{
  "abstract": "Stéphane Thobois mostly deals with Parkinson’s disease, Central nervous system disease, Neuroscience, Levodopa and Internal medicine. His research in Parkinson’s disease, focusing on Subthalamic nucleus specifically. His Temporal cortex, Basal ganglia and Parietal lobe study, which is part of a larger body of work in Neuroscience, is frequently linked to Motor imagery and Primary motor cortex, bridging the gap between disciplines.His Levodopa research focuses on Dyskinesia and how it connects with Randomized controlled trial, Physical medicine and rehabilitation, Punding, Dopamine dysregulation syndrome and Dopamine. His work deals with themes such as Apathy and Psychiatry, which intersect with Physical medicine and rehabilitation. His Internal medicine research is multidisciplinary, incorporating perspectives in Endocrinology, Physical therapy and Pathology.Impulse control disorders (ICD) are frequent and cumbersome behavioral disorders in patients with Parkinson’s disease (PD). Risk factors such as young age, male sex, dopamine agonist drugs, past psychiatric or addiction history, severity of motor fluctuations, and some specific genetic polymorphisms are well known. Their consequences may be severe for the patients and their relatives. Understanding their pathophysiological underpinnings is, therefore, crucial to provide the most adequat treatment. From a pathophysiological point of view, convergent data show the central role of an abnormal sensitization of the dopaminergic system. More recent studies suggest the involvement of other monoamine such as serotonin or noradrenalin. In terms of anatomo-functional abnormalities, dysfunction within the reward circuit but also inhibitory networks were found and lead to the perpetuation of aberrant and risky behaviors despite their negative consequences. These alterations pinpoint the dysfunction of reinforcement learning in ICD, which is biased toward the overvaluation of reward and underestimation of risk, and the deficit in inhibitory control mechanisms related to abnormal connectivity within and between the limbic and executive the associative and motor networks. Regarding therapeutic strategies, they mostly consist in the reduction of dopaminergic drugs especially dopamine agonists, with a risk of dopamine withdrawal syndrome. Other options such as cognitive and behavioral therapies may be useful and new pharmacological approaches targeting the noradrenergic or serotonergic systems need further assessment.",
  "authors": [
    {
      "affiliations": [
        "Hopital Neurologique Pierre Wertheimer Pathologies du Mouvement et Pathologies Neuromusculaires, Lyon, France"
      ],
      "name": "Stéphane Thobois"
    }
  ],
  "title": "Pathophysiology and Management of ICD in PD",
  "uid": "1b4cec6f-c2e6-5c98-a1e4-8623c21af5f1"
}