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Parkinson's Disease: Impulsivity Does Not Cause Impulse Control Disorders but Boosts Their Severity
Juan Marín-Lahoz1,2,3,4, Javier Pagonabarraga1,2,3, Saul Martinez-Horta1,2,3
1Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Frontiers in Psychiatry
|October 17, 2018
Summary
Impulsivity does not increase the risk of developing impulse control disorders (ICDs) in Parkinson's disease (PD). However, higher impulsivity is strongly linked to the severity of ICDs in PD patients.
Area of Science:
- Neuroscience
- Neurology
- Psychiatry
Background:
- Impulse control disorders (ICDs) are a frequent complication in Parkinson's disease (PD), particularly among patients treated with dopamine agonist therapy (DA).
- Impulsivity is hypothesized as a key mechanism underlying ICDs in PD, but empirical evidence remains limited.
Purpose of the Study:
- To investigate the association between impulsivity traits and motor inhibition with the presence and severity of ICDs in Parkinson's disease patients.
- To explore the relationship between impulsivity measures and dopamine agonist therapy in the context of ICDs.
Main Methods:
- A prospective, cross-sectional study involving 100 Parkinson's disease outpatients, excluding those with dementia or pre-existing ICDs.
- Impulsivity was assessed using the Barratt Impulsiveness Scale (BIS-11) for trait impulsivity and commission errors on the Continuous Performance Test (CE) for motor inhibition.
- ICD diagnosis was determined via clinical interview, and severity was measured using the Questionnaire for Impulsive-Compulsive Disorders.
Main Results:
- Thirty-one out of 100 patients were diagnosed with ICDs. Patients with ICDs were younger and more frequently used dopamine agonists, alcohol, and tobacco.
- No significant differences in trait impulsivity (BIS-11) or motor inhibition (CE) were observed between patients with and without ICDs.
- Impulsivity measures (BIS-11 and CE) were significantly correlated with the severity of ICDs among affected patients, independent of dopaminergic medication use.
Conclusions:
- Impulsivity is not associated with an increased prevalence of ICDs in Parkinson's disease.
- However, impulsivity is strongly linked to the severity of ICDs in PD patients.
- Assessing impulsivity may aid in identifying Parkinson's disease patients at risk for severe forms of ICDs, particularly when considering dopamine replacement therapy.