Reward pathways in Parkinson's disease: Clinical and theoretical implications
Article first published online: 14 APR 2008
© 2008 The Authors
Psychiatry and Clinical Neurosciences
Volume 62, Issue 2, pages 203–213, April 2008
How to Cite
Torta, D. M. E. and Castelli, L. (2008), Reward pathways in Parkinson's disease: Clinical and theoretical implications. Psychiatry and Clinical Neurosciences, 62: 203–213. doi: 10.1111/j.1440-1819.2008.01756.x
- Issue published online: 14 APR 2008
- Article first published online: 14 APR 2008
- Received 6 July 2007; revised 15 October 2007; accepted 29 October 2007.
- dopamine replacement therapy;
- hedonistic homeostatic dysregulation;
- impulsive decision making;
- Parkinson's disease;
- pathological gambling
Aims: The mesolimbic and mesocortical circuits are particularly involved in reward-related behavior in humans. Because these systems may be in some way altered in Parkinson's disease (PD), it is likely that some psychiatric manifestations of PD, such as hedonistic homeostatic dysregulation and pathological gambling, as well as impulsive decision making, may be ascribed to their involvement. The aim of the current article was to review recent literature on this topic in order to analyze whether these disturbances share a common ground and whether actual theoretical frameworks on addiction prove a useful tool for their interpretation.
Methods: Data were identified on searches of MEDLINE/PubMed databases from relevant articles published up until March 2007.
Results: All clinical manifestations (hedonistic homeostatic dysregulation, pathological gambling and impulsive decision making) seem to share a common multifaceted ground in which factors related to antiparkinsonian therapy, premorbid personality and progression of disease interact. Theoretical interpretations and conclusions drawn from experimental studies may help to shed light on the underlying pathological mechanisms.
Conclusions: Further studies are needed to analyze why, despite a common ground, only some patients develop those neuropsychiatric complications described here.