ReviewPathological gambling in Parkinson's disease. A comprehensive review
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Editor's comment: Pathologic gambling in Parkinson's disease recently has become more widely recognized as a possible complication of dopamine agonist therapy. It is a class specific effect and not necessarily related to any particular dopamine agonist. It usually occurs in younger males, but it also may develop in patients with earlier symptomatic disease onset, in those with a prior history of alcohol and/or substance abuse, or in those who possess personality traits characterized by impulsivity. The first line of therapy usually is a dose reduction or discontinuation of the dopamine agonist. Pathologic gambling also may occur in patients on levodopa monotherapy, but this is less frequent. In this review article, Gabriella Santangelo and her colleagues provide a comprehensive analysis of the prevalence of pathologic gambling and the associated clinical, behavioral, and cognitive features of this complication. Genetic susceptibility and possible therapeutic management also are addressed, as are the potential neuro-anatomical and functional correlates of pathological gambling.
Zbigniew K. Wszolek, Co-Editor in Chief, Department of Neurology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA