Neurofisiología de la hipersexualidad secundaria al tratamiento de enfermedad de Parkinson
Resumen
La hipersexualidad puede ser un síntoma secundario al tratamiento de la enfermedad de Parkinson (EP) y forma parte de algunos desórdenes en el control de impulsos en una proporción que va del 20-50% de los pacientes. En esta revisión analizamos las evidencias neurobiológicas que explican el incremento de la hipersexualidad durante el tratamiento con L-DOPA o agonistas dopaminergicos. Se llevó a cabo una búsqueda de información con los términos “Parkinson”, “Hypersexuality”, “Dopamine”, “Noradrenaline”, “L-DOPA”, “Brain”, “Impulse Control Disorders”, “Neurobiology”, buscadas en las bases de datos de PubMed, sciELO y Science Direct. La EP se caracteriza por la pérdida progresiva de neuronas dopaminérgicas de la parte compacta de la sustancia nigra y que proyectan al estriado, produciendo un desbalance en la capacidad motora. Al igual que hace 50 años el tratamiento actual para la EP redunda en el uso de agentes que eleven la disponibilidad de dopamina y otras aminas como la noradrenalina. El tratamiento con L-DOPA o agonistas específicos incrementa los niveles de actividad de dichas aminas incluso en estructuras cerebrales no claramente afectadas por la EP, como las proyecciones tubero-infundibulares y mesolímbicas. El incremento de actividad dopaminérgica en áreas específicas como el núcleo accumbens y el área preóptica/hipotálamo anterior puede explicar la hipersexualidad observada con el incremento súbito en los niveles de motivación y excitación sexual en pacientes tratados para la EP.
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DOI: https://doi.org/10.25009/eb.v6i13.2582
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