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Clinical Approach to Impulse Control-Related Behavioral Disorders in Parkinson's Disease: A Scoping Review
Jin Yi Goh1,2, Lai Gwen Chan3, Francisco Cardoso4
1Department of Neurology, National Neuroscience Institute, Singapore.
Movement Disorders Clinical Practice
|August 14, 2026
Summary
Impulse control disorders in Parkinson's disease (PD) require early recognition and tailored management. This review summarizes their mechanisms, assessment, and treatments, highlighting knowledge gaps for better patient care.
Area of Science:
- Neuroscience
- Clinical Neurology
- Psychiatry
Background:
- Impulse control disorders (ICD), dopamine dysregulation syndrome (DDS), and punding are compulsive behaviors in Parkinson's disease (PD).
- Distinct neurobiological mechanisms underlie each disorder, yet early recognition and treatment remain challenging.
- Despite improved understanding, significant challenges persist for clinicians, patients, and caregivers in managing these conditions.
Purpose of the Study:
- To consolidate definitions, neurobiological mechanisms, assessment tools, and management strategies for impulse-control and related behavioral disorders (ICBD) in PD.
- To identify current knowledge gaps and outline future research directions for ICBDs.
- To provide a comprehensive overview for improved clinical practice and patient outcomes.
Main Methods:
- A scoping review methodology was employed.
- Searches were conducted across major databases: PubMed, Embase, and psycINFO.
- 110 articles were selected from 540 identified for full-text review and analysis.
Main Results:
- Articles were categorized into prevalence, risk factors, genetics, behavioral studies, neuroimaging, and treatment options.
- Clinical phenotypes, pathophysiology, and treatment approaches for ICD, DDS, and punding were discussed.
- Knowledge gaps identified include understanding punding pathophysiology and validated rating scales for punding and DDS; future research may explore novel pharmacological and non-pharmacological interventions.
Conclusions:
- Distinguishing between different ICBDs is crucial for effective early intervention.
- Tailored management strategies are essential for optimal treatment outcomes.
- Monitoring treatment effects requires precise diagnostic and assessment tools.
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