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J Neurol Neurosurg Psychiatry. 1996 April; 60(4): 416–421.
PMCID: PMC1073895

Motivational deficits after brain injury: effects of bromocriptine in 11 patients.

Abstract

OBJECTIVE: To test the hypothesis that treatment with bromocriptine would ameliorate deficits in clinical motivation, responsiveness to reward, and frontal cognitive function after brain injury. METHOD: An open trial in six men and five women who had had either traumatic brain injury or subarachnoid haemorrhage between two months and five years previously. After repeated baseline assessments, bromocriptine was given in gradually increasing doses. Assessments were repeated at increasing doses, during maintenance, and after withdrawal. Novel structured instruments for quantifying motivation were developed; measures of anxiety and depression, and cognitive tests sensitive to motivation or frontal lobe involvement were also given. RESULTS: Bromocriptine treatment was followed by improved scores on all measures other than mood. Improvement was maintained after bromocriptine withdrawal in eight of the patients. CONCLUSION: Poor motivation in patients with brain injury may result from dysfunction in the mesolimbic/mesocortical dopaminergic circuitry, giving rise to associated deficiencies in reward responsiveness and frontal cognitive function.

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Selected References

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  • Vilkki J, Ahola K, Holst P, Ohman J, Servo A, Heiskanen O. Prediction of psychosocial recovery after head injury with cognitive tests and neurobehavioral ratings. J Clin Exp Neuropsychol. 1994 Jun;16(3):325–338. [PubMed]
  • Levin HS, High WM, Goethe KE, Sisson RA, Overall JE, Rhoades HM, Eisenberg HM, Kalisky Z, Gary HE. The neurobehavioural rating scale: assessment of the behavioural sequelae of head injury by the clinician. J Neurol Neurosurg Psychiatry. 1987 Feb;50(2):183–193. [PMC free article] [PubMed]
  • Ross ED, Stewart RM. Akinetic mutism from hypothalamic damage: successful treatment with dopamine agonists. Neurology. 1981 Nov;31(11):1435–1439. [PubMed]
  • Echiverri HC, Tatum WO, Merens TA, Coker SB. Akinetic mutism: pharmacologic probe of the dopaminergic mesencephalofrontal activating system. Pediatr Neurol. 1988 Jul-Aug;4(4):228–230. [PubMed]
  • Barrett K. Treating organic abulia with bromocriptine and lisuride: four case studies. J Neurol Neurosurg Psychiatry. 1991 Aug;54(8):718–721. [PMC free article] [PubMed]
  • Parks RW, Crockett DJ, Manji HK, Ammann W. Assessment of bromocriptine intervention for the treatment of frontal lobe syndrome: a case study. J Neuropsychiatry Clin Neurosci. 1992 Winter;4(1):109–111. [PubMed]
  • Müller U, von Cramon DY. The therapeutic potential of bromocriptine in neuropsychological rehabilitation of patients with acquired brain damage. Prog Neuropsychopharmacol Biol Psychiatry. 1994 Nov;18(7):1103–1120. [PubMed]
  • Nickels JL, Schneider WN, Dombovy ML, Wong TM. Clinical use of amantadine in brain injury rehabilitation. Brain Inj. 1994 Nov-Dec;8(8):709–718. [PubMed]
  • Van Reekum R, Bayley M, Garner S, Burke IM, Fawcett S, Hart A, Thompson W. N of 1 study: amantadine for the amotivational syndrome in a patient with traumatic brain injury. Brain Inj. 1995 Jan;9(1):49–53. [PubMed]
  • Lindvall O, Björklund A, Divac I. Organization of catecholamine neurons projecting to the frontal cortex in the rat. Brain Res. 1978 Feb 17;142(1):1–24. [PubMed]
  • Robertson A, Mogenson GJ. Evidence for a role for dopamine in self-stimulation of the nucleus accumbens of the rat. Can J Psychol. 1978 Jun;32(2):67–76. [PubMed]
  • Bozarth MA, Wise RA. Intracranial self-administration of morphine into the ventral tegmental area in rats. Life Sci. 1981 Feb 2;28(5):551–555. [PubMed]
  • Bozarth MA, Wise RA. Heroin reward is dependent on a dopaminergic substrate. Life Sci. 1981 Nov 2;29(18):1881–1886. [PubMed]
  • Fiorino DF, Coury A, Fibiger HC, Phillips AG. Electrical stimulation of reward sites in the ventral tegmental area increases dopamine transmission in the nucleus accumbens of the rat. Behav Brain Res. 1993 Jun 30;55(2):131–141. [PubMed]
  • Yoshida M, Yokoo H, Mizoguchi K, Kawahara H, Tsuda A, Nishikawa T, Tanaka M. Eating and drinking cause increased dopamine release in the nucleus accumbens and ventral tegmental area in the rat: measurement by in vivo microdialysis. Neurosci Lett. 1992 May 11;139(1):73–76. [PubMed]
  • Pfaus JG, Phillips AG. Role of dopamine in anticipatory and consummatory aspects of sexual behavior in the male rat. Behav Neurosci. 1991 Oct;105(5):727–743. [PubMed]
  • Wise RA. Catecholamine theories of reward: a critical review. Brain Res. 1978 Aug 25;152(2):215–247. [PubMed]
  • Thierry AM, Tassin JP, Blanc G, Glowinski J. Selective activation of mesocortical DA system by stress. Nature. 1976 Sep 16;263(5574):242–244. [PubMed]
  • Salamone JD. The involvement of nucleus accumbens dopamine in appetitive and aversive motivation. Behav Brain Res. 1994 Apr 18;61(2):117–133. [PubMed]
  • Weddell RA, Weiser R. A double-blind cross-over placebo-controlled trial of the effects of bromocriptine on psychomotor function, cognition, and mood in de novo patients with Parkinson's disease. Behav Pharmacol. 1995 Jan;6(1):81–91. [PubMed]
  • Brown AS, Gershon S. Dopamine and depression. J Neural Transm Gen Sect. 1993;91(2-3):75–109. [PubMed]
  • Goodwin FK, Sack RL. Central dopamine function in affective illness: evidence from precursors, enzyme inhibitors, and studies of central dopamine turnover. Adv Biochem Psychopharmacol. 1974;12(0):261–279. [PubMed]
  • Praag HM, Korf J, Lakke JPWF, Schut T. Dopamine metabolism in depressions, psychoses, and Parkinson's disease: the problem of the specificity of biological variables in behaviour disorders. Psychol Med. 1975 May;5(2):138–146. [PubMed]
  • Burton K, Calne DB. Pharmacology of Parkinson's disease. Neurol Clin. 1984 Aug;2(3):461–472. [PubMed]
  • Levi-Minzi S, Bermanzohn PC, Siris SG. Bromocriptine for "negative" schizophrenia. Compr Psychiatry. 1991 May-Jun;32(3):210–216. [PubMed]
  • Richards PM, Ruff RM. Motivational effects on neuropsychological functioning: comparison of depressed versus nondepressed individuals. J Consult Clin Psychol. 1989 Jun;57(3):396–402. [PubMed]
  • Buschke H, Fuld PA. Evaluating storage, retention, and retrieval in disordered memory and learning. Neurology. 1974 Nov;24(11):1019–1025. [PubMed]
  • Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361–370. [PubMed]

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