Clinical characteristics of impulse control and related disorders in Chinese Parkinson’s disease patients

Abstract

BackgroundImpulse control and related disorders (ICRDs) are clinically complications in Parkinson’s disease (PD). However, the clinical characteristics of ICRDs in Chinese PD patients were rarely reported. We aimed to explore the prevalence and the clinical profile of ICRDs in Chinese patients with PD.Methods142 Chinese PD patients were consecutively enrolled. The symptoms of ICRDs were assessed with the Questionnaire for Impulsive-Compulsive Disorders. The clinical characteristics of patients with ICRDs and without ICRDs were compared.ResultsICRDs were present in 31% of our patients. The most common ICRDs were compulsive medication use (11.3%) and punding (9.2%); the least frequent were walkabout (1.4%). Variables independently associated with ICRDs were earlier onset of the disease (≤55 years), severe cognitive impairment (MMSE 10–20), the dose of dopamine agonist (>1 mg/d) and dyskinesia.ConclusionsICRDs was commonly found in Chinese PD patients. Earlier onset of the disease, the dose of dopamine agonist, severe cognitive impairment and dyskinesia are independent factors associated with ICRDs. Our results will be benefit for clinicians to assess the risk of developing ICRDs before delivering dopaminergic medication.

Impulse control and related disorders in Parkinson’s disease

“…Very low prevalence rates of 3.53% for ICDs were reported in a Chinese study (hypersexuality 1.92%; gambling disorder 0.32%; binge eating 0.32%; problematic Internet use 0.32%) 25 . These results are not consistent with findings for Shanghai (global prevalence of ICDs of 31%; gambling disorder and binge eating being the most prevalent) 26 and Hong Kong (global prevalence 7%; gambling disorder and hypersexuality being the most frequent types) 27 . In Taiwan, the reported prevalence of ICDs among patients with PD was lower, at 4.49% (hypersexuality 2.99%; gambling disorder 1.49%; binge eating 0.37%) 28 .…”

“…In Taiwan, the reported prevalence of ICDs among patients with PD was lower, at 4.49% (hypersexuality 2.99%; gambling disorder 1.49%; binge eating 0.37%) 28 . A less widespread use of levodopa and DAs, methodological, cultural and demographic differences-even within the same country or ethnic group-may account for such discrepancies 25,26,27,28 .…”

“…Greater interest in gastronomy and the meaning attributed to meals as factors of social cohesion may explain the increased prevalence of binge eating in Latin European and American countries 15,20,30,31,32 . Compulsive buying seems to occur more frequently in industrialized countries, where consumerism is more developed and credit is more easily available 26 . Patients with low incomes, or residing in locations with scarce social security resources, may not have the economic conditions required to engage in gambling or shopping, thus they channel impulsivity to other types of behaviors 32 .…”

“…The association of ICDs and the use of DAs exhibits more of a class effect 14 . The ICDs were associated with use of pramipexole, pergolide, ropinirole, bromocriptine, apomorphine, rotigotine and piribedil 14,16,19,24,25,26,27,30,35 . The frequency of ICDs was similar for pramipexole and ropinirole in the DOMINION study (17.7% versus 15.5%) 14 .…”

A clinical and genetic study of impulsive-compulsive disorders in patients with Parkinson's disease

“…По данным эпидемиологических исследований, частота ИКР у пациентов с БП варьирует в широких пределах (от 3,5 до 42,8%) [6,7], что связано с использованием разных дизайнов исследований, опросников, шкал, культурными, социальными, экономическими особенностями [8][9][10]. Риск развития ИКР определяет целый ряд факторов: мужской пол, молодой возраст, ранний дебют БП, уровень образования, семейное положение, злоупотребление алкоголем, курение, наличие в анамнезе ИКР, депрессии [6,[11][12][13][14][15][16][17]. В ряде работ [18][19][20] отмечена связь между развитием ИКР и приемом дофаминергических препаратов, прежде всего агонистов дофаминовых рецепторов (АДР) и леводопы.…”