Affiliations: Department of Neurology, Hospital de Egas Moniz,
Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal | Department of Neurology and CEDOC, Faculdade de
Ciências Médicas, Universidade Nova de Lisboa, Lisboa,
Portugal | Department of Psychiatry and Mental Health, Centro
Hospitalar de Lisboa Ocidental, Lisboa, Portugal | Champalimaud Neuroscience Program, Instituto
Gulbenkian de Ciência, Oeiras, Portugal and Champalimaud Centre for the
Unknown, Lisboa, Portugal
Note: [] Corresponding author: Paulo Bugalho, Department of Neurology,
Hospital de Egas Moniz (CHLO), Rua da Junqueira, 126, 1349-019 Lisboa,
Portugal. Tel.: +351 213622459; E-mail: [email protected]
Abstract: Non-motor symptoms contribute significantly to Parkinson's disease
(PD) related disability. Impulse control disorders (ICDs) have been recently
added to the behavioural spectrum of PD-related non-motor symptoms. Such
behaviours are characterized by an inappropriate drive to conduct repetitive
behaviours that are usually socially inadequate or result in harmful
consequences. Parkinson disease impulse control disorders (PD-ICDs) have raised
significant interest in the scientific and medical community, not only because
of their incapacitating nature, but also because they may represent a valid
model of ICDs beyond PD and a means to study the physiology of drive, impulse
control and compulsive actions in the normal brain. In this review, we discuss
some unresolved issues regarding PD-ICDs, including the association with
psychiatric co-morbidities such as obsessive-compulsive disorder and with
dopamine related side effects, such as hallucinations and dyskinesias; the
relationship with executive cognitive dysfunction; and the neural underpinnings
of ICDs in PD. We also discuss the contribution of neuroscience studies based
on animal-models towards a mechanistic explanation of the development of
PD-ICDs, specifically regarding corticostriatal control of goal directed and
habitual actions.
