1 Section of Teaching, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, Københavns Universitet2 BRAIN Lab, Department of Neuroscience and Pharmacology, Faculty of Health and Medical Sciences, Københavns Universitet3 Department of Nuclear Medicine and PET-Centre, Aarhus University Hospital , Aarhus , Denmark ; Centre of Functionally Integrative Neuroscience, Aarhus University , Aarhus , Denmark.4 Institut for Klinisk Medicin - Center for Funktionelt Integrativ Neurovidenskab5 Section of Teaching, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, Københavns Universitet6 BRAIN Lab, Department of Neuroscience and Pharmacology, Faculty of Health and Medical Sciences, Københavns Universitet
a case report
Dopaminergic medication for motor symptoms in Parkinson's disease (PD) recently has been linked with impulse control disorders, including pathological gambling (PG), which affects up to 8% of patients. PG often is considered a behavioral addiction associated with disinhibition, risky decision-making, and altered striatal dopaminergic neurotransmission. Using [(11)C]raclopride with positron emission tomography, we assessed dopaminergic neurotransmission during Iowa Gambling Task performance. Here we present data from a single patient with PD and concomitant PG. We noted a marked decrease in [(11)C]raclopride binding in the left ventral striatum upon gambling, indicating a gambling-induced dopamine release. The results imply that PG in PD is associated with a high dose of dopaminergic medication, pronounced motor symptomatology, young age at disease onset, high propensity for sensation seeking, and risky decision-making. Overall, the findings are consistent with the hypothesis of medication-related PG in PD and underscore the importance of taking clinical variables, such as age and personality, into account when patients with PD are medicated, to reduce the risk of PG.
Frontiers in Behavioral Neuroscience, 2013, Vol 7, Issue 95, p. 1-8