Abstract
Background: In Parkinson's disease (PD), impulse control disorders (ICDs) develop as side-effect of dopaminergic replacement therapy (DRT). Cognitive, affective, and motivational correlates of ICD in medicated PD patients are debated. Here, we systematically reviewed and meta-analyzed the evidence for an association between ICD in PD and cognitive, affective, and motivational abnormalities.Methods: A systematic review and meta-analysis was performed on PubMed, Science Direct, ISI Web of Science, Cochrane, EBSCO for studies published between 1-1-2000 and 8-3-2017 comparing cognitive, affective, and motivational measures in PD patients with ICD (ICD+) vs. those without ICD (ICD–). Exclusion criteria were conditions other than PD, substance and/or alcohol abuse, dementia, drug naïve patients, cognition assessed by self-report tools. Standardized mean difference (SMD) was used, and random-effect model applied.Results: 10,200 studies were screened (title, abstract), 79 full-texts were assessed, and 25 were included (ICD+: 625 patients; ICD–: 938). Compared to ICD–, ICD+ showed worse performance reward-related decision-making (0.42 [0.02, 0.82], p = 0.04) and set-shifting tasks (SMD = −0.49 [95% CI −0.78, −0.21], p = 0.0008). ICD in PD was also related to higher self-reported rate of depression (0.35 [0.16, 0.54], p = 0.0004), anxiety (0.43 [0.18, 0.68], p = 0.0007), anhedonia (0.26 [0.01, 0.50], p = 0.04), and impulsivity (0.79 [0.50, 1.09], p < 0.00001). Heterogeneity was low to moderate, except for depression (I2 = 61%) and anxiety (I2 = 58%).Conclusions: ICD in PD is associated with worse set-shifting and reward-related decision-making, and increased depression, anxiety, anhedonia, and impulsivity. This is an important area for further studies as ICDs have negative impact on the quality of life of patients and their caregivers.
Highlights
Impulse control disorders (ICDs), such as pathological gambling, hypersexuality, binge-eating and compulsive shopping, can occur in over 13% of medicatedParkinson’s disease (PD) patients [1]
impulse control disorder (ICD) in PD is associated with worse set-shifting and reward-related decision-making, and increased depression, anxiety, anhedonia and impulsivity. This is an important area for further studies as ICDs have negative impact on the quality of life of patients and their caregivers
A systematic review and meta-analysis were performed to identify cognitive, affective and motivational factors associated with ICD in PD under dopaminergic replacement therapy (DRT) (ICD+)
Summary
In Parkinson’s disease (PD), impulse control disorders (ICDs) develop as side-effect of dopaminergic replacement therapy (DRT). One hypothesis is that DRT overdoses less-severely affected dopamine-modulated circuits on which cognition, affect and motivation depend. Cognitive, affective and motivational correlates of ICD in medicated PD patients are debated. We systematically reviewed and metaanalyzed the evidence for an association between ICD in PD and cognitive, affective and motivational abnormalities
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
