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Insights into pathophysiology of punding reveal possible treatment strategies

Molecular Psychiatry volume 15, pages 560–573 (2010)Cite this article

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Abstract

Punding is a stereotyped behavior characterized by an intense fascination with a complex, excessive, nongoal oriented, repetitive activity. Men tend to repetitively tinker with technical equipment such as radio sets, clocks, watches and car engines, the parts of which may be analyzed, arranged, sorted and cataloged but rarely put back together. Women, in contrast, incessantly sort through their handbags, tidy continuously, brush their hair or polish their nails. Punders are normally aware of the inapposite and obtuse nature of the behavior; however, despite the consequent self-injury, they do not stop such behavior. The most common causes of punding are dopaminergic replacement therapy in patients affected by Parkinson's disease (PD) and cocaine and amphetamine use in addicts. The vast majority of information about punding comes from PD cases. A critical review of these cases shows that almost all afflicted patients (90%) were on treatment with drugs acting mainly on dopamine receptors D1 and D2, whereas only three cases were reported in association with selective D2 and D3 agonists. Epidemiological considerations and available data from animal models suggest that punding, drug-induced stereotypies, addiction and dyskinesias all share a common pathophysiological process. Punding may be related to plastic changes in the ventral and dorsal striatal structures, including the nucleus accumbens, and linked to psychomotor stimulation and reward mechanisms. Possible management guidelines are proposed.

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References

  1. Rylander G . Psychoses and the punding and choreiform syndromes in addiction to central stimulant drugs. Psychiatr Neurol Neurochir 1972; 75: 203–212.

    CAS  PubMed  Google Scholar 

  2. Schiorring E . Psychopathology induced by ‘speed drugs’. Pharmacol Biochem Behav 1981; 14 (Suppl 1): 109–122.

    Article  PubMed  Google Scholar 

  3. Evans AH, Katzenschlager R, Paviour D, O’Sullivan JD, Appel S, Lawrence AD et al. Punding in Parkinson's disease: its relation to the dopamine dysregulation syndrome. Mov Disord 2004; 19: 397–405.

    Article  PubMed  Google Scholar 

  4. Voon V . Repetition repetition, and repetition: compulsive and punding behaviors in Parkinson's disease. Mov Disord 2004; 19: 367–370.

    Article  PubMed  Google Scholar 

  5. Friedman JH . Punding on levodopa. Biol Psychiatry 1994; 36: 350–351.

    Article  CAS  PubMed  Google Scholar 

  6. Gallagher DA, O’Sullivan SS, Evans AH, Lees AJ, Schrag A . Pathological gambling in Parkinson's disease: risk factors and differences from dopamine dysregulation. An analysis of published case series. Mov Disord 2007; 22: 1757–1763.

    Article  PubMed  Google Scholar 

  7. Shapiro MA, Chang YL, Munson SK, Okun MS, Fernandez HH . Hypersexuality and paraphilia induced by selegiline in Parkinson's disease: report of 2 cases. Parkinsonism Relat Disord 2006; 12: 392–395.

    Article  PubMed  Google Scholar 

  8. Pontone G, Williams JR, Bassett SS, Marsh L . Clinical features associated with impulse control disorders in Parkinson disease. Neurology 2006; 67: 1258–1261.

    Article  PubMed  Google Scholar 

  9. Nirenberg MJ, Waters C . Compulsive eating and weight gain related to dopamine agonist use. Mov Disord 2006; 21: 524–529.

    Article  PubMed  Google Scholar 

  10. Voon V, Potenza MN, Thomsen T . Medication-related impulse control and repetitive behaviors in Parkinson's disease. Curr Opin Neurol 2007; 20: 484–492.

    Article  PubMed  Google Scholar 

  11. Serrano-Duenas M . Chronic dopamimetic drug addiction and pathologic gambling in patients with Parkinson's disease—presentation of four cases. Ger J Psychiatry 2002; 5: 62–67.

    Google Scholar 

  12. Grosset KA, Grosset DG . Proposed dose equivalence for rapid switching between dopamine agonists in Parkinson's disease. Clin Ther 2006; 28: 1063–1064; author reply 1064.

    Article  PubMed  Google Scholar 

  13. Brady KT, Lydiard RB, Malcolm R, Ballenger JC . Cocaine-induced psychosis. J Clin Psychiatry 1991; 52: 509–512.

    CAS  PubMed  Google Scholar 

  14. Fasano A, Barra A, Nicosia P, Rinaldi F, Bria P, Bentivoglio AR et al. Cocaine addiction: from habits to stereotypical-repetitive behaviors and punding. Drug Alcohol Depend 2008; 96: 178–182.

    Article  CAS  PubMed  Google Scholar 

  15. Miyasaki JM, Al Hassan K, Lang AE, Voon V . Punding prevalence in Parkinson's disease. Mov Disord 2007; 22: 1179–1181.

    Article  PubMed  Google Scholar 

  16. Weintraub D, Siderowf AD, Potenza MN, Goveas J, Morales KH, Duda JE et al. Association of dopamine agonist use with impulse control disorders in Parkinson disease. Arch Neurol 2006; 63: 969–973.

    Article  PubMed  PubMed Central  Google Scholar 

  17. American Psychiatric Association. Diagnostic and Statistical Manual of Psychiatry -Text Revision, 4th edn. Washington, DC, 2000.

  18. Black KJ, Friedman JH . Repetitive and impulsive behaviors in treated Parkinson disease. Neurology 2006; 67: 1118–1119.

    Article  PubMed  Google Scholar 

  19. Stein DJ . Obsessive-compulsive disorder. Lancet 2002; 360: 397–405.

    Article  PubMed  Google Scholar 

  20. Fullana MA, Mataix-Cols D, Caspi A, Harrington H, Grisham JR, Moffitt TE et al. Obsessions and compulsions in the community: prevalence, interference, help-seeking, developmental stability, and co-occurring psychiatric conditions. Am J Psychiatry 2009; 166: 329–336.

    Article  PubMed  Google Scholar 

  21. Lawrence AJ, Blackwell AD, Barker RA, Spagnolo F, Clark L, Aitken MR et al. Predictors of punding in Parkinson's disease: results from a questionnaire survey. Mov Disord 2007; 22: 2339–2345.

    Article  PubMed  Google Scholar 

  22. Dell’Osso B, Altamura AC, Allen A, Marazziti D, Hollander E . Epidemiologic and clinical updates on impulse control disorders: a critical review. Eur Arch Psychiatry Clin Neurosci 2006; 256: 464–475.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Goodwin FK, Murphy DL, Brodie HK, Bunney Jr WE . Levodopa: alterations in behavior. Clin Pharmacol Ther 1971; 12: 383–396.

    Article  CAS  PubMed  Google Scholar 

  24. Bienvenu OJ, Samuels JF, Riddle MA, Hoehn-Saric R, Liang KY, Cullen BA et al. The relationship of obsessive-compulsive disorder to possible spectrum disorders: results from a family study. Biol Psychiatry 2000; 48: 287–293.

    Article  CAS  PubMed  Google Scholar 

  25. Lochner C, Hemmings SM, Kinnear CJ, Niehaus DJ, Nel DG, Corfield VA et al. Cluster analysis of obsessive-compulsive spectrum disorders in patients with obsessive-compulsive disorder: clinical and genetic correlates. Compr Psychiatry 2005; 46: 14–19.

    Article  PubMed  Google Scholar 

  26. Potenza MN, Voon V, Weintraub D . Drug Insight: impulse control disorders and dopamine therapies in Parkinson's disease. Nat Clin Pract Neurol 2007; 3: 664–672.

    Article  CAS  PubMed  Google Scholar 

  27. Voon V, Hassan K, Zurowski M, Duff-Canning S, de Souza M, Fox S et al. Prospective prevalence of pathologic gambling and medication association in Parkinson disease. Neurology 2006; 66: 1750–1752.

    Article  CAS  PubMed  Google Scholar 

  28. Dodd ML, Klos KJ, Bower JH, Geda YE, Josephs KA, Ahlskog JE . Pathological gambling caused by drugs used to treat Parkinson disease. Arch Neurol 2005; 62: 1377–1381.

    Article  PubMed  Google Scholar 

  29. Szarfman A, Doraiswamy PM, Tonning JM, Levine JG . Association between pathologic gambling and parkinsonian therapy as detected in the Food and Drug Administration Adverse Event database. Arch Neurol 2006; 63: 299–300; author reply 300.

    Article  PubMed  Google Scholar 

  30. Fernandez HH, Friedman JH . Punding on L-dopa. Mov Disord 1999; 14: 836–838.

    Article  CAS  PubMed  Google Scholar 

  31. Chartoff EH, Marck BT, Matsumoto AM, Dorsa DM, Palmiter RD . Induction of stereotypy in dopamine-deficient mice requires striatal D1 receptor activation. Proc Natl Acad Sci USA 2001; 98: 10451–10456.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Silveira-Moriyama L, Evans AH, Katzenschlager R, Lees AJ . Punding and dyskinesias. Mov Disord 2006; 21: 2214–2217.

    Article  PubMed  Google Scholar 

  33. Fasano A, Elia AE, Soleti F, Guidubaldi A, Bentivoglio AR . Punding and computer addiction in Parkinson's disease. Mov Disord 2006; 21: 1217–1218.

    Article  PubMed  Google Scholar 

  34. McKeon A, Josephs KA, Klos KJ, Hecksel K, Bower JH, Michael Bostwick J et al. Unusual compulsive behaviors primarily related to dopamine agonist therapy in Parkinson's disease and multiple system atrophy. Parkinsonism Relat Disord 2007; 13: 516–519.

    Article  PubMed  Google Scholar 

  35. Miwa H, Morita S, Nakanishi I, Kondo T . Stereotyped behaviors or punding after quetiapine administration in Parkinson's disease. Parkinsonism Relat Disord 2004; 10: 177–180.

    Article  PubMed  Google Scholar 

  36. Erberk-Ozen N . Manic symptoms probably associated with short-term low-dose quetiapine use. Adv Ther 2008; 25: 53–58.

    Article  CAS  PubMed  Google Scholar 

  37. Evans AH, Stegeman JR . Punding in patients on dopamine agonists for restless leg syndrome. Mov Disord 2008; 24: 140–141.

    Article  Google Scholar 

  38. Fan CC, Lin SK, Huang MC . Disulfiram-induced punding. J Clin Psychopharmacol 2008; 28: 473–474.

    Article  PubMed  Google Scholar 

  39. Bourdelat-Parks BN, Anderson GM, Donaldson ZR, Weiss JM, Bonsall RW, Emery MS et al. Effects of dopamine beta-hydroxylase genotype and disulfiram inhibition on catecholamine homeostasis in mice. Psychopharmacology (Berl) 2005; 183: 72–80.

    Article  CAS  Google Scholar 

  40. Ikemoto S, Panksepp J . The role of nucleus accumbens dopamine in motivated behavior: a unifying interpretation with special reference to reward-seeking. Brain Res Brain Res Rev 1999; 31: 6–41.

    Article  CAS  PubMed  Google Scholar 

  41. Wise RA, Rompre PP . Brain dopamine and reward. Annu Rev Psychol 1989; 40: 191–225.

    Article  CAS  PubMed  Google Scholar 

  42. Schultz W, Dayan P, Montague PR . A neural substrate of prediction and reward. Science 1997; 275: 1593–1599.

    Article  CAS  PubMed  Google Scholar 

  43. Jones SR, Garris PA, Wightman RM . Different effects of cocaine and nomifensine on dopamine uptake in the caudate-putamen and nucleus accumbens. J Pharmacol Exp Ther 1995; 274: 396–403.

    CAS  PubMed  Google Scholar 

  44. Venton BJ, Seipel AT, Phillips PE, Wetsel WC, Gitler D, Greengard P et al. Cocaine increases dopamine release by mobilization of a synapsin-dependent reserve pool. J Neurosci 2006; 26: 3206–3209.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Robbins TW, Mittleman G, O’Brien CP, Winn P . The neuropsychological significance of stereotypy induced by stimulant drugs. In: Cooper SJ, Dourish CT (eds). Neurobiology of Stereotyped Behaviour. Oxford: Claredon Press, 1990. pp 25–63.

    Google Scholar 

  46. Toates F . The interaction of cognitive and stimulus-response processes in the control of behaviour. Neurosci Biobehav Rev 1998; 22: 59–83.

    Article  CAS  PubMed  Google Scholar 

  47. Giovannoni G, O’Sullivan JD, Turner K, Manson AJ, Lees AJ . Hedonistic homeostatic dysregulation in patients with Parkinson's disease on dopamine replacement therapies. J Neurol Neurosurg Psychiatry 2000; 68: 423–428.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Pezzella FR, Colosimo C, Vanacore N, Di Rezze S, Chianese M, Fabbrini G et al. Prevalence and clinical features of hedonistic homeostatic dysregulation in Parkinson's disease. Mov Disord 2005; 20: 77–81.

    Article  PubMed  Google Scholar 

  49. Lawrence AD, Evans AH, Lees AJ . Compulsive use of dopamine replacement therapy in Parkinson's disease: reward systems gone awry? Lancet Neurol 2003; 2: 595–604.

    Article  CAS  PubMed  Google Scholar 

  50. Katajamaki J, Honkanen A, Piepponen TP, Linden IB, Zharkovsky A, Ahtee L . Conditioned place preference induced by a combination of L-dopa and a COMT inhibitor, entacapone, in rats. Pharmacol Biochem Behav 1998; 60: 23–26.

    Article  CAS  PubMed  Google Scholar 

  51. van der Kooy D, Swerdlow NR, Koob GF . Paradoxical reinforcing properties of apomorphine: effects of nucleus accumbens and area postrema lesions. Brain Res 1983; 259: 111–118.

    Article  CAS  PubMed  Google Scholar 

  52. Papp M . Different effects of short- and long-term treatment with imipramine on the apomorphine- and food-induced place preference conditioning in rats. Pharmacol Biochem Behav 1988; 30: 889–893.

    Article  CAS  PubMed  Google Scholar 

  53. Hoffman DC, Dickson PR, Beninger RJ . The dopamine D2 receptor agonists, quinpirole and bromocriptine produce conditioned place preferences. Prog Neuropsychopharmacol Biol Psychiatry 1988; 12: 315–322.

    Article  CAS  PubMed  Google Scholar 

  54. Zito KA, Vickers G, Roberts DC . Disruption of cocaine and heroin self-administration following kainic acid lesions of the nucleus accumbens. Pharmacol Biochem Behav 1985; 23: 1029–1036.

    Article  CAS  PubMed  Google Scholar 

  55. Nocjar C, Panksepp J . Chronic intermittent amphetamine pretreatment enhances future appetitive behavior for drug- and natural-reward: interaction with environmental variables. Behav Brain Res 2002; 128: 189–203.

    Article  CAS  PubMed  Google Scholar 

  56. Fabbrini G, Brotchie JM, Grandas F, Nomoto M, Goetz CG . Levodopa-induced dyskinesias. Mov Disord 2007; 22: 1379–1389; quiz 1523.

    Article  PubMed  Google Scholar 

  57. Aubert I, Guigoni C, Hakansson K, Li Q, Dovero S, Barthe N et al. Increased D1 dopamine receptor signaling in levodopa-induced dyskinesia. Ann Neurol 2005; 57: 17–26.

    Article  CAS  PubMed  Google Scholar 

  58. Graybiel AM, Canales JJ, Capper-Loup C . Levodopa-induced dyskinesias and dopamine-dependent stereotypies: a new hypothesis. Trends Neurosci 2000; 23: S71–S77.

    Article  CAS  PubMed  Google Scholar 

  59. Randrup A, Munkvad I . Stereotyped activities produced by amphetamine in several animal species and man. Psychopharmacologia 1967; 11: 300–310.

    Article  CAS  PubMed  Google Scholar 

  60. Kamath S, Bajaj N . Crack dancing in the United Kingdom: apropos a video case presentation. Mov Disord 2007; 22: 1190–1191.

    Article  PubMed  Google Scholar 

  61. Pierce RC, Kalivas PW . A circuitry model of the expression of behavioral sensitization to amphetamine-like psychostimulants. Brain Res Brain Res Rev 1997; 25: 192–216.

    Article  CAS  PubMed  Google Scholar 

  62. Clark D, White FJ . D1 dopamine receptor--the search for a function: a critical evaluation of the D1/D2 dopamine receptor classification and its functional implications. Synapse 1987; 1: 347–388.

    Article  CAS  PubMed  Google Scholar 

  63. Ridley RM . The psychology of perserverative and stereotyped behaviour. Prog Neurobiol 1994; 44: 221–231.

    Article  CAS  PubMed  Google Scholar 

  64. Robinson TE, Becker JB . Enduring changes in brain and behavior produced by chronic amphetamine administration: a review and evaluation of animal models of amphetamine psychosis. Brain Res 1986; 396: 157–198.

    Article  CAS  PubMed  Google Scholar 

  65. Robbins TW, Everitt BJ . Functional studies of the central catecholamines. Int Rev Neurobiol 1982; 23: 303–365.

    Article  CAS  PubMed  Google Scholar 

  66. Gerfen CR . The neostriatal mosaic: compartmentalization of corticostriatal input and striatonigral output systems. Nature 1984; 311: 461–464.

    Article  CAS  PubMed  Google Scholar 

  67. Saka E, Goodrich C, Harlan P, Madras BK, Graybiel AM . Repetitive behaviors in monkeys are linked to specific striatal activation patterns. J Neurosci 2004; 24: 7557–7565.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Kashihara K, Imamura T . Amantadine may reverse punding in Parkinson's disease—observation in a patient. Mov Disord 2008; 23: 129–130.

    Article  PubMed  Google Scholar 

  69. Everitt BJ, Dickinson A, Robbins TW . The neuropsychological basis of addictive behaviour. Brain Res Brain Res Rev 2001; 36: 129–138.

    Article  CAS  PubMed  Google Scholar 

  70. Vanderschuren LJ, Di Ciano P, Everitt BJ . Involvement of the dorsal striatum in cue-controlled cocaine seeking. J Neurosci 2005; 25: 8665–8670.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  71. Graybiel AM, Aosaki T, Flaherty AW, Kimura M . The basal ganglia and adaptive motor control. Science 1994; 265: 1826–1831.

    Article  CAS  PubMed  Google Scholar 

  72. Volkow ND, Wang GJ, Telang F, Fowler JS, Logan J, Childress AR et al. Cocaine cues and dopamine in dorsal striatum: mechanism of craving in cocaine addiction. J Neurosci 2006; 26: 6583–6588.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Kalivas PW, Volkow ND . The neural basis of addiction: a pathology of motivation and choice. Am J Psychiatry 2005; 162: 1403–1413.

    Article  PubMed  Google Scholar 

  74. Di Chiara G, Bassareo V . Reward system and addiction: what dopamine does and doesn’t do. Curr Opin Pharmacol 2007; 7: 69–76.

    Article  CAS  PubMed  Google Scholar 

  75. Whishaw IQ, Fiorino D, Mittleman G, Castaneda E . Do forebrain structures compete for behavioral expression? Evidence from amphetamine-induced behavior, microdialysis, and caudate-accumbens lesions in medial frontal cortex damaged rats. Brain Res 1992; 576: 1–11.

    Article  CAS  PubMed  Google Scholar 

  76. Jentsch JD, Taylor JR . Impulsivity resulting from frontostriatal dysfunction in drug abuse: implications for the control of behavior by reward-related stimuli. Psychopharmacology (Berl) 1999; 146: 373–390.

    Article  CAS  Google Scholar 

  77. Volle E, Beato R, Levy R, Dubois B . Forced collectionism after orbitofrontal damage. Neurology 2002; 58: 488–490.

    Article  CAS  PubMed  Google Scholar 

  78. Mink JW . The basal ganglia: focused selection and inhibition of competing motor programs. Prog Neurobiol 1996; 50: 381–425.

    Article  CAS  PubMed  Google Scholar 

  79. Barnes J, Boubert L . Executive functions are impaired in patients with Parkinson's disease with visual hallucinations. J Neurol Neurosurg Psychiatry 2008; 79: 190–192.

    Article  CAS  PubMed  Google Scholar 

  80. Matochik JA, London ED, Eldreth DA, Cadet JL, Bolla KI . Frontal cortical tissue composition in abstinent cocaine abusers: a magnetic resonance imaging study. Neuroimage 2003; 19: 1095–1102.

    Article  PubMed  Google Scholar 

  81. Tucker KA, Potenza MN, Beauvais JE, Browndyke JN, Gottschalk PC, Kosten TR . Perfusion abnormalities and decision making in cocaine dependence. Biol Psychiatry 2004; 56: 527–530.

    Article  CAS  PubMed  Google Scholar 

  82. Braak H, Bohl JR, Muller CM, Rub U, de Vos RA, Del Tredici K . Stanley Fahn Lecture 2005: the staging procedure for the inclusion body pathology associated with sporadic Parkinson's disease reconsidered. Mov Disord 2006; 21: 2042–2051.

    Article  PubMed  Google Scholar 

  83. Anderson SW, Damasio H, Damasio AR . A neural basis for collecting behaviour in humans. Brain 2005; 128: 201–212.

    Article  PubMed  Google Scholar 

  84. Jankovic J . Motor fluctuations and dyskinesias in Parkinson's disease: clinical manifestations. Mov Disord 2005; 20 (Suppl 11): S11–S16.

    Article  PubMed  Google Scholar 

  85. Shin HS . Metabolism of selegiline in humans. Identification, excretion, and stereochemistry of urine metabolites. Drug Metab Dispos 1997; 25: 657–662.

    CAS  PubMed  Google Scholar 

  86. Levin FR, Evans SM, Coomaraswammy S, Collins ED, Regent N, Kleber HD . Flupenthixol treatment for cocaine abusers with schizophrenia: a pilot study. Am J Drug Alcohol Abuse 1998; 24: 343–360.

    Article  CAS  PubMed  Google Scholar 

  87. Grant JE, Kim SW . Medication management of pathological gambling. Minn Med 2006; 89: 44–48.

    PubMed  PubMed Central  Google Scholar 

  88. Nguyen FN, Pauly RR, Okun MS, Fernandez HH . Punding as a complication of brain stem stroke?: report of a case. Stroke 2007; 38: 1390–1392.

    Article  PubMed  Google Scholar 

  89. Thomas A, Iacono D, Luciano AL, Armellino K, Di Iorio A, Onofrj M . Duration of amantadine benefit on dyskinesia of severe Parkinson's disease. J Neurol Neurosurg Psychiatry 2004; 75: 141–143.

    CAS  PubMed  PubMed Central  Google Scholar 

  90. Durif F, Debilly B, Galitzky M, Morand D, Viallet F, Borg M et al. Clozapine improves dyskinesias in Parkinson disease: a double-blind, placebo-controlled study. Neurology 2004; 62: 381–388.

    Article  CAS  PubMed  Google Scholar 

  91. Rodrigues JP, Walters SE, Watson P, Stell R, Mastaglia FL . Globus pallidus stimulation in advanced Parkinson's disease. J Clin Neurosci 2007; 14: 208–215.

    Article  CAS  PubMed  Google Scholar 

  92. Shahed J, Poysky J, Kenney C, Simpson R, Jankovic J . GPI deep brain stimulation for Tourette syndrome improves tics and psychiatric comorbidities. Neurology 2007; 68: 159–160.

    Article  CAS  PubMed  Google Scholar 

  93. Meseguer Gancedo E, Garcia Ruiz P . Punding in Parkinson's disease. Neurologia 2002; 17: 228.

    CAS  PubMed  Google Scholar 

  94. Kumar S . Punding in Parkinson's disease related to high-dose levodopa therapy. Neurol India 2005; 53: 362.

    Article  PubMed  Google Scholar 

  95. Miwa H, Kondo T . Increased writing activity in Parkinson's disease: a punding-like behavior? Parkinsonism Relat Disord 2005; 11: 323–325.

    Article  PubMed  Google Scholar 

  96. Kummer A, Maia DP, Salgado JV, Cardoso FE, Teixeira AL . Dopamine dysregulation syndrome in Parkinson's disease: case report. Arq Neuropsiquiatr 2006; 64: 1019–1022.

    Article  PubMed  Google Scholar 

  97. Bonvin C, Horvath J, Christe B, Landis T, Burkhard PR . Compulsive singing: another aspect of punding in Parkinson's disease. Ann Neurol 2007; 62: 525–528.

    Article  PubMed  Google Scholar 

  98. O’Sullivan SS, Evans AH, Lees AJ . Punding in Parkinson's disease. Pract Neurol 2007; 7: 397–399.

    Article  PubMed  Google Scholar 

  99. Jenner P . Dopamine agonists, receptor selectivity and dyskinesia induction in Parkinson's disease. Curr Opin Neurol 2003; 16 (Suppl 1): S3–S7.

    Article  CAS  PubMed  Google Scholar 

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AF is partially funded by NEURECA ONLUS-Milan.

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  1. Department of Neuroscience, Catholic University of Sacred Heart, Rome, Italy

    A Fasano

  2. Institute of Neurology CSS, School of Medicine, Belgrade, Serbia

    I Petrovic

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Fasano, A., Petrovic, I. Insights into pathophysiology of punding reveal possible treatment strategies. Mol Psychiatry 15, 560–573 (2010). https://doi.org/10.1038/mp.2009.95

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