nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2013-2397nnp-176Research ArticleArticlesСтатьиDopamine dysregulation syndrome in Parkinson’s diseaseДофаминовый дизрегуляционный синдром при болезни ПаркинсонаNikitinaA VNikitinaA V

Department of Neurology

Department of Neurology

-FedorovaNatalia VladimirovnaFedorovaNatalia Vladimirovna

Department of Neurology

Department of Neurology

natalia.fedorova@list.ru20131503201351NO1 (2013)4246Copyright © Nikitina A.V., Fedorova N.V., 20132013Nikitina A.V., Fedorova N.V.Nikitina A.V., Fedorova N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/176

Dopamine dysregulation syndrome (DDS) is an iatrogenic disease developing during dopaminergic therapy. According to the data available in the literature, DDS develops in 3-4% of the Parkinson’s disease (PD) cases. DDS in PD is frequently accompanied by other impulse control disorders (ICD): punding, compulsive shopping, hypersexuality, overeating. 246 patients with PD, of whom 16 (6.4%) were found to have DDS, were examined. The patients’ age was 64±7.4 years. Women (n = 10) more often developed DDS than men (n = 6). The patients mainly suffered from the mixed form of the disease. Stages III and IV were diagnosed in 72 and 22%, respectively. The duration of PD was 12+2.6 years. In the PD patients with DDS, the quality-of-life indicators ranged from 19.8 to 90% (54+20.1%). The equivalent dose of levodopa is 1323.4+299 mg/day. DDS was concurrent with other types of ICD in 4 patients: panding in 2, compulsive shopping and punding in 1, and punding and hypersexuality. The doses of levodopa were corrected in patients receiving high doses of dopaminergic drugs. In the patients with DDS concurrent with punding or hypersexuality, the dose of dopaminergic receptor agonists was gradually reduced and subsequently discontinued.

Дофаминовый дизрегуляционный синдром (ДДС) является ятрогенным заболеванием, развивающимся на фоне дофаминергической терапии. По данным литературы, ДДС развивается в 3—4% случаев при болезни Паркинсона (БП). ДДС при БП часто сочетается с другими нарушениями импульсного контроля (НИК): пандингом, шопингоманией, гиперсексуальностью, перееданием. Исследовано 246пациентов с БП, у 16 (6,4%) из которых выявлен ДДС. Средний возраст больных составил 64±7,4 года. ДДС чаще развивался у женщин (женщин — 10, мужчин — 6). Больные преимущественно страдали смешанной формой заболевания. У 72% пациентов диагностирована III стадия, у 22% — IV стадия заболевания. Длительность БП составила 12+2,6 года. Показатели качества жизни у больных БП с ДДС колебались от 19,8 до 90% (54+20,1%). Эквивалентная доза леводопы — 1323,4+299 мг/сут. У 4 больных ДДС сочетался с другими видами НИК: у 2 — с пандингом, у 1 — с шопингоманией и пандингом, у 1 — с пандингом и гиперсексуальностью. У больных БП, принимающих высокие дозы дофаминергических препаратов, проводили коррекцию дозы препаратов леводопы. У больных с комбинацией ДДС и пандинга или гиперсексуальности постепенно уменьшали дозу агонистов дофаминергических рецепторов с последующей отменой препарата.

болезнь Паркинсонадофаминовый дизрегуляционный синдромдофаминергическая терапияParkinson’s diseasedopamine dysregulation syndromedopaminergic therapyReferences<div><p>O’Sullivan S.S., Evans A.H., Lees A.J. Dopamine Dysregulation syndronme: an overview of its epidemiology, mechanism and management. CNS Drugs 2009;23(2):157—70.</p><p>Giovannoni G., O’Sullivan J.D., Terner K. et al. Hedonistic homeostatic dysregulation in patients with Parkinson’s disease on dopamine replacement therapies. J Neurol Neurosurg Psych 2000;68:423—8.</p><p>Lawrence A.D., Evans A.H., Lees A.J. Compulsive use of dopamine replacement therapy in Parkinson’s disease: reward systems gone awry? Lancet Neurol 2003;2:595-604.</p><p>Evans A.H., Lees A.J. Dopamine dysregulation syndrome in Parkinson’s disease. Curr Opin Neurol 2004;17:393-8.</p><p>Priebe S. Levodopa dependence: a case report. Pharmacopsychiatry 1984;17:109-10.</p><p>Evans A.H., Katzenschlager R., Pavior D. et al. Punding in Parkinson’s disease: its relation to the dopamine dysregulation syndrome. Mov Dis 2004;19:397-405.</p><p>Nausieda P.A. Sinemet «abusers». Clin Neuropharmacol 1985;8:318-27.</p><p>Serrano-Duenas M. Chronic dopaminergic drug addiction and pathologic gambling in patients with Parkinson’s disease: presentation of four cases. German J Psychiatry 2002;5: 62—6.</p><p>Muller U., Reuter M., Hermann W., Gertz H.J. Levodopa dependency in Parkinson’s disease: case report and review [in German]. Nervenarzt 2002;73:887-91.</p><p>Funkiewiez A., Ardouin C., Krack P. et al. Acute psychotropic effects of bilateral subthalamic nucleus stimulation and levodopa in Parkinson’s disease. Mov Dis 2003;18:524-30.</p><p>Lawrence A.D., Calder A.J., McGowan S.W., Grasby P.M. Selective disruption of the recognition of facial expression of anger. Neuroreport 2002;13—4.</p><p>Berger C., Mehrhoff F.W., Beier K.M., Meinck H.M. Sexual delinquency and Parkinson’s disease [in German]. Nervenarzt 2003;74:370-5.</p><p>Jimenez-Jimenez F.J., Sayed Y., Garcia-Soldevilla M.A., Barcenilla B. Possible zoophilia associated with dopaminergic therapy in Parkinson’s disease. Ann Parmacother 2002;36:1178-9.</p><p>Potenza M.N., Steinberg M.A., Skudlarsci P. et al. Gambling urges in pathological gambling: a functional magnetic resonance imaging study. Arch Gen Psychiatry 2003;60:828-36.</p><p>Voon V. Repetition, repetition, and repetition: Compulsive and punding behaviors in Parkinson’s disease. Mov Dis 2004;19:367-70.</p><p>German D.C., Manaye K., Smith W.K. et al. Midbrain dopaminergic cell loss in Parkinson’s disease: computer visualization. AnnNeurol 1989;26:507-14.</p><p>Fiorillo C.D., Tobler P.N., Schultz W. Discrete coding of reward probability and uncertainty by dopamine neurons. Science 2003;299:1898-902.</p><p>Li Y., Kauer J.A. Repeated exposure to amphetamine disrupts dopaminergic modulation of excitatory synaptic plasticity and neurotransmission in nucleus accumbens. Synapse 2004;51:1-10.</p><p>Fuente- Fernandez R., Ruth T.J., Sossi V. et al. Expectation and dopamine release: mechanism of the placebo effect in Parkinson’s disease. Science 2001;293:1164-6.</p><p>Hoehn M.M., Yahr M.D. Parkinsonism: onset, progression, and mortality. Neurology 1967;17(5):427—42.</p><p>Weintraub D., Hoops S., Shea J.A. et al. Validation of the questionnaire for impulsive-compulsive disorders in Parkinson’s disease. Mov Dis 2009;24(10):1461—7.</p><p>Plutchik R., van Praag H. The measurement of suicidality, aggresivity and impulsivity. Prog Neuropsychopharmacol Biol Psychiatry 1989;13: S23—S34.</p><p>Taylor J. A personality scale of manifest anxiety. J Abnormal Soc Psychol 1953;48(2):285—90.</p><p>Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol 1959;32:50-5.</p><p>Folstein M.F., Folstein S.E., McHugh P.R. 3Mini-mental stated A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12(3):189—98.</p><p>Hobson D.E., Lang A.E., Martin W.R. et al. Excessive daytime sleepiness and sudden-onset sleep in Parkinson’s disease. JAMA 2002;287(4):455—63.</p><p>Houeto J.L., Mesnage V., Mallet L. et al. Behavioral disorders, Parkinson’s disease and subthalamic stimulation. J Neurol Neurosurg Psych 2002;72(6):701—7.</p><p>Follet K.A., Weaver F.M., Stern M. et al. Pallidal versus subthalamic deep-brain stimulation for Parkinson’s disease. New Engl J Med 2010;362(22):2077—91.</p><p>Bandini F., Primavera A., Pizzorno M., Cocito L. Using STN DBS and medication reduction as a strategy to treat pathological gambling in Parkinson’s disease. Parkins Relat Dis 2007;13(6):369—71.</p><p>Lim S.Y., O’Sullivan S.S., Kotscet K. et al. Dopamine disregulation syndrome, impulsive controle disorders and punding after deep brain stimulation surgery for Parkinson’s disease. J Clin Neurosci 2009;16(9):1148—52.</p></div><br /><div><p>O’Sullivan S.S., Evans A.H., Lees A.J. Dopamine Dysregulation syndronme: an overview of its epidemiology, mechanism and management. CNS Drugs 2009;23(2):157—70.</p><p>Giovannoni G., O’Sullivan J.D., Terner K. et al. Hedonistic homeostatic dysregulation in patients with Parkinson’s disease on dopamine replacement therapies. J Neurol Neurosurg Psych 2000;68:423—8.</p><p>Lawrence A.D., Evans A.H., Lees A.J. Compulsive use of dopamine replacement therapy in Parkinson’s disease: reward systems gone awry? Lancet Neurol 2003;2:595-604.</p><p>Evans A.H., Lees A.J. Dopamine dysregulation syndrome in Parkinson’s disease. Curr Opin Neurol 2004;17:393-8.</p><p>Priebe S. Levodopa dependence: a case report. Pharmacopsychiatry 1984;17:109-10.</p><p>Evans A.H., Katzenschlager R., Pavior D. et al. Punding in Parkinson’s disease: its relation to the dopamine dysregulation syndrome. Mov Dis 2004;19:397-405.</p><p>Nausieda P.A. Sinemet «abusers». Clin Neuropharmacol 1985;8:318-27.</p><p>Serrano-Duenas M. Chronic dopaminergic drug addiction and pathologic gambling in patients with Parkinson’s disease: presentation of four cases. German J Psychiatry 2002;5: 62—6.</p><p>Muller U., Reuter M., Hermann W., Gertz H.J. Levodopa dependency in Parkinson’s disease: case report and review [in German]. Nervenarzt 2002;73:887-91.</p><p>Funkiewiez A., Ardouin C., Krack P. et al. Acute psychotropic effects of bilateral subthalamic nucleus stimulation and levodopa in Parkinson’s disease. Mov Dis 2003;18:524-30.</p><p>Lawrence A.D., Calder A.J., McGowan S.W., Grasby P.M. Selective disruption of the recognition of facial expression of anger. Neuroreport 2002;13—4.</p><p>Berger C., Mehrhoff F.W., Beier K.M., Meinck H.M. Sexual delinquency and Parkinson’s disease [in German]. Nervenarzt 2003;74:370-5.</p><p>Jimenez-Jimenez F.J., Sayed Y., Garcia-Soldevilla M.A., Barcenilla B. Possible zoophilia associated with dopaminergic therapy in Parkinson’s disease. Ann Parmacother 2002;36:1178-9.</p><p>Potenza M.N., Steinberg M.A., Skudlarsci P. et al. Gambling urges in pathological gambling: a functional magnetic resonance imaging study. Arch Gen Psychiatry 2003;60:828-36.</p><p>Voon V. Repetition, repetition, and repetition: Compulsive and punding behaviors in Parkinson’s disease. Mov Dis 2004;19:367-70.</p><p>German D.C., Manaye K., Smith W.K. et al. Midbrain dopaminergic cell loss in Parkinson’s disease: computer visualization. AnnNeurol 1989;26:507-14.</p><p>Fiorillo C.D., Tobler P.N., Schultz W. Discrete coding of reward probability and uncertainty by dopamine neurons. Science 2003;299:1898-902.</p><p>Li Y., Kauer J.A. Repeated exposure to amphetamine disrupts dopaminergic modulation of excitatory synaptic plasticity and neurotransmission in nucleus accumbens. Synapse 2004;51:1-10.</p><p>Fuente- Fernandez R., Ruth T.J., Sossi V. et al. Expectation and dopamine release: mechanism of the placebo effect in Parkinson’s disease. Science 2001;293:1164-6.</p><p>Hoehn M.M., Yahr M.D. Parkinsonism: onset, progression, and mortality. Neurology 1967;17(5):427—42.</p><p>Weintraub D., Hoops S., Shea J.A. et al. Validation of the questionnaire for impulsive-compulsive disorders in Parkinson’s disease. Mov Dis 2009;24(10):1461—7.</p><p>Plutchik R., van Praag H. The measurement of suicidality, aggresivity and impulsivity. Prog Neuropsychopharmacol Biol Psychiatry 1989;13: S23—S34.</p><p>Taylor J. A personality scale of manifest anxiety. J Abnormal Soc Psychol 1953;48(2):285—90.</p><p>Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol 1959;32:50-5.</p><p>Folstein M.F., Folstein S.E., McHugh P.R. 3Mini-mental stated A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12(3):189—98.</p><p>Hobson D.E., Lang A.E., Martin W.R. et al. Excessive daytime sleepiness and sudden-onset sleep in Parkinson’s disease. JAMA 2002;287(4):455—63.</p><p>Houeto J.L., Mesnage V., Mallet L. et al. Behavioral disorders, Parkinson’s disease and subthalamic stimulation. J Neurol Neurosurg Psych 2002;72(6):701—7.</p><p>Follet K.A., Weaver F.M., Stern M. et al. Pallidal versus subthalamic deep-brain stimulation for Parkinson’s disease. New Engl J Med 2010;362(22):2077—91.</p><p>Bandini F., Primavera A., Pizzorno M., Cocito L. Using STN DBS and medication reduction as a strategy to treat pathological gambling in Parkinson’s disease. Parkins Relat Dis 2007;13(6):369—71.</p><p>Lim S.Y., O’Sullivan S.S., Kotscet K. et al. Dopamine disregulation syndrome, impulsive controle disorders and punding after deep brain stimulation surgery for Parkinson’s disease. J Clin Neurosci 2009;16(9):1148—52.</p></div><br />

The authors declare that there are no conflicts of interest present.