Impulse control disorders in Parkinson's disease versus in healthy controls: A different predictive model

Abstract

Impulse control disorders (ICDs), including compulsive gambling, buying, sexual behaviour and eating, are not only a severe disorder that can affect the general, nonclinical population, but also a serious, increasingly recognized psychiatric complication in Parkinson's disease (PD). Previous research detected some risk factors for their occurrence in PD patients and in the general population, including impulsivity. However, impulsivity is a multidimensional construct that comprises several aspects, including reflection impulsivity and delay discounting. The present work assessed different facets of impulsivity in both PD patients and in the healthy controls (HCs) to examine whether they scored differently, and if the occurrence of ICDs in PD patients and in the HCs was predicted by different aspects of impulsivity. The results showed that ICDs in PD patients were predicted by a strong preference for immediate rewards, whereas ICDs in the HCs were predicted by a deficient reflective ability. The present findings may help clinicians in the early identification of PD patients who could develop ICDs by simply assessing their impulsivity in terms of delay discounting. Furthermore, this work contributed to identify another risk factor for ICDs in the non-clinical population.

Impulse Control Disorders in Parkinson’s Disease: From Bench to Bedside

“…ICD symptoms in newly diagnosed drug-naïve PD patients actually seem to be comparable to that of the general population, around 20% (Antonini et al, 2011;Weintraub et al, 2013). However, recent research has suggested a difference in the nature of ICRBs among these populations, whereby delay discounting (with preference for smaller and more immediate rewards over larger but more delayed rewards) and deficits in reflection impulsivity (ability to collect sufficient information prior to decision-making) better predict ICDs in the PD and general populations, respectively (Izzo et al, 2020).…”

Inhibition of Indirect Pathway Activity Causes Abnormal Decision-Making In a Mouse Model of Impulse Control Disorder in Parkinson’s Disease

“…To model alterations in decision making seen in impulse control disorder (ICD), we took advantage of a normal cognitive phenomenon, delay discounting, in which the value of a reward is discounted by the time needed to wait for it (32). Delay discounting behavior is abnormal in individuals with ICD, with more pronounced discounting, or intolerance for delays (10)(11)(12). We adapted a rodent delay discounting task for use in healthy and parkinsonian mice (Fig.…”

Bipolar spectrum disorders in neurologic disorders

“…While visual modality is the most common presentation of hallucinations in all three conditions (49-51), delusional content may differ, with paranoid delusions more commonly found in DLB and grandiose types in BSD (53). Impulsivity is a core feature of BSD that leads to engagement in risky behaviors, especially during the manic/hypomanic phases (3,54) and is also present in parkinsonian patients (55). However, for decades, parkinsonian ICDs have been attributed to iatrogenic side effects of Dopamine Agonist therapies (56)(57)(58)(59)(60)(61)(62)(63)(64), before being recognized as a core symptom of the disease, appearing often before any exposition to drug treatments.…”