Assessing impulse control behaviors in early Parkinson's disease: a longitudinal study

Area of Science:

• Neurology
• Neuroscience
• Psychiatry

Background:

• Impulse control behaviors (ICBs) are common in Parkinson's disease (PD), but their predictors and biological correlates are not well understood.
• Limited data exists on the longitudinal changes and associated factors of ICBs in early-stage PD.

Purpose of the Study:

• To identify clinical, imaging, and biological predictors of longitudinal changes in ICBs in early-stage PD.
• To investigate the association of ICBs with various clinical factors, including mood, sleep, and autonomic function.

Main Methods:

• Utilized data from the Parkinson's Progression Markers Initiative (PPMI), a prospective cohort study.
• Employed Cox regression models to analyze associations between baseline variables and the incidence of ICBs over 5 years in 401 PD patients and 185 healthy controls (HC).

Main Results:

• ICB prevalence increased in PD patients (20.7% to 27.3%) over 5 years, while decreasing in HC (19.5% to 15.2%).
• Longitudinally, ICBs in PD were associated with depression, anxiety, autonomic dysfunction, and excessive daytime sleepiness (EDS). Dopamine agonist treatment correlated with ICBs.
• Anxiety, rapid eye movement sleep behavior disorder (RBD), and cerebrospinal fluid (CSF) p-tau levels at baseline predicted incident ICBs.

Conclusions:

• ICBs significantly increase over time in early PD and are associated with specific clinical symptoms and dopaminergic medication use.
• Anxiety, RBD, and CSF p-tau are key predictors for the development of ICBs in early PD.
• Further research incorporating imaging and biomarkers is needed to fully elucidate the complex relationships underlying ICBs in PD.