The risky business of dopamine agonists in Parkinson disease and impulse control disorders

Behav Neurosci. 2011 Aug;125(4):492-500. doi: 10.1037/a0023795.

Abstract

Risk-taking behavior is characterized by pursuit of reward in spite of potential negative consequences. Dopamine neurotransmission along the mesocorticolimbic pathway is a potential modulator of risk behavior. In patients with Parkinson's disease (PD), impulse control disorder (ICD) can result from dopaminergic medication use, particularly dopamine agonists (DAA). Behaviors associated with ICD include hypersexuality as well as compulsive gambling, shopping, and eating, and these behaviors are potentially linked to alterations to risk processing. Using the Balloon Analogue Risk Task, we assessed the role of agonist therapy on risk-taking behavior in PD patients with (n = 22) and without (n = 19) active ICD symptoms. Patients performed the task both "on" and "off" DAA. DAA increased risk-taking in PD patients with active ICD symptoms, but it did not affect risk behavior of PD controls. DAA dose was also important in explaining risk behavior. Both groups similarly reduced their risk-taking in high compared to low risk conditions and following the occurrence of a negative consequence, suggesting that ICD patients do not necessarily differ in their abilities to process and adjust to some aspects of negative consequences. Our findings suggest dopaminergic augmentation of risk-taking behavior as a potential contributing mechanism for the emergence of ICD in PD patients.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Disruptive, Impulse Control, and Conduct Disorders / chemically induced*
  • Disruptive, Impulse Control, and Conduct Disorders / complications
  • Disruptive, Impulse Control, and Conduct Disorders / epidemiology
  • Dopamine Agonists / adverse effects*
  • Female
  • Gambling
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Parkinson Disease / complications
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / epidemiology
  • Risk Factors
  • Risk-Taking*
  • Severity of Illness Index
  • Sexual Dysfunction, Physiological / chemically induced
  • Sexual Dysfunction, Physiological / epidemiology

Substances

  • Dopamine Agonists