Abstract
Background: To establish the frequency of impulse control disorder (ICD) in Parkinson's disease (PD).Methods: Within the Luxembourg Parkinson's Study, PD patients were evaluated for ICD presence (score ≥ 1 on MDS-UPDRS I item 1.6), use of dopamine agonists (DA) and other medications.Results: 470 patients were enrolled. Among 217 patients without DA use, 6.9% scored positive for ICD, vs. 15.4% among 253 patients with DA use (p = 0.005). The regression analysis showed that age at PD diagnosis had only a minor impact on ICD occurrence, while there was no influence by gender or co-medications. The longitudinal study over 2 years in 156 patients demonstrated increasing ICD frequency in DA users (p = 0.005).Conclusion: This large and non-interventional study confirms that PD patients with DA treatment show higher frequency of ICD than patients without DA use. It newly demonstrates that ICD can develop independently from age, gender, or co-medications.
Highlights
Impulse control disorder (ICD) has been described by the World Health Organization (WHO) in 1992 as “repeated acts that have no clear rational motivation, generally harm the person’s own interests and those of other people, and are associated with impulses the person experiences as uncontrollable” [1].Following the WHO definition, four types of ICD have been defined: binge eating, excessive shopping, pathological gambling and hypersexuality [2, 3]
Subjects were eligible for the study when fulfilling the following criteria: Parkinson’s disease (PD) diagnosis based on the UK PD Society Brain Bank criteria [17] and a score of ≥18 points on the Montreal Cognitive Assessment (MoCA) [18] in order to ensure sufficient comprehension of the questionnaires used
dopamine agonists (DA)+ were younger at PD diagnosis than DA– (58.5 [27.2–78.4] vs. 61.2 [31.3–79.4] years; p = 0.001) and had a longer disease duration (8.1 [0–34] vs. 5.7 [0–26] years, p < 0.001)
Summary
Impulse control disorder (ICD) has been described by the World Health Organization (WHO) in 1992 as “repeated acts that have no clear rational motivation, generally harm the person’s own interests and those of other people, and are associated with impulses the person experiences as uncontrollable” [1].Following the WHO definition, four types of ICD have been defined: binge eating, excessive shopping, pathological gambling and hypersexuality [2, 3]. Pilot studies on ICD in PD have proposed to classify hobbyism and sometimes punding under the ICD umbrella [4, 5]. The latter behaviors may reflect perturbed impulse-control, they are less strictly defined and are frequently overlapping with normal behavior [6]. The frequency of ICD in de novo PD patients is similar to the general population [5], but numerous studies reported higher frequency during the course of the disease [8,9,10,11,12]. To establish the frequency of impulse control disorder (ICD) in Parkinson’s disease (PD)
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