Protocol Number: 08-N-0023

Title:

Motor Cortex Reward Signaling in Parkinson Disease

Number:

08-N-0023

Summary:

Background:

The brain releases signals to mark rewards for certain behavior. Some medications for Parkinson disease (PD) can cause some patients to engage in compulsive behavior, possibly because the medications affect this reward system.

By using transcranial magnetic stimulation (TMS), researchers can study brain activity when an individual receives a reward.

Objectives:

To learn how the brains of people with PD behave when rewarded.

To learn whether two common Parkinson medications (levodopa and pramipexole) change this behavior.

To compare reward signals in the brains of healthy volunteers with reward signals in the brains of people with PD.

Eligibility:

Women between 50 and 80 years of age and men between 45 and 80 years of age.

Participants will be divided into healthy volunteers and volunteers who have mild to moderate PD.

Design:

Prescreening will consist of a neurological examination and a series of questions about gambling habits and drug and alcohol use.

Participation in a TMS study involving a computer game simulation of a slot machine:

-Before the simulation, participants will receive TMS to establish a baseline response rate.

-During the simulation, participants will play a game in which they will receive real money.

TMS will be administered to each patient under three different conditions:

-TMS administered when patients have not taken any Parkinson medication.

-TMS administered after patients have taken levodopa.

-TMS administered after patients have taken pramipexole.

Sponsoring Institute:

National Institute of Neurological Disorders and Stroke (NINDS)

Recruitment Detail

Type: Participants currently recruited/enrolled

Gender: Male & Female

Referral Letter Required: No

Population Exclusion(s): Children

Eligibility Criteria:

INCLUSION CRITERIA:

HEALTHY SUBJECTS:

-Age 45-80 yrs

PATIENTS:

-Mild-moderate disease (Hoehn and Yahr stage 1-2).

-Age 45-80 yrs for men, 50-80 for women.

EXCLUSION CRITERIA:

-Pre-menopausal status in women: Preliminary data in healthy, cycling women suggests that the variation in paired-pulse inhibition caused by the menstrual cycle may obscure the change in the response induced by the behavioral task.

-Significant neurological or psychiatric history (including PD) for the Healthy Subjects Group)

-Significant neurological or psychiatric history (other than PD) for the Patient Group

-Cognitively impaired subjects for both groups. Cognitive impairment will be ruled out by a Mini Mental State Score of 28 or more.

-Exposure to DA agonists within a month of study

-History of habitual gambling, defined as either visiting casinos more than once per month or playing cards for money more than once per week or gambling over the internet more than once per month

-History of impulse control disorders, such as overeating, overspending or sexual compulsions

-Habitual consumption of more than two drinks a day, marijuana more than once a week or any other illicit drug use within the last three months

-Metal in the cranial cavity or eye, pacemaker, implanted pumps or stimulators

-Use of non-PD related medications affecting the DA system, such as phenothiazine antihistamines (promethazine), antiemetics or decongestants in the last month

-Non-English speaking subjects

Special Instructions:

Currently Not Provided

Keywords:

Disruptive Behavior Disorders

Behavior

Gambling

Dopaminergic Mechanisms

Dopamine

Recruitment Keyword(s):

Parkinson Disease

PD

Condition(s):

Parkinson Disease

Investigational Drug(s):

None

Investigational Device(s):

None

Intervention(s):

None

Supporting Site:

National Institute of Neurological Disorders and Stroke

Contact(s):

Patient Recruitment and Public Liaison Office
Building 61
10 Cloister Court
Bethesda, Maryland 20892-4754
Toll Free: 1-800-411-1222
TTY: 301-594-9774 (local),1-866-411-1010 (toll free)
Fax: 301-480-9793

Electronic Mail:prpl@mail.cc.nih.gov

Citation(s):

Avanzi M, Uber E, Bonfˆ F. Pathological gambling in two patients on dopamine replacement therapy for Parkinson's disease. Neurol Sci. 2004 Jun;25(2):98-101.

Cohen MX, Young J, Baek JM, Kessler C, Ranganath C. Individual differences in extraversion and dopamine genetics predict neural reward responses. Brain Res Cogn Brain Res. 2005 Dec;25(3):851-61. Epub 2005 Nov 11.

Strobel A, Spinath FM, Angleitner A, Riemann R, Lesch KP. Lack of association between polymorphisms of the dopamine D4 receptor gene and personality. Neuropsychobiology. 2003; (1):52-6.

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