as pathological gambling. We had the opportunity to follow a patient who experienced Parkinson's disease 7 years ago when he was using pramipexole and again, recently, when he was treated with levodopa (L-dopa) and low frequency stimulation of the nucleus of the pedunculopontine tegmentus (PPTg) but no dopamine agonists. The same patient had shown, when studied with fluorodeoxyglucose-positron emission tomography in the condition PPTg-ON, a peculiar increased activity in the left ventral striatum. This case report confirms that, in a predisposed personality, ICD may arise from the perturbation of endogenous pathways, which connect the brainstem to the basal ganglia.

Stefani, A. (2010). Pathological gambling from dopamine agonist and deep brain stimulation of the nucleus tegmenti pedunculopontine. BMJ CASE REPORT, 2010 [10.1136/bcr.02.2010.2774].

Pathological gambling from dopamine agonist and deep brain stimulation of the nucleus tegmenti pedunculopontine

Stefani A
2010-05-01

Abstract

In patients with Parkinson's disease, aberrant or excessive dopaminergic stimulation is commonly indicated as the trigger factor in unmasking impulse control disorders (ICDs) such as pathological gambling. We had the opportunity to follow a patient who experienced Parkinson's disease 7 years ago when he was using pramipexole and again, recently, when he was treated with levodopa (L-dopa) and low frequency stimulation of the nucleus of the pedunculopontine tegmentus (PPTg) but no dopamine agonists. The same patient had shown, when studied with fluorodeoxyglucose-positron emission tomography in the condition PPTg-ON, a peculiar increased activity in the left ventral striatum. This case report confirms that, in a predisposed personality, ICD may arise from the perturbation of endogenous pathways, which connect the brainstem to the basal ganglia.
mag-2010
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/26 - NEUROLOGIA
English
Levodopa; Gambling; Parkinson Disease; Deep Brain Stimulation; Humans; Antiparkinson Agents; Middle Aged; Dopamine Agents; Pedunculopontine Tegmental Nucleus; Male
Stefani, A. (2010). Pathological gambling from dopamine agonist and deep brain stimulation of the nucleus tegmenti pedunculopontine. BMJ CASE REPORT, 2010 [10.1136/bcr.02.2010.2774].
Stefani, A
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/218424
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