J Clin Neurol.  2015 Jan;11(1):42-47. 10.3988/jcn.2015.11.1.42.

Whole-Brain Diffusion-Tensor Changes in Parkinsonian Patients with Impulse Control Disorders

• Yoo HB
• Lee JY
• Lee JS
• Kang H
• Kim YK
• Song IC
• Lee DS
• Jeon BS

• KMID: 2179571
• DOI: http://doi.org/10.3988/jcn.2015.11.1.42

Abstract

BACKGROUND AND PURPOSE
The aim of this study was to determine the changes in diffusion-tensor images associated with medication-related impulse control disorder (ICD) in Parkinson's disease (PD) patients undergoing chronic dopamine-replacement therapy.
METHODS
Nineteen PD patients, comprising 10 with ICD (PD-ICD) and 9 without ICD (PD-nonICD), and 18 age-matched healthy controls (HCs) with no cognitive or other psychiatric disorders were analyzed. All subjects underwent 3-T magnetic resonance diffusion-tensor imaging. For all PD patients, clinical data on PD duration, antiparkinsonian medication dosages, Unified Parkinson's Disease Rating Scale and Mini-Mental State Examination were collected. Whole-brain voxel-based measures of fractional anisotropy (FA) and mean diffusivity (MD) were analyzed.
RESULTS
In comparison with HCs, the PD-nonICD subjects had low FA at the bilateral orbitofrontal areas. While the PD-ICD subjects exhibited no such difference, their FA was significantly elevated at the anterior corpus callosum. Analysis of FA between the two PD groups revealed that FA in the anterior corpus callosum, right internal capsule posterior limbs, right posterior cingulum, and right thalamic radiations were significantly higher (corrected p<0.05) in the PD-ICD than in the PD-nonICD patients. MD did not differ between the PD-ICD and PD-nonICD groups in any brain regions.
CONCLUSIONS
The PD-ICD patients appear to have relatively preserved white-matter integrity in the regions involved in reward-related behaviors compared to PD-nonICD patients. Further investigation is required to determine whether the difference in FA between PD-ICD and PD-nonICD patients reflects microstructural differences in the pathological progression of PD or is secondary to ICD.

Keyword

impulse control disorders; Parkinson's disease; diffusion-tensor imaging

MeSH Terms

Anisotropy
Brain
Corpus Callosum
Extremities
Humans
Disruptive, Impulse Control, and Conduct Disorders*
Internal Capsule
Parkinson Disease

Figure

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  Fig. 1 Comparison of FA maps between PD-nonICD patients and HC subjects. PD-nonICD

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  Fig. 2 Comparison of FA maps between PD-ICD patients and HC subjects. PD-ICD>HC, p<0.05 (corrected). CC: corpus callosum, FA: fractional anisotropy, HC: healthy control, ICD: impulse control disorder, PD: Parkinson's disease.

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  Fig. 3 Comparison of FA maps between PD-ICD patients and PD-nonICD patients. PD-ICD>PD-nonICD, p<0.05 (corrected). CC: corpus callosum, FA: fractional anisotropy, HC: healthy control, ICD: impulse control disorder, PD: Parkinson's disease, SN: substantia nigra.

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