Inhibitory control dysfunction in parkinsonian impulse control disorders

Garance M. Meyer, Charlotte Spay, Alina Beliakova, Gabriel Gaugain, Gianni Pezzoli, Bénédicte Ballanger, Philippe Boulinguez, Roberto Cilia

Research output: Contribution to journalArticlepeer-review

Abstract

Impulse control disorders (ICDs) in Parkinson's disease have been associated with dysfunctions in the control of value- or reward-based responding (choice impulsivity) and abnormalities in mesocorticolimbic circuits. The hypothesis that dysfunctions in the control of response inhibition (action impulsivity) also play a role in Parkinson's disease ICDs has recently been raised, but the underlying neural mechanisms have not been probed directly. We used high-resolution EEG recordings from 41 patients with Parkinson's disease with and without ICDs to track the spectral and dynamical signatures of different mechanisms involved in inhibitory control in a simple visuomotor task involving no selection between competing responses and no reward to avoid potential confounds with reward-based decision. Behaviourally, patients with Parkinson's disease with ICDs proved to be more impulsive than those without ICDs. This was associated with decreased beta activity in the precuneus and in a region of the medial frontal cortex centred on the supplementary motor area. The underlying dynamical patterns pinpointed dysfunction of proactive inhibitory control, an executive mechanism intended to gate motor responses in anticipation of stimulation in uncertain contexts. The alteration of the cortical drive of proactive response inhibition in Parkinson's disease ICDs pinpoints the neglected role the precuneus might play in higher order executive functions in coordination with the supplementary motor area, specifically for switching between executive settings. Clinical perspectives are discussed in the light of the non-dopaminergic basis of this function.

Original languageEnglish
Pages (from-to)3734-3747
Number of pages14
JournalBrain
Volume143
Issue number12
DOIs
Publication statusPublished - Dec 1 2020

Keywords

  • beta
  • impulsivity
  • inhibitory control
  • Parkinson
  • precuneus

ASJC Scopus subject areas

  • Clinical Neurology

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