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Watch for Behavioral Problems in Parkinson Patients

Watch for Behavioral Problems in Parkinson PatientsScientists have learned that pathologic gambling may accompany Parkinson’s disease. New research suggests individuals with PD and a gambling problem are more likely to display abnormal social behavior and make poor decisions in ambiguous circumstances.

A number of studies have already associated pathological gambling with Parkinson’s, suggesting that it is a frequent impulse control disorder associated mainly with dopamine replacement therapy.

Researchers from the Raul Carrea Institute for Neurological Research (FLENI) in Buenos Aires, Argentina, interviewed the immediate relatives of seven Parkinson’s patients who were pathological gamblers.

They also interviewed the families of 13 patients – matched by age, sex, education and disease severity – who did not gamble.

They found that the gamblers were less cooperative with others, had difficulties making or keeping close relationships and often did what they wanted, without caring what other people thought.

The researchers also found that the patients in the pathological gambling group performed worse in the Iowa Gambling Task, which is used to assess decision-making abilities in ambiguous or risky situations.

“The object of this study was to assess decision-making processes in Parkinson’s Disease patients with and without pathological gambling by asking them and their relatives to take part in a series of tests,” says Dr. Ramon Leiguarda, an expert in cognitive neurology.

“We found that the patients in the pathological gambling group were more likely to make poor decisions and select disadvantageous alternatives more frequently than advantageous alternatives.”

The combination of poor decision-making and abnormal social behavior has led the team to conclude that dopamine replacement therapy can induce dysfunction in the areas of the brain that control affective decision making – the ventromedial prefrontal cortex and amygdala-ventral striatum system.

Six of the seven pathological gamblers who took part in the study were male. At the time of the study they had an average age of 61 and their average age at diagnosis was 52.

Six of the patients had no history of gambling before developing Parkinson’s Disease. One patient had played poker with friends for 30 years, but his gambling behavior exacerbated after starting dopamine replacement therapy and now included roulette and horse racing.

The other six participants said that their preferred type of gambling was slot machines.

Four of the seven displayed other impulse control disorders – two were also compulsive shoppers and two displayed hypersexuality.

“We believe that the behavior highlighted in our study, combined with previous research into the links between Parkinson’s Disease and pathological gambling, point to dopamine replacement therapy causing dysfunction in specific areas of the brain,” says Dr. Leiguarda.

“Further studies that assess Parkinson’s Disease patients recovering from pathological gambling are needed to better understand the physiopathology of this impulse control disorder.”

The research is found in the January issue of the European Journal of Neurology.

Source: Wiley-Blackwell

Watch for Behavioral Problems in Parkinson Patients

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2015). Watch for Behavioral Problems in Parkinson Patients. Psych Central. Retrieved on July 16, 2018, from https://psychcentral.com/news/2010/01/18/watch-for-behavioral-problems-in-parkinson-patients/10801.html

 

Scientifically Reviewed
Last updated: 6 Oct 2015
Last reviewed: By John M. Grohol, Psy.D. on 6 Oct 2015
Published on PsychCentral.com. All rights reserved.