Abstract
IntroductionImpulse control behaviors (ICBs) are impulsive–compulsive behaviors often associated with dopamine replacement therapy in Parkinson's disease (PD). Although remission can occur in ICB, only four reports on the ratio of remission and the persistence of ICB have been published, and the associated factors with ICB remission or persistence have been little known. Therefore, we conducted a longitudinal assessment of the remission, persistence, and development of ICB and those associated factors in patients with PD.MethodsWe retrospectively investigated a PD database at Aomori Prefectural Central Hospital, Japan. One hundred and forty‐eight patients with PD who could be followed up for 2 years were enrolled. ICB was assessed using the Questionnaire for Impulsive–Compulsive Disorders in Parkinson's disease. Motor severity (Hoehn and Yahr scale and United Parkinson's Disease Rating Scale), cognitive function (Mini–Mental State Examination), and other clinical variables (sex, age, onset age, disease duration, olfactory dysfunction, and dyskinesia) and medications used to treat PD were assessed. Univariate analyses were performed.ResultsSeven patients were excluded because of the exclusion criteria, and 141 patients were analyzed. Thirty patients (21.3%) had ICB at baseline, and these patients also had significantly higher use of pergolide. The ICB remission rate was 60%, the ICB persistence ratio was 40%, and the ICB development ratio was 12.6% over 2 years. Statistically, younger age and pergolide use were associated with ICB persistence. Being male, having dyskinesia, and rotigotine, entacapone, zonisamide, and istradefylline use were associated with ICB development.ConclusionThis study suggests that younger age and pergolide use may be the new associated factors with ICB persistence and that entacapone, zonisamide, and istradefylline use may be associated with the development of ICB. Drug profiles and medication practices in Japan may explain the association of these factors with ICB.
Highlights
Impulse control behaviors (ICBs) are impulsive–compulsive behaviors often associated with dopamine replacement therapy in Parkinson’s disease (PD)
We retrospectively investigated sequential outpatients with PD using a computerized medical database of the movement disorder clinic at Aomori Prefectural Central Hospital, Aomori, which is a regional tertiary center located in northern territory of Japan
The ICB remission ratio in PD was found to range from 40% over a 3.5-year follow-up period by Siri et al (2015) in Italy, 58.1% over 12.1 months by Avila et al (2011) in Spain, 72.7% over 43.2 months by Sohtaoglu et al (2010) in Turkey to 73.3% over 29.2 months by Mamikonyan et al (2008) in the United States
Summary
Impulse control disorder (ICD) generally refers to four major disorders: pathological gambling, compulsive sexual behavior, compulsive buying, and binge eating. Previous studies have shown that dopamine agonist (DA) use is the most consistent predictor of ICB (Weintraub, Koester, et al, 2010; Weintraub, et al, 2015; Zurowski & O’Brien, 2015). The factors associated with ICB remission were reduction in DA use (Avila et al, 2011), lower DA dosage (Mamikonyan et al, 2008; Sohtaoglu et al, 2010), and better working memory performance (Bastiaens et al, 2013). We conducted a longitudinal case–control study of the remission, persistence, and development of ICB and its associated factors, in relation to medication in patients with PD
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