Abstract
Although several case-control studies on the prevalence of Impulse-Control Disorders (ICDs) in Parkinson's Disease (PD) have been conducted, no meta-analytic study on this topic has previously been published. Thus, knowledge about the overall prevalence rate of ICD in PD and factors that might moderate this relationship is lacking. Prevalence studies of ICDs in PD were identified by computer searches in the MEDLINE, PsycINFO, and Web of Science databases, covering the period from January 2000 to February 2017. Data for N = 4,539, consisting of 2,371 PD patients and 2,168 healthy controls, representing 14 case-control studies were included. Estimation of the odds ratio (OR) of ICDs in PD compared to healthy controls was conducted using random-effects models. Mixed-effects models were applied in the moderator analysis of heterogeneity. Publication bias was estimated using a contour-enhanced funnel plot, the Rüker's test, and fail-safe N test for estimating the number of potential missing studies. Overall, the results showed significantly higher ratios for several ICDs in PD compared to healthy controls with the estimated overall ORs ranging between 2.07, 95% CI [1.26, 3.48], for having any ICDs, and 4.26, 95% CI [2.17, 8.36], for hypersexuality. However, the random-effects results for shopping were non-significant, though the fixed-effects model was significant (OR = 1.66, 95%CI [1.21, 2.27]). The testing of potential moderator variables of heterogeneity identified the following two variables that were both associated with increased risk: being medically treated for PD and disease duration. The results must be interpreted with some caution due to possible small-studies effect or publication bias. Individuals with PD seem to have a significantly greater risk of suffering from ICDs compared to healthy controls. Gambling, hypersexuality, eating, punding, and hobbying are all ICDs significantly associated with PDs being medically treated for PD.
Highlights
Impulse control disorders (ICDs) are a collective term for nonmotor symptoms that include pathological gambling, compulsive shopping, hypersexuality, and binge eating [1]
The studies were included if they fulfilled the following criteria: (a) the full article was published in English, (b) the article was published between the year 2000 and January 19, 2017, (c) the article had to contain original data on prevalence rates for ICDs and/or impulse-control disorders and related behaviors, and (d) the article had to be a case–control study or a case–control poster
Eleven studies reported which dopamine agonists (DAs) and mean dose were given to the patients, and nine studies reported levodopa usage and mean dose
Summary
Impulse control disorders (ICDs) are a collective term for nonmotor symptoms that include pathological gambling, compulsive shopping, hypersexuality, and binge eating [1]. Behavioral disorders such as hobbyism (including pathological internet use), punding, and walkabout have been reported in patients with Parkinson’s disease (PD) [2,3,4]. ICDs are behavioral addictions marked by an uncontrollable and irresistible drive or temptation to perform an action, even though this may be adverse to oneself or others. Such behaviors are often performed without the patient experiencing distress [5]. Several case–control studies on the prevalence of ImpulseControl Disorders (ICDs) in Parkinson’s Disease (PD) have been conducted, no metaanalytic study on this topic has previously been published. Knowledge about the overall prevalence rate of ICD in PD and factors that might moderate this relationship is lacking
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