Impulse control disorders and related behaviours (ICD-RBs) in Parkinson′s disease patients: Assessment using "Questionnaire for impulsive-compulsive disorders in Parkinson′s disease" (QUIP)

Abstract

Background:There is limited data on the prevalence of impulse control disorder and related behaviors (ICD-RBs) in Indian patients with Parkinson's Disease (PD). In the context of potential genetic and environmental factors affecting the expression of ICD-RBs, studying other multiethnic populations may bring in-sights into the mechanisms of these disorders.Objectives:To ascertain point prevalence estimate of ICD-RBs in Indian PD patients, using the validated “Questionnaire for Impulsive-Compulsive Disorders in Parkinson's disease (QUIP)” and to examine their association with Dopamine replacement therapy (DRT).Materials and Methods:This was a hospital based observational cross-sectional study. After taking informed consent, patients and their informants (spouse, or primary caregiver) were made to complete the QUIP, and were instructed to answer questions based on behaviors that occurred anytime during PD that lasted at least four consecutive weeks.Results:Total of 299 patients participated in the study. At least one ICD-RB was present in 128 (42.8%), at least one Impulse control disorder (ICD) was present in 74 (24.75%) and at least one Impulse control related compulsive behaviour (ICRB) was present in 93 (31.1%) patients. Punding was the most frequent (12.4%) followed by hyper sexuality (11.04%), compulsive hobbyism (9.4%), compulsive shopping (8.4%), compulsive medication use (7.7%), compulsive eating (5.35%), walkabout (4%) and pathological gambling (3.3%). ≥ 2 ICD-RBs were observed in 15.7% of patients. After multivariate analysis, younger age of onset, being unmarried were specifically associated with presence of ICD. Longer disease duration was specifically associated with presence of ICRB. Whereas smoking and higher dopamine levodopa equivalent daily doses (DA LEDD) were associated with both presence of ICD and ICRB. Higher LD LEDD was specifically associated with presence of ICD-RB.Conclusions:Our study revealed a relatively higher frequency of ICD-RBs, probably because of the use of screening instrument and because we combined both ICDs and ICRBs. Also high proportion of DA use (81.6%) among our patients might be responsible. The role of genetic factors that might increase the risk of developing ICD-RBs in this population needs further exploration.

Impulse control disorders in advanced Parkinson's disease with dyskinesia: The ALTHEA study

“…There were sex‐ and age‐related differences, including greater frequency in men and younger age at diagnosis in patients with multiple ICDs and related behaviors . Moreover, we also found sex‐pecific susceptibility in ICDs and related behaviors subtypes, namely, women were the only group to constitute the binge eating group, and men were more represented in the DDS and hobbyism subgroups.…”

Dyskinesias and impulse control disorders in Parkinson's disease: From pathogenesis to potential therapeutic approaches

“…Impulse control disorders (ICD), such as pathological gambling (PG), hypersexuality, binge eating, and compulsive buying, are defined as the failure to resist an impulse, drive, or temptation to perform an act harmful to either the self or others according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (American Psychiatric Association, 1994). Their prevalence according to these diagnostic criteria is about 14% of PD patients under DA replacement therapy (Weintraub et al, 2010a); however, according to the "Questionnaire for impulsive-compulsive disorders in Parkinson's disease" (QUIP) (Weintraub et al, 2009), prevalence rises to around 40% (Sharma et al, 2015, Garcia-Ruiz et al, 2014. Other impulsive-compulsive behaviors (ICB) such as punding (i.e.…”

The effects of motor rehabilitation training on clinical symptoms and serum BDNF levels in Parkinson’s disease subjects

“…Unfortunately, pharmacological treatments are able to reduce the symptoms, but do not block the disease progression (Worth 2013) and, on the long term, produce significant clinical motor and no motor side effects such as dyskinesia (Huot et al2013) and impulse control disorders (Garcia-Ruiz et al 2014;Sharma et al 2015;Weintraub et al 2009). For these reasons, in the recent years the scientific community has started to explore alternative non pharmacological therapeutic approaches.…”