Pathological gambling from dopamine agonist and deep brain stimulation of the nucleus tegmenti pedunculopontine. (18th November 2010)

• Record Type: Journal Article
• Authors: Stefani, A; Galati, S; Brusa, L; Pierantozzi, M; Peppe, A; Stanzione, P
• Is Part Of: BMJ case reports. Volume 2010
• Publication Date: 2010-11-18
• Subjects: Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr.02.2010.2774
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : In patients with Parkinson's disease, aberrant or excessive dopaminergic stimulation is commonly indicated as the trigger factor in unmasking impulse control disorders (ICDs) such as pathological gambling. We had the opportunity to follow a patient who experienced Parkinson's disease 7 years ago when he was using pramipexole and again, recently, when he was treated with levodopa (L-dopa) and low frequency stimulation of the nucleus of the pedunculopontine tegmentus (PPTg) but no dopamine agonists. The same patient had shown, when studied with fluorodeoxyglucose-positron emission tomography in the condition PPTg-ON, a peculiar increased activity in the left ventral striatum. This case report confirms that, in a predisposed personality, ICD may arise from the perturbation of endogenous pathways, which connect the brainstem to the basal ganglia.