Clinical spectrum of impulse control disorders in Parkinson's disease

Abstract

Impulse control disorders (ICDs), including compulsive gambling, buying, sexual behavior, and eating, are a serious and increasingly recognized psychiatric complication in Parkinson's disease (PD). Other impulsive-compulsive behaviors (ICBs) have been described in PD, including punding (stereotyped, repetitive, purposeless behaviors) and dopamine dysregulation syndrome (DDS; compulsive PD medication overuse). ICDs have been most closely related to the use of dopamine agonists (DAs), perhaps more so at higher doses; in contrast, DDS is primarily associated with shorter-acting, higher-potency dopaminergic medications, such as apomorphine and levodopa. Possible risk factors for ICDs include male sex, younger age and younger age at PD onset, a pre-PD history of ICDs, and a personal or family history of substance abuse, bipolar disorder, or gambling problems. Given the paucity of treatment options and potentially serious consequences, it is critical for PD patients to be monitored closely for development of ICDs as part of routine clinical care.

The factors associated with impulse control behaviors in Parkinson's disease: A 2‐year longitudinal retrospective cohort study

“…Overall, patients in the ICB persister group were younger, pergolide use than ICB remitters. Younger age and pergolide use have been reported to be risk factors for the development of ICB (Antonini et al., 2017; Weintraub et al., 2006, 2015; Zurowski & O'Brien, 2015). Our findings suggest that these factors may also be related to the persistence of ICB.…”

“…The prevalence of ICD or ICB has been reported to be 3.5%–58.3% in patients with Parkinson's disease (PD) (Antonini et al., 2017; Callesen, Weintraub, Damholdt, & Moller, 2014; Erga, Alves, Larsen, Tysnes, & Pedersen, 2017; Fan, Ding, Ma, & Chan, 2009; Rodriguez‐Violante, Gonzalez‐Latapi, Cervantes‐Arriaga, Camacho‐Ordonez, & Weintraub, 2014; Vela et al., 2016). ICB is an important nonmotor complication in patients with PD because it is associated with functional impairment, decreased quality of life and increased caregiver burden (Weintraub, David, Evans, Grant, & Stacy, 2015). 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).…”

“…ICB is an important nonmotor complication in patients with PD because it is associated with functional impairment, decreased quality of life and increased caregiver burden (Weintraub, David, Evans, Grant, & Stacy, 2015). 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). ICB is also independently associated with younger age, younger age at PD onset, previous ICB history, family history of gambling disorders, concurrent cigarette smoking, unmarried status, depression, anxiety, alcohol use, novelty‐seeking traits, higher DA dosage, combination DA and L‐DOPA therapy, and higher L‐dopa doses (Weintraub, Koester, et al., 2010; Weintraub, et al., 2015; Zurowski & O'Brien, 2015).…”

“…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). ICB is also independently associated with younger age, younger age at PD onset, previous ICB history, family history of gambling disorders, concurrent cigarette smoking, unmarried status, depression, anxiety, alcohol use, novelty‐seeking traits, higher DA dosage, combination DA and L‐DOPA therapy, and higher L‐dopa doses (Weintraub, Koester, et al., 2010; Weintraub, et al., 2015; Zurowski & O'Brien, 2015). There are conflicting data about whether amantadine and deep brain stimulation may be a treatment or a potential risk factor for ICB (Cera et al., 2014; Weintraub, Sohr, 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). However, the reduction or discontinuation of DA may induce DA withdrawal symptoms and worsen motor symptoms, meaning that formulating a treatment strategy for ICB is problematic (Weintraub et al., 2015; Zurowski & O'Brien, 2015). Furthermore, little is known about the factors regarding ICB remission and persistence.…”