Using STN DBS and medication reduction as a strategy to treat pathological gambling in Parkinson's disease.
We describe two patients with Parkinson's disease (PD) who developed clinical criteria of pathological gambling addiction in the setting of increased dopamine replacement therapy (levodopa and dopamine agonist medications). The second patient showed also signs of dopamine dysregulation syndrome, with an addiction to dopaminergic medication. Neither patients responded to the standard therapy for gambling behavior, but dramatically improved after bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) and early postoperative withdrawal of dopaminergic therapy. The possible therapeutic role of subthalamic nucleus deep brain stimulation (STN-DBS) on such a disabling behavior needs to be investigated prospectively.
Bandini
Fabio
F
Department of Neurosciences, Ophthalmology and Genetics, University of Genoa, Via A. De Toni 5, 16132 Genoa, Italy. fbandini@neurologia.unige.it
Primavera
Alberto
A
Pizzorno
Matteo
M
Cocito
Leonardo
L
D000328:Adult; D052160:Benzothiazoles / Q000627:therapeutic use*; D046690:Deep Brain Stimulation / Q000379:methods*; D018491:Dopamine Agonists / Q000627:therapeutic use*; D005715:Gambling; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000473:pathology / Q000523:psychology* / Q000628:therapy; D000077487:Pramipexole; D020531:Subthalamic Nucleus / Q000503:physiopathology* / Q000528:radiation effects
D052160:Benzothiazoles; D018491:Dopamine Agonists; D000077487:Pramipexole