Premium
Functional Inhibitory Control Dynamics in Impulse Control Disorders in Parkinson's Disease
Author(s) -
PazAlonso Pedro M.,
NavalpotroGomez I.,
Boddy P.,
DacostaAguayo R.,
DelgadoAlvarado M.,
QuirogaVarela A.,
JimenezUrbieta H.,
Carreiras M.,
RodriguezOroz Maria C.
Publication year - 2020
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.27885
Subject(s) - functional magnetic resonance imaging , impulse control , neuroscience , subthalamic nucleus , hyperactivation , striatum , parkinson's disease , psychology , insula , ventral striatum , basal ganglia , dopamine , medicine , audiology , disease , central nervous system , deep brain stimulation
Background Impulse control disorders related to alterations in the mesocorticolimbic dopamine network occur in Parkinson's disease (PD). Our objective was to investigate the functional neural substrates of reward processing and inhibitory control in these patients. Methods Eighteen PD patients with impulse control disorders, 17 without this complication, and 18 healthy controls performed a version of the Iowa Gambling Task during functional magnetic resonance scanning under 3 conditions: positive, negative, and mixed feedback. Whole‐brain contrasts, regions of interest, time courses, functional connectivity analyses, and brain‐behavior associations were examined. Results PD patients with impulse control disorders exhibited hyperactivation in subcortical and cortical regions typically associated with reward processing and inhibitory control compared with their PD and healthy control counterparts. Time‐course analyses revealed that only PD patients with impulse control disorders exhibited stronger signal intensity during the initial versus final periods of the negative‐feedback condition in bilateral insula, and right ventral striatum. Interestingly, hyperactivation of all the examined right‐lateralized frontostriatal areas during negative feedback was positively associated with impulse control disorder severity. Importantly, positive associations between impulse control disorder severity and regional activations in the right insula and right inferior frontal gyrus, but not the right subthalamic nucleus, were mediated by functional connectivity with the right ventral striatum. Conclusions During a reward‐based task, PD patients with impulse control disorders showed hyperactivation in a right‐lateralized network of regions including the subthalamic nucleus that was strongly associated with impulse control disorder severity. In these patients, the right ventral striatum in particular played a critical role in modulating the functional dynamics of right‐lateralized inhibitory‐control frontal regions when facing penalties. © 2019 International Parkinson and Movement Disorder Society