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Too much of a good thing: hedonistic homoeostatic dysregulation and other behavioural consequences of excessive dopamine replacement therapy in Parkinson's disease.
Journal of Neurology, Neurosurgery, and Psychiatry ( IF 8.7 ) Pub Date : 2020-03-05 , DOI: 10.1136/jnnp-2019-322378
John D O'Sullivan 1, 2
Affiliation  

The recognition and description of a behavioural syndrome in a group of patients with Parkinson’s disease (PD) who take dopamine replacement therapy in quantities beyond what is required to treat motor symptoms 20 years ago1 sparked interest for a number of reasons. In addition to its deficiency being integral to PD, dopamine had long been regarded as a critical neurotransmitter involved in reward systems reduction in dopamine associated with depression and increased dopamine with addiction. Within the addiction field, these patients represented a real-life experiment to support the prevailing models suggesting maladaptive mesolimbic dopamine circuits underlying addiction.2 Conversely in the field of neurology, the paper highlighted and built on occasional observations and case reports of abnormal behaviour with excessive use of dopaminergic medication in PD, and proposed a pathophysiological framework within which these behaviours could be understood. Too much of a good thing: hedonistic homoeostatic dysregulation and other behavioural consequences of excessive dopamine replacement therapy in Parkinson's disease Authors : John Daniel O’Sullivan Year Published : 2000 Number of times cited : 635 The appellation ‘hedonistic homoeostatic dysregulation’ was idiosyncratic and served two main purposes in addition to its novelty to neurologists.1 First it emphasised the similarity between this behaviour in PD and generic drug abuse or dependence with the term initially used to describe to describe a neurobiological theory of drug addiction.3 Second it circumvented the use of the pejorative term ‘addiction’, particularly when the drugs that are being misused in these patients are necessary …

中文翻译:

太好了:享乐主义的稳态止血功能失调以及过度的多巴胺替代疗法在帕金森氏病中的其他行为后果。

对一组帕金森氏病(PD)患者采取多巴胺替代疗法的数量超出20年前治疗运动症状所需的剂量,这种行为综合征的认识和描述引起了人们的兴趣,原因有很多。除了其缺陷是PD不可或缺的,多巴胺长期以来一直被认为是重要的神经递质,参与了与抑郁症相关的多巴胺减少和成瘾引起的多巴胺增加的奖励系统。在成瘾领域,这些患者代表了一个现实生活中的实验,以支持流行的模型,这些模型表明成瘾的基础是适应不良的中脑边缘多巴胺回路。2相反,在神经学领域,该论文强调并建立在偶然观察和PD过量使用多巴胺能药物的异常行为的病例报告的基础上,并提出了可以理解这些行为的病理生理学框架。太好了:帕金森氏病的享乐主义同调失调和过度多巴胺替代疗法的其他行为后果作者:约翰·丹尼尔·奥沙利文出版年:2000被引用次数:635称谓“享乐主义同调失调”是特质的除了对神经科医师的新颖性外,它还具有两个主要目的。1首先,它强调了PD行为与一般药物滥用或依赖性之间的相似性,该术语最初用于描述药物成瘾的神经生物学理论。
更新日期:2020-05-15
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