scholarly journals Non-motor symptom burden in patients with Parkinson’s disease with impulse control disorders and compulsive behaviours: results from the COPPADIS cohort

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
S. Jesús ◽  
◽  
M. A. Labrador-Espinosa ◽  
A. D. Adarmes ◽  
C. Méndel-Del Barrio ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Impulse Control ◽  
Dopamine Agonists ◽  
Rating Scale ◽  
Disease Onset ◽  
Impulse Control Disorders ◽  
Nonmotor Symptoms ◽  
Premorbid Personality ◽  
Validated Questionnaire

Abstract The study was aimed at analysing the frequency of impulse control disorders (ICDs) and compulsive behaviours (CBs) in patients with Parkinson’s disease (PD) and in control subjects (CS) as well as the relationship between ICDs/CBs and motor, nonmotor features and dopaminergic treatment in PD patients. Data came from COPPADIS-2015, an observational, descriptive, nationwide (Spain) study. We used the validated Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS) for ICD/CB screening. The association between demographic data and ICDs/CBs was analyzed in both groups. In PD, this relationship was evaluated using clinical features and treatment-related data. As result, 613 PD patients (mean age 62.47 ± 9.09 years, 59.87% men) and 179 CS (mean age 60.84 ± 8.33 years, 47.48% men) were included. ICDs and CBs were more frequent in PD (ICDs 12.7% vs. 1.6%, p < 0.001; CBs 7.18% vs. 1.67%, p = 0.01). PD patients had more frequent previous ICDs history, premorbid impulsive personality and antidepressant treatment (p < 0.05) compared with CS. In PD, patients with ICDs/CBs presented younger age at disease onset, more frequent history of previous ICDs and premorbid personality (p < 0.05), as well as higher comorbidity with nonmotor symptoms, including depression and poor quality of life. Treatment with dopamine agonists increased the risk of ICDs/CBs, being dose dependent (p < 0.05). As conclusions, ICDs and CBs were more frequent in patients with PD than in CS. More nonmotor symptoms were present in patients with PD who had ICDs/CBs compared with those without. Dopamine agonists have a prominent effect on ICDs/CBs, which could be influenced by dose.

scholarly journals Dopamine and reward hypersensitivity in Parkinson’s disease with impulse control disorder

Brain ◽  
2020 ◽  
Vol 143 (8) ◽  
pp. 2502-2518
Author(s):  
Daniel S Drew ◽  
Kinan Muhammed ◽  
Fahd Baig ◽  
Mark Kelly ◽  
Youssuf Saleh ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Impulse Control ◽  
Dopamine Agonists ◽  
Impulse Control Disorders ◽  
Reward Sensitivity ◽  
Impulse Control Disorder ◽  
Dopaminergic Medication ◽  
Neuropsychiatric Complications ◽  
Pupillary Responses

Abstract Impulse control disorders in Parkinson’s disease are common neuropsychiatric complications associated with dopamine replacement therapy. Some patients treated with dopamine agonists develop pathological behaviours, such as gambling, compulsive eating, shopping, or disinhibited sexual behaviours, which can have a severe impact on their lives and that of their families. In this study we investigated whether hypersensitivity to reward might contribute to these pathological behaviours and how this is influenced by dopaminergic medication. We asked participants to shift their gaze to a visual target as quickly as possible, in order to obtain reward. Critically, the reward incentive on offer varied over trials. Motivational effects were indexed by pupillometry and saccadic velocity, and patients were tested ON and OFF dopaminergic medication, allowing us to measure the effect of dopaminergic medication changes on reward sensitivity. Twenty-three Parkinson’s disease patients with a history of impulse control disorders were compared to 26 patients without such behaviours, and 31 elderly healthy controls. Intriguingly, behavioural apathy was reported alongside impulsivity in the majority of patients with impulse control disorders. Individuals with impulse control disorders also exhibited heightened sensitivity to exogenous monetary rewards cues both ON and OFF (overnight withdrawal) dopamine medication, as indexed by pupillary dilation in anticipation of reward. Being OFF dopaminergic medication overnight did not modulate pupillary reward sensitivity in impulse control disorder patients, whereas in control patients reward sensitivity was significantly reduced when OFF dopamine. These effects were independent of cognitive impairment or total levodopa equivalent dose. Although dopamine agonist dose did modulate pupillary responses to reward, the pattern of results was replicated even when patients with impulse control disorders on dopamine agonists were excluded from the analysis. The findings suggest that hypersensitivity to rewards might be a contributing factor to the development of impulse control disorders in Parkinson’s disease. However, there was no difference in reward sensitivity between patient groups when ON dopamine medication, suggesting that impulse control disorders may not emerge simply because of a direct effect of dopaminergic drug level on reward sensitivity. The pupillary reward sensitivity measure described here provides a means to differentiate, using a physiological measure, Parkinson’s disease patients with impulse control disorder from those who do not experience such symptoms. Moreover, follow-up of control patients indicated that increased pupillary modulation by reward can be predictive of the risk of future emergence of impulse control disorders and may thereby provide the potential for early identification of patients who are more likely to develop these symptoms.

scholarly journals Analysis of Impulse Control Disorders (ICDs) and Factors Associated with Their Development in a Parkinson’s Disease Population

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1263
Author(s):  
Mauricio Iván García-Rubio ◽  
María Elisa Otero-Cerdeira ◽  
Christian Gabriel Toledo-Lozano ◽  
Sofía Lizeth Alcaraz-Estrada ◽  
Juan Antonio Suárez-Cuenca ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Binge Eating ◽  
Impulse Control ◽  
Dopamine Agonists ◽  
Protective Factor ◽  
Impulse Control Disorders ◽  
Compulsive Shopping ◽  
Factors Associated ◽  
Clinical Records

Parkinson’s disease (PD) is a neurodegenerative disease in which non-motor symptoms may appear before motor phenomena, which include Impulse Control Disorders (ICDs). The objective of this study is to identify factors associated with the development of ICDs in PD. An analytical, cross-sectional study was conducted using clinical records from patients diagnosed with PD, both genders, from 40 to 80 years old. Clinical and demographic data were collected: 181 patients were recruited; 80 of them showed PD and ICDs, and they constituted the study group, whereas 101 patients with PD without ICDs constituted the control reference group. The duration of PD was longer in the group with ICDs (p < 0.008), and all patients showed at least one ICD: binge eating (61.29%), compulsive shopping (48.75%), hypersexuality (23.75%), gambling behavior (8.75%), and punding (3.75%). After logistic regression analysis, only the use of dopamine agonists remained associated with ICDs (p < 0.001), and the tremorgenic form was suggested to be a protective factor (p < 0.001). Positive associations were observed between the rigid-akinetic form and compulsive shopping (p < 0.007), between male and hypersexuality (p < 0.018), and between dopamine agonists and compulsive shopping (p < 0.004), and negative associations were observed between motor fluctuations and compulsive shopping (p < 0.031), between Deep Brain Stimulation and binge eating (p < 0.046), and between levodopa consumption and binge eating (p < 0.045). Binge eating, compulsive shopping, and hypersexuality were the most frequent ICDs. Complex forms and motor complications of PD were associated with the development of ICDs.

Apathy and impulse control disorders association: A study in a sample of Parkinson's disease patients

2016 ◽  
Vol 33 (S1) ◽  
pp. S396-S396
Author(s):  
N. Sáez-Francàs ◽  
N. Ramirez ◽  
J. Alegre-Martin ◽  
O. De Fabregues ◽  
J. Alvarez-Sabin ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Trait Anxiety ◽  
Impulse Control ◽  
Rating Scale ◽  
Neurodegenerative Disorder ◽  
Linear Regression Analysis ◽  
Impulse Control Disorders ◽  
Hamilton Depression Scale ◽  
Wide Range

IntroductionParkinson's disease (PD) is a neurodegenerative disorder that is associated with a wide range of motor symptoms, cognitive deficits and behavioral disorders. Apathy and impulse control disorders (ICDs) are common in these patients and have been considered opposite ends of a reward and motivation disorders continuum.AimTo evaluate the association and impact of ICDs presence on apathy symptoms in PDs patients, considering the influence of other psychopathological symptoms on this association.MethodsThis is a cross-sectional, observational study in which 115 consecutive medicated PD patients without dementia (mean age 61.22 ± 13.5 years; 63.5% men) were recruited. All the patients underwent a psychiatric and neurologic evaluation. Motor dysfunction was assessed with the Unified Parkinson's disease Rating Scale (UPDRS), ICDs were evaluated with the Minnesota Impulse Control Disorders Inventory (MIDI) and apathy with the Lille Apathy Scale (LARS). The Hamilton Depression scale (HAM-D). The State-Trait Anxiety Inventory (STAI-S) and Barrat Impulsivity Scale (BIS) were also administrated.ResultsTwenty-seven (23.5%) patients showed an ICD. Patients with an ICD scored higher in apathy (P = 0.012), trait anxiety (P = 0.003) and impulsivity (P = 0.008). There were no differences in depressive symptoms. In the linear regression analysis, TCI was associated with more severe apathy (b = 4.20, t = 2.15, P = 0.034).ConclusionsICDs and apathy are frequent in PD. Although ICDs have been related with a hyperdopaminergic state and apathy with low dopamine levels, the observed frequent association suggests common etiopathological mechanisms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Dopamine agonists and risk: impulse control disorders in Parkinson's; disease

Brain ◽  
2011 ◽  
Vol 134 (5) ◽  
pp. 1438-1446 ◽  
Author(s):  
Valerie Voon ◽  
Jennifer Gao ◽  
Christina Brezing ◽  
Mkael Symmonds ◽  
Vindhya Ekanayake ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Impulse Control ◽  
Dopamine Agonists ◽  
Impulse Control Disorders

scholarly journals Impulse control disorders in Parkinson’s disease

2021 ◽  
Vol 21 (1) ◽  
pp. 30-35
Author(s):  
Mateusz Toś
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Impulse Control ◽  
Atypical Antipsychotics ◽  
Disease Onset ◽  
Impulse Control Disorders ◽  
Motor Symptoms ◽  
Mesolimbic Pathway ◽  
Non Motor Symptoms ◽  
Antiparkinsonian Drugs

Parkinson’s disease is a neurodegenerative disease characterised by typical motor symptoms and a range of non-motor symptoms, among which impulse control disorders, defined by an inability to resist temptations, impulses or urges, despite them being potentially harmful to the patient or caregivers, are gaining an increasing research interest. The most common compulsive activities include pathological gambling, hyper-sexuality, compulsive buying, and binge eating. The prevalence of impulse control disorders varies greatly depending on the country where the study was conducted, probably due to cultural and socioeconomic factors or the research methods used. Non-ergotamine dopamine agonists, and to a lesser extent highdose L-dopa and other antiparkinsonian drugs, are considered to be major risk factors for the development of impulse control disorders. Young age of patients, male gender, and early age of disease onset also increase the risk of developing this type of disorder. A probable cause of impulse control disorders is a state of dopaminergic overstimulation within the mesolimbic pathway and frontal-striatal circuit. The management of impulse control disorders is particularly challenging in view of the possible worsening of motor symptoms. The primary strategy remains dose reduction, discontinuation or switching from a dopamine agonist to another drug. If this type of intervention has failed, it is advisable to add atypical antipsychotics or antiepileptic drugs. Because of the low detection rate of impulse control disorders and their potentially devastating impact on patients’ personal and family lives, every clinician managing patients with Parkinson’s disease should be particularly vigilant for the presence of such disorders.

scholarly journals Piribedil and Pathological Gambling in six Parkinsonian patients

2015 ◽  
Vol 73 (2) ◽  
pp. 115-118 ◽  
Author(s):  
Federico E. Micheli ◽  
Juan C. Giugni ◽  
Micke E. De Arco Espinosa ◽  
Daniela S. Calvo ◽  
Gabriela B. Raina
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Differential Diagnosis ◽  
Pathological Gambling ◽  
Impulse Control ◽  
Dopamine Agonists ◽  
Case Reports ◽  
Impulse Control Disorders

Impulse control disorders (ICD) in Parkinson's disease (PD) have attracted increasing interest. They are characterized by the inability to control the impulse to perform an act that can be detrimental to them or to others. Although dopamine agonists (DA), as a group, have been associated with impulse control disorders (ICD), piribedil has rarely been reported to cause them. Method Case reports of six parkinsonian patients on piribedil presenting pathological gambling (PG). Results All of the patients presented ICD associated with piribedil use. Two of them received this medication as first treatment and four of them who had developed ICDs secondary to other DA that reappeared with piribedil. Conclusion Despite piribedil is commercially available in only a few countries, it should be considered in the differential diagnosis of PG in patients with PD.

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