Regional cerebral blood flow in a patient with restless legs syndrome exhibiting pramipexole‐induced hypersexuality
Abstract Background Impulse control disorders (ICDs), including hypersexuality, are associated with adverse effects of dopamine agonists, such as pramipexole, particularly in the treatment of Parkinson's disease and restless legs syndrome (RLS). The underlying mechanisms remain unclear in ICDs...
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Wiley
2025-06-01
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| Series: | PCN Reports |
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| Online Access: | https://doi.org/10.1002/pcn5.70121 |
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| author | Toshiki Obata Ryota Kobayashi Toshinori Shirata Keisuke Noto Yasuhiro Sugai Gaku Aboshi Masafumi Kanoto Akihito Suzuki |
| author_facet | Toshiki Obata Ryota Kobayashi Toshinori Shirata Keisuke Noto Yasuhiro Sugai Gaku Aboshi Masafumi Kanoto Akihito Suzuki |
| author_sort | Toshiki Obata |
| collection | DOAJ |
| description | Abstract Background Impulse control disorders (ICDs), including hypersexuality, are associated with adverse effects of dopamine agonists, such as pramipexole, particularly in the treatment of Parkinson's disease and restless legs syndrome (RLS). The underlying mechanisms remain unclear in ICDs in patients with RLS, and no neuroimaging studies have investigated regional cerebral blood flow (rCBF) changes in RLS patients with ICDs. Case Presentation A 60‐year‐old man with RLS developed hypersexuality after initiating pramipexole at 0.5 mg/day. He exhibited inappropriate sexual behaviors toward hospital staff. Single‐photon emission computed tomography revealed increased rCBF in the bilateral orbitofrontal cortex and medial frontal cortex, as well as in the left striatum and thalamus. The hypersexuality gradually resolved following pramipexole discontinuation. Conclusion This case suggests that pramipexole‐induced hypersexuality in RLS may be linked to increased rCBF within the mesocorticolimbic network, including orbitofrontal cortex, medial frontal cortex, and striatum, thereby impairing impulse control. Despite the relatively low dose of pramipexole (0.5 mg/day), individual susceptibility factors, such as depressive symptoms and intellectual disability, may have contributed to ICD onset. Given the lack of prior studies examining rCBF in RLS patients with ICDs, further research is needed to elucidate the pathophysiological mechanisms and risk factors associated with pramipexole‐induced ICDs in RLS. |
| format | Article |
| id | doaj-art-71681eaa96a9495c977f351b18cab92b |
| institution | OA Journals |
| issn | 2769-2558 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wiley |
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| series | PCN Reports |
| spelling | doaj-art-71681eaa96a9495c977f351b18cab92b2025-08-20T02:22:04ZengWileyPCN Reports2769-25582025-06-0142n/an/a10.1002/pcn5.70121Regional cerebral blood flow in a patient with restless legs syndrome exhibiting pramipexole‐induced hypersexualityToshiki Obata0Ryota Kobayashi1Toshinori Shirata2Keisuke Noto3Yasuhiro Sugai4Gaku Aboshi5Masafumi Kanoto6Akihito Suzuki7Department of Psychiatry Yamagata University Faculty of Medicine Yamagata JapanDepartment of Psychiatry Yamagata University Faculty of Medicine Yamagata JapanDepartment of Psychiatry Yamagata University Faculty of Medicine Yamagata JapanDepartment of Psychiatry Yamagata University Faculty of Medicine Yamagata JapanDivision of Diagnostic Radiology, Department of Radiology Yamagata University Faculty of Medicine Yamagata JapanDepartment of Psychiatry Nihonkai General Hospital Sakata Yamagata JapanDivision of Diagnostic Radiology, Department of Radiology Yamagata University Faculty of Medicine Yamagata JapanDepartment of Psychiatry Yamagata University Faculty of Medicine Yamagata JapanAbstract Background Impulse control disorders (ICDs), including hypersexuality, are associated with adverse effects of dopamine agonists, such as pramipexole, particularly in the treatment of Parkinson's disease and restless legs syndrome (RLS). The underlying mechanisms remain unclear in ICDs in patients with RLS, and no neuroimaging studies have investigated regional cerebral blood flow (rCBF) changes in RLS patients with ICDs. Case Presentation A 60‐year‐old man with RLS developed hypersexuality after initiating pramipexole at 0.5 mg/day. He exhibited inappropriate sexual behaviors toward hospital staff. Single‐photon emission computed tomography revealed increased rCBF in the bilateral orbitofrontal cortex and medial frontal cortex, as well as in the left striatum and thalamus. The hypersexuality gradually resolved following pramipexole discontinuation. Conclusion This case suggests that pramipexole‐induced hypersexuality in RLS may be linked to increased rCBF within the mesocorticolimbic network, including orbitofrontal cortex, medial frontal cortex, and striatum, thereby impairing impulse control. Despite the relatively low dose of pramipexole (0.5 mg/day), individual susceptibility factors, such as depressive symptoms and intellectual disability, may have contributed to ICD onset. Given the lack of prior studies examining rCBF in RLS patients with ICDs, further research is needed to elucidate the pathophysiological mechanisms and risk factors associated with pramipexole‐induced ICDs in RLS.https://doi.org/10.1002/pcn5.70121hypersexualitypramipexolerestless legs syndromeregional cerebral blood flowsingle‐photon emission computed tomography (SPECT) |
| spellingShingle | Toshiki Obata Ryota Kobayashi Toshinori Shirata Keisuke Noto Yasuhiro Sugai Gaku Aboshi Masafumi Kanoto Akihito Suzuki Regional cerebral blood flow in a patient with restless legs syndrome exhibiting pramipexole‐induced hypersexuality PCN Reports hypersexuality pramipexole restless legs syndrome regional cerebral blood flow single‐photon emission computed tomography (SPECT) |
| title | Regional cerebral blood flow in a patient with restless legs syndrome exhibiting pramipexole‐induced hypersexuality |
| title_full | Regional cerebral blood flow in a patient with restless legs syndrome exhibiting pramipexole‐induced hypersexuality |
| title_fullStr | Regional cerebral blood flow in a patient with restless legs syndrome exhibiting pramipexole‐induced hypersexuality |
| title_full_unstemmed | Regional cerebral blood flow in a patient with restless legs syndrome exhibiting pramipexole‐induced hypersexuality |
| title_short | Regional cerebral blood flow in a patient with restless legs syndrome exhibiting pramipexole‐induced hypersexuality |
| title_sort | regional cerebral blood flow in a patient with restless legs syndrome exhibiting pramipexole induced hypersexuality |
| topic | hypersexuality pramipexole restless legs syndrome regional cerebral blood flow single‐photon emission computed tomography (SPECT) |
| url | https://doi.org/10.1002/pcn5.70121 |
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