Sleep and REM sleep behaviour disorder in Parkinson’s disease with impulse control disorder

Fantini, María Livia; Figorilli, Michela; Arnulf, Isabelle; Zibetti, Maurizio; Pereira, Bruno; Beudin, Patricia; Puligheddu, Monica; Cormier‐Dequaire, Florence; Lacomblez, Lucette; Benchetrit, Eve; Corvol, Jean‐Christophe; Cicolin, Alessandro; Lopiano, Leonardo; Marqués, Ana; Durif, Franck

doi:10.1136/jnnp-2017-316576

Cited by 33 publications

(23 citation statements)

References 40 publications

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“…PD-RBD was identified as an independent risk factor in a large cross-sectional study. 8 This finding was then replicated in cohorts with both clinically 44 and polysomnography 7 -diagnosed PD-RBD. Further studies with smaller sample sizes, 45–47 aiming to specifically address this question, have failed to show this association.…”

Section: Discussionmentioning

confidence: 73%

“…Certain risk factors have been identified, including dopaminergic medication, predominantly dopamine agonists (DAs), along with demographic and disease-specific factors such as the presence of motor complications. In addition, while the presence of REM sleep behavior disorder (RBD) may infer a higher risk of developing PD-ICD, 7,8 it is not known whether RBD itself or whether a particular RBD-PD subtype confers an increase risk. 9…”

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confidence: 99%

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Impulse control disorders in Parkinson disease and RBD

et al. 2019

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ObjectiveTo describe the prevalence, natural history, and risk factors for impulse control behaviors (ICBs) among people with Parkinson disease (PD), those with REM sleep behavior disorder (RBD), and controls.MethodsParticipants with early PD (within 3.5 years of diagnosis), those with RBD, and controls were clinically phenotyped and screened for ICBs longitudinally (with the Questionnaire for Impulsivity in Parkinson's Disease). ICB-positive individuals were invited for a semistructured interview, repeated 1 year later. The severity of the ICB was assessed with the Parkinson's Impulse Control Scale. Multiple imputation and regression models were used to estimate ICB prevalence and associations.ResultsData from 921 cases of PD at baseline, 768 cases at 18 months, and 531 cases at 36 months were included, with 21% to 25% screening positive for ICBs at each visit. Interviews of ICB screen–positive individuals revealed that 10% met formal criteria for impulse control disorders (ICD), while 33% had subsyndromal ICD (ICB symptoms without reaching the formal diagnostic criteria for ICD). When these data were combined through the use of multiple imputation, the prevalence of PD-ICB was estimated at 19.1% (95% confidence interval 10.1–28.2). On follow-up, 24% of cases of subsyndromal ICD had developed full symptoms of an ICD. PD-ICD was associated with dopamine agonist use, motor complications, and apathy but not PD-RBD. ICD prevalence in the RBD group (1%) was similar to that in controls (0.7%).ConclusionsICBs occur in 19.1% of patients with early PD, many persisting or worsening over time. RBD is not associated with increased ICD risk. Psychosocial drivers, including mood and support networks, affect severity.

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Section: Discussionmentioning

confidence: 73%

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confidence: 99%

Impulse control disorders in Parkinson disease and RBD

et al. 2019

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“…Interestingly, patients with ICDs presented with a higher familial history of addictive behaviors (pathological gambling, alcohol abuse), suggesting an important genetic component in this population. In addition, PD patients with ICDs and related behaviors presented more severe nonmotor complications (UPDRS I) and motor complications (UPDRS IV), in accordance with recent studies showing an association of ICDs with dyskinesia and sleep disorders, suggesting common pathogenic mechanisms responsible for the development of severe versions of the disease and emergence of ICDs …”

Section: Discussionmentioning

confidence: 99%

Suggestive association between OPRM1 and impulse control disorders in Parkinson's disease

et al. 2018

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Background Impulse control disorders are frequently associated with dopaminergic therapy in Parkinson's disease. Genetic studies have suggested a high heritability of impulse control disorders in the general population and in PD. The aim of this study was to identify candidate gene variants associated with impulse control disorders and related behaviors in PD. Methods We performed a multicenter case‐control study in PD patients with (cases) or without impulse control disorders and related behaviors despite significant dopamine agonist exposure of >300 mg levodopa‐equivalent daily dose during 12 months (controls). Behavioral disorders were assessed using the Ardouin scale. We investigated 50 variants in 24 candidate genes by a multivariate logistic regression analysis adjusted for sex and age at PD onset. Results The analysis was performed on 172 cases and 132 controls. Cases were younger (60 ± 8 vs 63 ± 8 years; P < 0.001) and had a higher family history of pathological gambling (12% vs 5%, P = 0.03). No variant was significantly associated with impulse control disorders or related behaviors after correction for multiple testing, although the 2 top variants were close to significant (OPRM1 rs179991, OR, 0.49; 95%CI, 0.32‐0.76; P = 0.0013; Bonferroni adjusted P = 0.065; DAT1 40‐base pair variable number tandem repeat, OR, 1.82; 95%CI, 1.24‐2.68; P = 0.0021; Bonferroni adjusted P = 0.105). Conclusions Our results are suggestive of a novel association of the opioid receptor gene OPRM1 with impulse control disorders and related behaviors in PD and confirm a previous association with DAT1. Although replication in independent studies is needed, our results bring potential new insights to the understanding of molecular mechanisms of impulse control disorders. © 2018 International Parkinson and Movement Disorder Society

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“…Sleep disorders have also been investigated, with some studies finding more sleep impairment and daytime sleepiness in PD patients with ICDs (5, 65). Although some studies that defined sleep disorders through questionnaires found an association with ICDs, more recent studies—including those that have screened sleep disorders through polysomnography exams—have revealed inconsistent results (15, 78, 143, 144). Patients with ICDs may also have more restless leg syndrome (65).…”

Section: Premorbidities and Comorbiditiesmentioning

confidence: 99%

Medications, Deep Brain Stimulation, and Other Factors Influencing Impulse Control Disorders in Parkinson's Disease

et al. 2019

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Impulse control disorders (ICDs) in Parkinson's disease (PD) have a high cumulative incidence and negatively impact quality of life. ICDs are influenced by a complex interaction of multiple factors. Although it is now well-recognized that dopaminergic treatments and especially dopamine agonists underpin many ICDs, medications alone are not the sole cause. Susceptibility to ICD is increased in the setting of PD. While causality can be challenging to ascertain, a wide range of modifiable and non-modifiable risk factors have been linked to ICDs. Common characteristics of PD patients with ICDs have been consistently identified across many studies; for example, males with an early age of PD onset and dopamine agonist use have a higher risk of ICD. However, not all cases of ICDs in PD can be directly attributable to dopamine, and studies have concluded that additional factors such as genetics, smoking, and/or depression may be more predictive. Beyond dopamine, other ICD associations have been described but remain difficult to explain, including deep brain stimulation surgery, especially in the setting of a reduction in dopaminergic medication use. In this review, we will summarize the demographic, genetic, behavioral, and clinical contributions potentially influencing ICD onset in PD. These associations may inspire future preventative or therapeutic strategies.

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Sleep and REM sleep behaviour disorder in Parkinson’s disease with impulse control disorder

Abstract: This large, controlled series of patients with PD with ICDs assessed by v-PSG confirms the association between ICDs and RBD. Increased surveillance of symptoms of ICDs should be recommended in patients with PD with RBD.

Cited by 33 publications

References 40 publications

Impulse control disorders in Parkinson disease and RBD

Impulse control disorders in Parkinson disease and RBD

Suggestive association between OPRM1 and impulse control disorders in Parkinson's disease

Medications, Deep Brain Stimulation, and Other Factors Influencing Impulse Control Disorders in Parkinson's Disease

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