The rise and fall of impulse control behavior disorders

Abstract

IntroductionImpulse control disorders (ICDs) are psychiatric disorders characterized by the failure to resist an impulse or by the temptation to perform an act that is harmful to oneself or to others. MethodsICDs, including pathological gambling, hypersexuality, compulsive eating and shopping, can occur as a complication of Parkinson's disease (PD) together with other behavioral disorders, including dopamine dysregulation syndrome. This review is based on a literature search updated to May 2017, focusing on the epidemiology, clinical features, and therapeutic options of ICDs associated with PD. ResultsStudies on the prevalence of ICDs confirm that they represent common phenomena associated with PD, with some centers reporting up to 40% of the PD population affected; the relative prevalence of the main ICDs shows significant variability, with a majority of the studies reporting that hypersexuality is the commonest one. Risk factors associated with the development of ICDs in PD were systematically evaluated, confirming the correlation between these disorders and male gender, younger age at PD onset and family history for addiction. ConclusionsWe will discuss the recent advances on the functional neuroanatomy, the role of dopamine-serotonin interactions and the cognitive profile associated with ICDs. Management of PD-related ICDs is still based on poor evidence, and this topic should be the object for future research