Session Time: 1:15pm-2:45pm
Location: Hall 3FG
Objective: The aim of this study was to investigate the neural underpinnings of the dopaminergic dysregulation syndrome( DDS ) during the “off-phase”.
Background: The DDS in Parkinson’s disease (PD) is a complication of the parkinsonian treatment referring to the uncontrolled, excessive and compulsive use of dopaminergic replacement therapy that patients exert during the ineffective period of the prescribed medications (the so-called “off-phase”). DDS patients develop a sort of addiction to dopaminergic medication and thus they could be considered a useful model in order to better understand the pathophysiology of behavioural and substance addictions. Despite DDS is not often easy to detect, in a previous study we showed that pain (a common symptom in PD patients) could represent a marker of the DDS and other types of compulsive behaviors (such as behavioural addictions).
Methods: 10 PD patients with DDS and pain were compared with a group of 10 PD patients without DDS as control group, by means 18-FDG-PET (positron emission tomography), during the “off” and “on” phase. PET studies were performed according to the EANM Guidelines  by a Discovery ST-E System (General Electric) in 3D modality. One-way analysis of variance (ANOVA) was performed using SPM2 f-contrast routine using the two groups as factors.
Results: DDS-PD patients respect to PD control group showed a major hypometabolism of bilateral parieto-temporo-occipital cortex, which is significantly more pronounced in off-phase than in on-phase (p=0.001). Futhermore, DDS-PD patients showed an hypermetabolism of bilateral mesial orbitofrontal cortex during off-phase (p=0.001) that disappear during on-phase.
Conclusions: 18F-FDG PET may represent a good tool to differentiate different types of pain in PD. In particularly, metabolism study may be helpful to distinguish dystonic by “compulsive”pain , during off phases. Neurocircuitries related to impulsivity, compulsivity and reward are altered by over dopaminergic stimulation in PD, and pain may represent a signal of dopaminergic addiction.
To cite this abstract in AMA style:G. Albani, A. Cistaro, P. Fania, S. Margotti, V. Arena, A. Mauro. Off-painfull state in Parkinson’s disease patients: A redflag of complulsive behavior. Data from a PET-FDG study [abstract]. Mov Disord. 2018; 33 (suppl 2). https://www.mdsabstracts.org/abstract/off-painfull-state-in-parkinsons-disease-patients-a-redflag-of-complulsive-behavior-data-from-a-pet-fdg-study/. Accessed December 7, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/off-painfull-state-in-parkinsons-disease-patients-a-redflag-of-complulsive-behavior-data-from-a-pet-fdg-study/