Impulse Control Disorders in Parkinson Disease

Abstract

Context: An association between dopamine-replacement therapies and impulse control disorders (ICDs) in Parkinson disease (PD) has been suggested in preliminary studies. Objectives: To ascertain point prevalence estimates of 4 ICDs in PD and examine their associations with dopamine-replacement therapies and other clinical characteristics. Design: Cross-sectional study using an a priori established sampling procedure for subject recruitment and raters blinded to PD medication status. Patients: Three thousand ninety patients with treated idiopathic PD receiving routine clinical care at 46 movement disorder centers in the United States and Canada. Main Outcome Measures: The Massachusetts Gambling Screen score for current problem/pathological gambling, the Minnesota Impulsive Disorders Interview score for compulsive sexual behavior and buying, and Diagnostic and Statistical Manual of Mental Disorders research criteria for binge-eating disorder. Results: An ICD was identified in 13.6% of patients (gambling in 5.0%, compulsive sexual behavior in 3.5%, compulsive buying in 5.7%, and binge-eating disorder in 4.3%), and 3.9% had 2 or more ICDs. Impulse control disorders were more common in patients treated with a dopamine agonist than in patients not taking a dopamine agonist (17.1% vs 6.9%; odds ratio [OR], 2.72; 95% confidence interval [CI], 2.08-3.54; PϽ .001). Impulse control disorder frequency was similar for pramipexole and ropinirole (17.7% vs 15.5%; OR, 1.22; 95% CI, 0.94-1.57; P =.14). Additional variables independently associated with ICDs were levodopa use, living in the United States, younger age, being unmarried, current cigarette smoking, and a family history of gambling problems. Conclusions: Dopamine agonist treatment in PD is associated with 2-to 3.5-fold increased odds of having an ICD. This association represents a drug class relationship across ICDs. The association of other demographic and clinical variables with ICDs suggests a complex relationship that requires additional investigation to optimize prevention and treatment strategies.

Relationships between activity and well‐being in people with parkinson's disease

“…Frequent additional nonmotor symptoms include depression, anxiety, apathy, (hypo‐)mania, dementia, psychosis, and impulse control disorder (Callesen, Weintraub, Damholdt, & Moller, 2014; van der Hoek et al., 2011; Maier et al., 2014; Reijnders, Ehrt, Weber, Aarsland, & Leentjens, 2008; Richard, 2007; Riedel et al., 2008; Sagna, Gallo, & Pontone, 2014; Starkstein, Brockman, & Hayhow, 2012). Together with motor symptoms (Appleman, Stavitsky, & Cronin‐Golomb, 2011; Hechtner et al., 2014; Weintraub et al., 2010), nonmotor symptoms can severely affect patients′ health‐related quality of life (Montel, Bonnet, & Bungener, 2009; Shearer, Green, Counsell, & Zajicek, 2012; for reviews see Den Oudsten, Van Heck, & De Vries, 2007; van Uem et al., 2016). Health‐related quality of life encompasses those aspects of well‐being and satisfaction with life that affect the individual's physical and mental health, including functional status, and social support as well as the subjective health perception (Centers for Disease Control and Prevention, 2000).…”

The factors associated with impulse control behaviors in Parkinson's disease: A 2‐year longitudinal retrospective cohort study

“…Being male has been reported as a risk factor for the development of ICB (Antonini et al., 2017; Weintraub, Koester, et al., 2010; Weintraub, et al., 2015; Zurowski & O'Brien, 2015). Both L‐DOPA induced dyskinesia (LID), and ICB can be induced by excessive dopaminergic stimulation in the motor or limbic territories of the striatum (Jimenez‐Urbieta et al., 2015; Rocha, Gago, Barbosa, Cavaleiro, & Laranjinha, 2015).…”

“…In addition, patients with moderate‐to‐severe dyskinesia had ICB more frequently than patients with only mild dyskinesia (Biundo et al., 2017). DA use and high doses of DA have previously been shown to increase the risk of ICB development (Moore, Glenmullen, et al., 2014; Weintraub, Koester, et al., 2010). …”

“…ICB is an important nonmotor complication in patients with PD because it is associated with functional impairment, decreased quality of life and increased caregiver burden (Weintraub, David, Evans, Grant, & Stacy, 2015). Previous studies have shown that dopamine agonist (DA) use is the most consistent predictor of ICB (Weintraub, Koester, et al., 2010; Weintraub, et al., 2015; Zurowski & O'Brien, 2015). ICB is also independently associated with younger age, younger age at PD onset, previous ICB history, family history of gambling disorders, concurrent cigarette smoking, unmarried status, depression, anxiety, alcohol use, novelty‐seeking traits, higher DA dosage, combination DA and L‐DOPA therapy, and higher L‐dopa doses (Weintraub, Koester, et al., 2010; Weintraub, et al., 2015; Zurowski & O'Brien, 2015).…”

“…Previous studies have shown that dopamine agonist (DA) use is the most consistent predictor of ICB (Weintraub, Koester, et al., 2010; Weintraub, et al., 2015; Zurowski & O'Brien, 2015). ICB is also independently associated with younger age, younger age at PD onset, previous ICB history, family history of gambling disorders, concurrent cigarette smoking, unmarried status, depression, anxiety, alcohol use, novelty‐seeking traits, higher DA dosage, combination DA and L‐DOPA therapy, and higher L‐dopa doses (Weintraub, Koester, et al., 2010; Weintraub, et al., 2015; Zurowski & O'Brien, 2015). There are conflicting data about whether amantadine and deep brain stimulation may be a treatment or a potential risk factor for ICB (Cera et al., 2014; Weintraub, Sohr, et al., 2010; Weintraub et al., 2015; Zurowski & O'Brien, 2015).…”