Impulse Control Disorders in the Polish Population of Patients with Parkinson’s Disease

Abstract

Background and Objectives: Parkinson’s disease (PD) is one of the most common neurodegenerative diseases in the world. It is characterized by the presence of not only typical motor symptoms but also several less known and aware non-motor symptoms (NMS). The group of disorders included in the NMS is Impulse Control Disorders (ICDs). ICDs are a group of disorders in which patients are unable to resist temptations and feel a strong, pressing desire for specific activities such as gambling, hypersexuality, binge eating, and compulsive buying. The occurrence of ICDs is believed to be associated primarily with dopaminergic treatment, with the use of dopamine agonists (DA), and to a lesser extent with high doses of L-dopa. The aim of our study was to develop a profile of Polish ICDs patients and assess the frequency of occurrence of ICDs, as well as determine the risk factors associated with these disorders against the background of the PD population from other countries. Materials and Methods: Our prospective study included 135 patients with idiopathic PD who were hospitalized between 2020 and 2022 at the Neurological Department of University Central Hospital in Katowice. In the assessment of ICDs, we used the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease (QUIP). Other scales with which we assessed patients with PD were as follows: MDS-UPDRS part III and modified Hoehn–Yahr staging. Clinical data on age, gender, disease duration and onset, motor complications, and medications were collected from electronic records. Results: ICDs were detected in 27.41% of PD patients (binge eating in 12.59%, hypersexuality in 11.11%, compulsive buying in 10.37%, and pathological gambling occurred in only 5.19% of patients. In total, 8.89% had two or more ICDs). The major finding was that ICDs were more common in patients taking DA than in those who did not use medication from this group (83.78% vs. 54.07%, respectively; p = 0.0015). Patients with ICDs had longer disease duration, the presence of motor complications, and sleep disorders. An important finding was also a very low detection of ICDs in a routine medical examination; only 13.51% of all patients with ICDs had a positive medical history of this disorder. Conclusions: ICDs are relatively common in the population of Polish PD patients. The risk factors for developing ICDs include longer duration of the disease, presence of motor complications, sleep disorders, and use of DA and L-dopa. Due to the low detectability of ICDs in routine medical history, it is essential for physicians to pay more attention to the possibility of the occurrence of these symptoms, especially in patients with several risk factors. Further prospective studies on a larger group of PD patients are needed to establish a full profile of Polish PD patients with ICDs.

Non-Motor Disorders in Parkinson Disease and Other Parkinsonian Syndromes

“…Impulse Control Disorders (ICDs) including pathological gambling, hypersexuality, compulsive eating, compulsive buying, and other related behaviors are NMSs of PD. A prospective study by Toś et al [7] found a prevalence of 27.41% in Polish PD patients, which is comparable to other European populations. The risk factors for developing ICDs include a longer duration of the disease, motor complications, sleep disorders, and the use of DA and L-dopa.…”

Impulse Control Disorders in Parkinson’s Disease and Atypical Parkinsonian Syndromes—Is There a Difference?

“…This study covered a cohort of Polish patients with idiopathic Parkinson's disease (PD) from the study by Toś et al [17], extended with additional patients-a total of 185 patients with PD and 35 patients with atypical parkinsonian syndromes (27 with PSP and 9 with MSA) consecutively enrolled in the study from November 2020 to June 2023. The inclusion criteria were as follows: (a) informed and voluntary consent to participate in the study; (b) clinical diagnosis of one of the parkinsonian syndromes: PD, according to the Movement Disorder Society Clinical Diagnostic Criteria for Parkinson's disease [18], clinically established MSA or clinically probable MSA according to the Movement Disorder Society Criteria for the Diagnosis of Multiple System Atrophy [19], and clinically probable PSP or clinically possible PSP according clinical diagnosis of progressive supranuclear palsy based on the Movement Disorder Society criteria [20]; (c) the motor and cognitive patient's condition enabled the completion of the questionnaire.…”