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Background: Impulse control disorders are frequently associated with dopaminergic therapy in Parkinson's disease. Genetic studies have suggested a high heritability of impulse control disorders in the general population and in PD. The aim of this study was to identify candidate gene variants associated with impulse control disorders and related behaviors in PD.Methods: We performed a multicenter case-control study in PD patients with (cases) or without impulse control disorders and related behaviors despite significant dopamine agonist exposure of >300 mg levodopa-equivalent daily dose during 12 months (controls). Behavioral disorders were assessed using the Ardouin scale. We investigated 50 variants in 24 candidate genes by a multivariate logistic regression analysis adjusted for sex and age at PD onset.Results: The analysis was performed on 172 cases and 132 controls. Cases were younger (60 ± 8 vs 63 ± 8 years; P < 0.001) and had a higher family history of pathological gambling (12% vs 5%, P = 0.03). No variant was significantly associated with impulse control disorders or related behaviors after correction for multiple testing, although the 2 top variants were close to significant (OPRM1 rs179991, OR, 0.49; 95%CI, 0.32-0.76; P = 0.0013; Bonferroni adjusted P = 0.065; DAT1 40-base pair variable number tandem repeat, OR, 1.82; 95%CI, 1.24-2.68; P = 0.0021; Bonferroni adjusted P = 0.105).Conclusions: Our results are suggestive of a novel association of the opioid receptor gene OPRM1 with impulse control disorders and related behaviors in PD and confirm a previous association with DAT1. Although replication in independent studies is needed, our results bring potential new insights to the understanding of molecular mechanisms of impulse control disorders. © 2018 International Parkinson and Movement Disorder Society. [ABSTRACT FROM AUTHOR]

The neural bases of interactions between anxiety and cognitive control are not fully understood. We conducted an fMRI study in healthy participants and in patients with an anxiety disorder (social phobia) to determine the impact of stress on the brain network involved in cognitive control. Participants performed two working memory tasks that differed in their level of performance-induced stress. In both groups, the cognitive tasks activated a frontoparietal network, involved in working memory tasks. A supplementary activation was observed in the right ventrolateral prefrontal cortex (VLPFC) in patients during the more stressful cognitive task. Region of interest analyses showed that activation in the right VLPFC decreased in the more stressful condition as compared to the less stressful one in healthy subjects and remain at a similar level in the two cognitive tasks in patients. This pattern was specific to the right when compared to the left VLPFC activation. Anxiety was positively correlated with right VLPFC activation across groups. Finally, left dorsolateral prefrontal cortex (DLPFC) activation was higher in healthy subjects than in patients in the more stressful task. These findings demonstrate that in healthy subjects, stress induces an increased activation in left DLPFC, a critical region for cognitive control, and a decreased activation in the right VLPFC, an area associated with anxiety. In patients, the differential modulation between these dorsal and ventral PFC regions disappears. This absence of modulation may limit anxious patients' ability to adapt to demanding cognitive control tasks. Hum Brain Mapp, 2012. © 2011 Wiley Periodicals, Inc [ABSTRACT FROM AUTHOR]

Background Fear of blushing (FB) in front of other people is a frequent and potentially incapacitating problem, but is not yet described as a specific diagnosis in psychiatric classifications. This can be explained by a lack of comparative studies with other forms of social anxiety disorder (SAD). Our aim was thus to explore the specificity of FB in patients with SAD. Methods SAD patients with FB but without other social threat ( n = 142), the majority of whom were referred by a department of surgery after an initial request of sympathetic block for facial blushing, were compared to SAD patients with FB and other associated social fears ( n = 97), and to SAD patients without FB ( n = 190). They were assessed and compared with a structured diagnostic interview for DSM-IV and various scales measuring social anxiety, other anxiety and depressive symptoms, impairment and personality traits. Results The group with pure FB showed specific profiles when compared with the two other groups: later age of onset, less comorbidity, lower behavioral and temperamental inhibition, and higher self-esteem. However, their levels of social anxiety and impairment were high. No important differences appeared between the two other groups. Conclusion The specificity of FB should be considered in the social anxiety spectrum, and could be viewed either as a SAD subtype or as SAD form secondary to facial blushing. Further epidemiological and therapeutic studies on this disorder are necessary. [ABSTRACT FROM AUTHOR]

Objective: The present study concerns the objective and quantitative measurement of checking activity, which represents the most frequently observed compulsions in obsessive–compulsive disorder (OCD). To address this issue, we developed an instrumental task producing repetitive checking in OCD subjects. Method: Fifty OCD subjects and 50 normal volunteers (NV) were administered a delayed matching-to-sample task that offered the unrestricted opportunity to verify the choice made. Response accuracy, number of verifications, and response time for choice taken to reflect the degree of uncertainty and doubt were recorded over 50 consecutive trials. Results: Despite similar levels of performance, patients with OCD demonstrated a greater number of verifications and a longer response time for choice before checking than NV. Such behavioral patterns were more pronounced in OCD subjects currently experiencing checking compulsions. Conclusion: The present task might be of special relevance for the quantitative assessment of checking behaviors and for determining relationships with cognitive processes. [ABSTRACT FROM AUTHOR]

Cloninger has proposed a new procedure to assess personality disorders on the basis of his model of temperament and character. We explored the psychometric characteristics of this instrument in 560 male prisoners, using factor analyses. Results showed that the 20 items relating to the general personality criteria have acceptable internal consistency and that the three-factor structure of the temperament items used to subtype personality disorder are correctly identified by a maximum likelihood factor analysis model with varimax rotation. Overall, 32% of prisoners had a personality disorder according to this model, and it was possible to subtype 68% of these. This new diagnostic procedure for personality disorder seemed to have satisfactory basic psychometric characteristics but further study is required to explore the concurrent validity and the reliability of this instrument. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Pathological gambling (PG) related to dopaminergic treatment in Parkinson's disease (PD) is part of a spectrum of behavioral disorders called the dopamine dysregulation syndrome (DDS). We describe a series of PD patients with preoperative active PG due to dopaminergic treatment from a total of 598 patients who have undergone surgery for subthalamic nucleus stimulation for disabling motor fluctuations. The patients had systematic open assessment of behavioral symptoms and standardized assessments of motor symptoms, mood, and apathy. Seven patients (6 men, 1 woman; age, 54 ± 9 years; levodopa equivalent dose, 1,390 ± 350 mg/day) had preoperative PG over a mean of 7 years, intolerant to reduction in medication. Six had nonmotor fluctuations and four had other behavioral symptoms consistent with a diagnosis of the DDS. After surgery, motor symptoms improved, allowing for 74% reduction of dopaminergic treatment, below the dosage of gambling onset. In all patients, PG resolved postoperatively after 18 months on average (range, 0-48), although transient worsening occurred in two. Improvement paralleled the time course and degree of reduction in dopaminergic treatment. Nonmotor fluctuations, off period dysphoria, and other symptoms of the DDS improved. Two patients developed persistent apathy. In conclusion, PG and other symptoms of the DDS-associated dopaminergic treatment improved in our patients following surgery. Dopaminergic dysregulation commonly attributed to pulsatile overstimulation of the limbic dopaminergic system may be subject to desensitization on chronic subthalamic stimulation, which has a relative motor selectivity and allows for decrease in dopaminergic treatment. © 2006 Movement Disorder Society [ABSTRACT FROM AUTHOR]

Objective: To explore the psychometric characteristics of a modified version of the Cloninger's personality questionnaire, the Temperament and Character inventory-Revised (TCI-R). Method: A 482-subject sample, including clinical and non-clinical subjects, completed the TCI-R. We performed principal component analyses and explored the factorial structure of the questionnaire, and the internal consistency of each dimension. Results: The factorial structure of the TCI-R was well defined as expected and similar to those shown with the TCI. Robust factors were obtained for Reward Dependence and Persistence in the TCI-R, even more clearly than in the original TCI. All dimensions obtained higher alpha Cronbach coefficients with the TCI-R than with the TCI. We obtained highly satisfying reliability coefficients in test-retest and TCI/ TCI-R comparisons. Conclusion: The TCI-R seems to have similar psychometric and feasibility characteristics as those of the initial version, but with significant improvements in terms of factorial structure and internal consistency of most dimensions. [ABSTRACT FROM AUTHOR]

Objective: In Lebanon, benzodiazepines are often available without medical prescription. We aimed to carry out the first community‐based pharmaco‐epidemiological study on benzodiazepine consumption in the Middle East Area. Method: The prevalence of past‐month benzodiazepine use was assessed in a 1000‐subject randomized sample from the Lebanese community, and risk factors were studied in a group of 496 current users. Results: Benzodiazepine use during the past month was found in 9.6% of subjects. Four variables were significantly associated with use: age higher than 45 years, female sex, cigarette smoking and the existence of a recent life event. Benzodiazepine dependence was found in 50.2% of users. Conclusion: Benzodiazepine use in Lebanon is particularly high, and can be related to well‐known factors such as female sex and age, but other potent specific variables, such as war stress or the lack of control on drug access, can be hypothesized. [ABSTRACT FROM AUTHOR]

Objectives: Incidence–prevalence–mortality (IPM) models have been developped to estimate incidence or prevalence when one of these two measures is unavailable. We aimed to test the consistency of an IPM model of psychotic disorders on a recent incidence–prevalence couple dataset and to identify potential causes of inconsistency by applying the model to (a) the whole population, (b) female and male subgroups, (c) migrant subgroups, and (d) psychotic disorders with age at onset (AAO) between 18 and 24 (18–24 AAO). Methods: We modelled prevalence (MP) using incidence data and the expected mortality and remission values. We then compared the MP to the observed prevalence (OP). Results: In the whole population, the model significantly underestimated the prevalence (MP = 3.30, 95% CI [2.97, 3.66]; OP = 4.98, 95% CI [4.58, 5.41]). The results were similar for the two genders. In the migrants group, results were in the opposite direction, the model significantly overestimating the prevalence. Finally, in the 18–24 AAO subgroup, the model performed well, with OP and MP not significantly different. Conclusion: These results suggest that standard IPM models do not perform well for psychotic disorders and more complex models taking into account the heterogeneity of the sample (in terms of remission, mortality, population movements, etc.) need to be developed. [ABSTRACT FROM AUTHOR]

Several letters to the editor are presented in response to the articles in previous issues including "Treating addictions with deep brain stimulation is premature but well-controlled clinical trials should be performed," and "Deep brain stimulation for the treatment of addiction."