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@ARTICLE{Hammes:860706,
author = {Hammes, Jochen and Theis, Hendrik and Giehl, Kathrin and
Hoenig, Merle C and Greuel, Andrea and Tittgemeyer, Marc and
Timmermann, Lars and Fink, Gereon Rudolf and Drzezga,
Alexander and Eggers, Carsten and van Eimeren, Thilo},
title = {{D}opamine metabolism of the nucleus accumbens and
fronto-striatal connectivity modulate impulse control},
journal = {Brain},
volume = {142},
number = {3},
issn = {1460-2156},
address = {Oxford},
publisher = {Oxford Univ. Press},
reportid = {FZJ-2019-01371},
pages = {733-743},
year = {2019},
abstract = {Impulsive-compulsive behaviours like pathological gambling
or hypersexuality are a frequent side effect of dopamine
replacement therapy in patients with Parkinson’s disease.
Multiple imaging studies suggest a significant reduction of
presynaptic dopamine transporters in the nucleus accumbens
to be a predisposing factor, reflecting either a reduction
of mesolimbic projections or, alternatively, a lower
presynaptic dopamine transporter expression per se. Here, we
aimed to test the hypothesis of fewer mesolimbic projections
as a risk factor by using dopamine synthesis capacity as a
proxy of dopaminergic terminal density. Furthermore,
previous studies have demonstrated a reduction of
fronto-striatal connectivity to be associated with increased
risk of impulsive-compulsive behaviour in Parkinson’s
disease. Therefore, another aim of this study was to
investigate the relationship between severity of
impulsive-compulsive behaviour, dopamine synthesis capacity
and fronto-striatal connectivity. Eighty participants
underwent resting state functional MRI and anatomical
T1-weighted images [mean age: 68 ± 9.9 years, $67\%$ male
(patients)]. In 59 participants, 18F-DOPA-PET was obtained
and voxel-wise Patlak slopes indicating dopamine synthesis
capacity were calculated. All participants completed the
QUIP-RS questionnaire, a well validated test to quantify
severity of impulsive-compulsive behaviour in Parkinson’s
disease. A voxel-wise correlation analysis between dopamine
synthesis capacity and QUIP-RS score was calculated for
striatal regions. To investigate the relationship between
symptom severity and functional connectivity, voxel-wise
correlations were performed. A negative correlation was
found between dopamine synthesis capacity and QUIP-RS score
in the nucleus accumbens (r = −0.57, P = 0.001), a region
functionally connected to the rostral anterior cingulate
cortex. The connectivity strength was modulated by QUIP-RS,
i.e. patients with more severe impulsive-compulsive
behaviours had a weaker functional connectivity between
rostral anterior cingulate cortex and the nucleus accumbens.
In addition, cortical thickness and severity of
impulsive-compulsive behaviour were positively correlated in
the subgenual rostral anterior cingulate cortex. We found
three factors to be associated with severity of
impulsive-compulsive behaviour: (i) decreased dopamine
synthesis capacity in the nucleus accumbens; (ii) decreased
functional connectivity of the rostral anterior cingulate
cortex with the nucleus accumbens; and (iii) increased
cortical thickness of the subgenual rostral anterior
cingulate cortex. Rather than a downregulation of dopamine
transporters, a reduction of mesolimbic dopaminergic
projections in conjunction with a dysfunctional rostral
anterior cingulate cortex—a region known to play a key
role in impulse control—could be the most crucial
neurobiological risk factor for the development of
impulsive-compulsive behaviours in patients with
Parkinson’s disease under dopamine replacement therapy.},
cin = {INM-3 / INM-2},
ddc = {610},
cid = {I:(DE-Juel1)INM-3-20090406 / I:(DE-Juel1)INM-2-20090406},
pnm = {572 - (Dys-)function and Plasticity (POF3-572)},
pid = {G:(DE-HGF)POF3-572},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:30753324},
UT = {WOS:000512724900026},
doi = {10.1093/brain/awz007},
url = {https://juser.fz-juelich.de/record/860706},
}