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.
Highlights
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
ICDs and CBs were more frequent in patients with PD compared with the CS (ICDs 12.7% vs. 1.6%, respectively, p < 0.001; CBs 7.18% vs. 1.67%, respectively, p = 0.01)
In COPPADIS, we found a high rate of depression as well as a poorer perception of mood disturbances according to the Non-Motor Symptoms Scale (NMSS), PDQ-39 and Neuropsychiatry Inventory (NPI)
Summary
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. 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. Epidemiologic factors such as sex, age and age at onset could influence the incidence of ICDs and CBs1 It is controversial whether these disorders are exclusively linked to the first years of disease evolution when patients still have an integrum ventral s triatum[2], or whether they are associated with longer exposure to dopamine t reatment[3]. Under external dopaminergic stimulation by DRT, the regulation of mesocorticolimbic pathway activity might be inappropriate, inducing an aberrant response to reward tasks and impulsivity traits[9] Despite this fact, not all patients undergoing DRT treatment have ICDs or CBs, suggesting the action of a neurobiological substrate leading to individual susceptibility[5]. There is controversy regarding DA dose and ICDs, given it is not fully understood whether the ICDs are associated with the DA dose alone or in combination with the dose of levodopa and other dopaminergic drugs[2,3,12]
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