Impulse control disorder in PD: A lateralized monoaminergic frontostriatal disconnection syndrome?
Impulse Control Disorder symptoms (ICD) in Parkinson's disease (PD) has been recently associated by magnetic Resonance imaging with impaired cortico-striatal connectivity, especially between left putamen and frontal associative areas.



84 patients entered the study (21 PD-ICD+ and 64 PD-ICD-) and underwent DATSCAN imaging. The striatal tracer uptake was evaluated using BRASS software (Hermes, Sweden). The whole-brain analysis was performed with Statistical Parametric Mapping (SPM).



PD-ICD+ showed a significant reduction of left putaminal and left inferior frontal gyrus tracer uptake compared to PD-ICD-. Functional covariance analysis using left putamen as the seed point showed that, in contrast to ICD-patients, ICD+ patients had no functional covariance with contralateral basal ganglia and ipsilateral cingulate cortex, as index of an impaired inter- and intra-hemispheric dopamine binding in PD-ICD+.



the results support and expand the concept of a functional disconnection syndrome linked to ICD symptoms in PD patients through an asymmetric molecular frontostriatal network breakdown with left basal ganglia as central hub.
Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Stroke Unit, Azienda Ospedaliera "Spedali Civili", Spedali Civili Hospital, Brescia, Italy. Electronic address: zedtower@gmail.com.
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Premi
Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy; Department of Neurodegeneration and Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany.
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Pilotto
Department of Medical Imaging, Geneva University Hospital, Geneva, Switzerland.
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Garibotto
Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
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Bigni
Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
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Turrone
Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
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Alberici
Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
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Cottini
Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
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Poli
Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
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Bianchi
Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
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Formenti
Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
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Cosseddu
Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
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Gazzina
Stroke Unit, Azienda Ospedaliera "Spedali Civili", Spedali Civili Hospital, Brescia, Italy.
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Magoni
Nuclear Medicine Unit, Azienda Azienda Ospedaliera "Spedali Civili", Spedali Civili Hospital, Brescia, Italy.
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Bertoli
Nuclear Medicine Unit, Azienda Azienda Ospedaliera "Spedali Civili", Spedali Civili Hospital, Brescia, Italy.
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Paghera
Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
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Borroni
Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
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Padovani
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001931:Brain Mapping / Q000379:methods; D003342:Corpus Striatum / Q000473:pathology / Q000503:physiopathology*; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000150:complications*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000503:physiopathology*; D010300:Parkinson Disease / Q000150:complications*
(123)I-FP-CIT imaging; Functional covariance analysis; Impulse control disorders; Parkinson’s disease; Statistical parametric mapping