Amongst the impulse-control disorders (ICDs) associated with dopamine-replacement therapy in patients with Parkinson's disease (PD) is a repetitive, complex, stereotyped behaviour called punding. Disruption of the reciprocal loops between the striatum and structures in the prefrontal cortex (PFC) following dopamine depletion may predispose patients with PD to these behavioural disorders. The purpose of the present study was to assess the effects of repetitive transcranial magnetic stimulation (rTMS) over the dorsolateral PFC (DLPFC) on punding in PD. We used low-frequency (LF) rTMS in four PD patients presenting with punding. Punding was transiently reversed by LF-rTMS over the DLPFC without enhancing motor impairment. The effect was more sustained after right DLPFC rTMS. Therefore, LF-rTMS produced a transient beneficial effect in PD patients with punding, similar to that reported in PD patients with levodopa-induced dyskinesias. rTMS might have therapeutic potential for the treatment of punding and perhaps other ICDs in PD.

Repetitive transcranial magnetic stimulation transiently reduces punding in Parkinson's disease: a preliminary study

DE BLASI, Pierpaolo;
2014

Abstract

Amongst the impulse-control disorders (ICDs) associated with dopamine-replacement therapy in patients with Parkinson's disease (PD) is a repetitive, complex, stereotyped behaviour called punding. Disruption of the reciprocal loops between the striatum and structures in the prefrontal cortex (PFC) following dopamine depletion may predispose patients with PD to these behavioural disorders. The purpose of the present study was to assess the effects of repetitive transcranial magnetic stimulation (rTMS) over the dorsolateral PFC (DLPFC) on punding in PD. We used low-frequency (LF) rTMS in four PD patients presenting with punding. Punding was transiently reversed by LF-rTMS over the DLPFC without enhancing motor impairment. The effect was more sustained after right DLPFC rTMS. Therefore, LF-rTMS produced a transient beneficial effect in PD patients with punding, similar to that reported in PD patients with levodopa-induced dyskinesias. rTMS might have therapeutic potential for the treatment of punding and perhaps other ICDs in PD.
JOURNAL OF NEURAL TRANSMISSION
121
3
267
274
http://link.springer.com/article/10.1007/s00702-013-1100-3
Aged; Disruptive, Impulse Control, and Conduct Disorders; Double-Blind Method; Female; Humans; Male; Middle Aged; Parkinson Disease; Psychiatric Status Rating Scales; Severity of Illness Index; Statistics, Nonparametric; Time Factors; Transcranial Magnetic Stimulation
Nardone, Raffaele; De Blasi, Pierpaolo; Höller, Yvonne; Christova, Monica; Tezzon, Frediano; Trinka, Eugen; Brigo, Francesco
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2318/1537814
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