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The relationship between impulsivity and impulse control disorders in Parkinson's disease
Ioannis U Isaias1, Chiara Siri, Roberto Cilia
1Parkinson Institute, Istituti Clinici di Perfezionamento, Milan, Italy.
Movement Disorders : Official Journal of the Movement Disorder Society
|December 11, 2007
Summary
Impulse control disorders are common in Parkinson's disease (PD) patients on dopaminergic therapy, with higher impulsivity and compulsivity noted. Individual susceptibility factors, not medication specifics, appear to underlie these behaviors.
Area of Science:
- Neuroscience
- Psychiatry
- Movement Disorders
Background:
- Dopaminergic medications are increasingly recognized for behavioral side effects in Parkinson's disease (PD).
- Understanding these behaviors is crucial for managing PD patients on dopaminergic therapy.
Purpose of the Study:
- To evaluate the prevalence of impulse control disorders (ICDs) in PD patients on stable dopaminergic therapy.
- To compare ICDs and related psychological factors between PD patients and healthy controls.
- To identify factors associated with ICDs in PD.
Main Methods:
- Fifty cognitively intact PD patients on stable dopaminergic therapy and 100 healthy controls were assessed.
- Evaluated for compulsive sexual behavior, buying, intermittent explosive disorders (Minnesota Impulsive Disorders Interview), pathological gambling (South Oaks Gambling Screen), impulsivity (Barratt Impulsiveness Scale), compulsivity (Maudsley Obsessional-Compulsive Inventory), and depression (Geriatric Depression Scale).
Main Results:
- Overall, 28% of PD patients and 20% of controls reported at least one abnormal behavior or pathological gambling score.
- PD patients exhibited significantly higher scores for impulsivity, compulsivity, and depression compared to controls.
- Male gender and higher impulsivity scores were associated with increased probability of ICDs in PD patients, independent of medication type or dose.
Conclusions:
- Impulse control disorders are prevalent in PD patients treated with dopaminergic therapy, but also occur in controls.
- Individual susceptibility factors, including high impulsivity and depression, play a significant role in the development of abnormal behaviors.
- Further research into individual risk factors is warranted for better management of behavioral side effects in PD.
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