RT Journal Article
T1 A circuit‐based approach to modulate hypersexuality in Parkinson's disease
A1 Mata Marín, David
A1 Pineda Pardo, José Ángel
A1 Michiels, Mario
A1 Pagge, Cristina
A1 Ammann, Claudia
A1 Martínez Fernández, Raúl
A1 Molina, José Antonio
A1 Vela Desojo, Lydia
A1 Alonso Frech, Fernando
A1 Obeso Martín, Ignacio
AB Aim: Impulse‐control disorder is a common neuropsychiatric complication in Parkinson's disease (PD) under dopamine replacement therapy. Prior studies tested the balance between enhanced desire towards reward and cognitive control deficits, hypothesized to be biased towards the former in impulse control disorders. We provide evidence for this hypothesis by measuring behavioral and neural patterns behind the influence of sexual desire over response inhibition and tools towards functional restoration using repetitive transcranial stimulation in patients with hypersexuality as predominant impulsive disorder. Methods: The effect of sexual cues on inhibition was measured with a novel erotic stop‐signal task under on and off dopaminergic medication. Task‐related functional and anatomical connectivity models were estimated in 16 hypersexual and 17 nonhypersexual patients with PD as well as in 17 healthy controls. Additionally, excitatory neuromodulation using intermittent theta‐burst stimulation (sham‐controlled) was applied over the pre‐supplementary motor area in 20 additional hypersexual patients with PD aiming to improve response inhibition.Results: Compared with their nonhypersexual peers, patients with hypersexuality recruited caudate, pre‐supplementary motor area, ventral tegmental area, and anterior cingulate cortex while on medication. Reduced connectivity was found between pre‐supplementary motor area and caudate nucleus in hypersexual compared with nonhypersexual patients (while medicated), a result paralleled by compensatory enhanced anatomical connectivity. Furthermore, stimulation over the pre‐supplementary motor area improved response inhibition in hypersexual patients with PD when exposed to sexual cues.Conclusion: This study, therefore, has identified a specific fronto‐striatal and mesolimbic circuitry underlying uncontrolled sexual responses in medicated patients with PD where cortical neuromodulation halts its expression.
PB Wiley
SN 1323-1316
SN 1440-1819
YR 2023
FD 2023-02-03
LK https://hdl.handle.net/20.500.14352/103748
UL https://hdl.handle.net/20.500.14352/103748
LA eng
NO Mata-Marín, D., Pineda-Pardo, J. Á., Michiels, M., Pagge, C., Ammann, C., Martínez-Fernández, R., Molina, J. A., Vela-Desojo, L., Alonso-Frech, F. and Obeso, I. (2023), A circuit-based approach to modulate hypersexuality in Parkinson's disease. Psychiatry and Clinical Neurosciences, 77, 223-232. https://doi.org/10.1111/pcn.13523
NO 2023 Acuerdos transformativos CRUE
NO Ministerio de Ciencia, Innovación y Universidades
NO Instituto de Salud Carlos III
NO Fundación Jesús de Gangoiti Barrera
DS Docta Complutense
RD 5 abr 2025