Impulsive and Compulsive Behaviors in Parkinson's Disease

Averbeck, BB; Ss, O'Sullivan; Djamshidian, Atbin

doi:10.1146/annurev-clinpsy-032813-153705

Cited by 58 publications

(62 citation statements)

References 169 publications

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“…Impulsive compulsive behaviours (ICBs) are increasingly recognized as a devastating complication of Parkinson's disease (PD) treatment, and include pathological gambling, compulsive sexual disorder, excessive inappropriate shopping, binge eating, compulsive shopping, and the dopamine dysregulation syndrome (Lees syndrome) [1, 2]. ICBs have been reported to be no more frequent in untreated PD than in the general population, which would suggest that PD pathology alone is unlikely to increase the risk of addictive behaviours [3, 4].…”

Section: Introductionmentioning

confidence: 99%

Jumping to conclusions in untreated patients with Parkinson's disease

et al. 2016

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Background Jumping to conclusions due to impulsivity has been shown to be a sensitive marker for dopamine dysregulation and addictive behaviour patterns in treated patients with Parkinson's disease (PD). It is unknown whether drug naïve PD patients, who have never received dopaminergic therapy also have deficits in information sampling. Methods Twenty five de novo PD patients and twenty matched healthy controls were recruited and tested on the beads task, which is a validated information sampling task to assess reflection impulsivity and a temporal discounting questionnaire. Results Patients gathered significantly less information and made more irrational choices than matched controls. There was, however, no group difference on the temporal discounting questionnaire. Conclusions Poor information sampling and irrational decision making may be an inherent component of the neuropsychological deficit in Parkinson's disease. These findings suggest that underlying impulsivity detected by a metric task is common in de novo PD.

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Section: Introductionmentioning

confidence: 99%

Jumping to conclusions in untreated patients with Parkinson's disease

et al. 2016

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“…It is possible that dopamine agonists in combination with STN-DBS cause sensitization of the mesolimbic dopamine levels resulting in reduced decision threshold in perceptual decision making tasks. As was the case in our cohort, a significant proportion of people with PD undergoing DBS have a younger age of PD onset, which in itself is a risk factor for the development of impulsive-compulsive behaviours (ICBs)[20]. Additionally, younger PD patients are often prescribed dopamine agonists more frequently than L-dopa, and dopamine agonists are generally accepted to be more strongly associated than levodopa with the development of most ICBs.…”

Section: Discussionmentioning

confidence: 91%

In a Rush to Decide: Deep Brain Stimulation and Dopamine Agonist Therapy in Parkinson's Disease

Djamshidian

O’Sullivan

Tomassini

et al. 2014

Journal of Parkinson's Disease

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Background: It has been suggested that all patients with Parkinson's disease (PD) who undergo functional neurosurgery have difficulties in slowing down in high conflict tasks. However, it is unclear whether concomitant dopaminergic medication is responsible for this impairment. Objective: To assess perceptual decision making in PD patients with bilateral deep brain stimulation. Methods: We tested 27 PD patients with bilateral deep brain stimulation on a task in which participants had to filter task relevant information from background noise. Thirteen patients were treated with Levodopa monotherapy and 14 patients were treated with Levodopa in combination with a dopamine agonist. Results were compared to healthy matched controls. Results: We found that all PD patients who were treated with a dopamine agonist made faster decisions than controls and PD patients who were not exposed to a dopamine agonist. Further, all patients made more errors than controls, but there was no difference between the two patient groups. Conclusions: Our results suggest that dopamine agonist therapy rather than deep brain stimulation is likely responsible for the inability to slow down in high conflict situations in PD. These results further strengthen the need to reduce dopamine agonists in PD patients undergoing functional neurosurgery in order to prevent them making inadvisable decisions.

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“…The longer length of follow‐up in this group of patients raises the possibility that the lifetime prevalence of DDS may be higher than has hitherto been recognized. An alternative explanation is that patients with DDS were more likely to donate their brains because of increased impulsivity levels …”

Section: Discussionmentioning

confidence: 99%

The Outcome of Dopamine Dysregulation Syndrome in Parkinson's Disease: A Retrospective Postmortem Study

Barbosa

Djamshidian

Lees

et al. 2018

Movement Disord Clin Pract

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Introduction We have performed a retrospective analysis of the frequency and relation to treatment of dopamine dysregulation syndrome (DDS) using the Queen Square Brain Bank (QSBB) database. Methods A search of the QSBB database for consecutive cases donated between 2005 and 2016 with a pathological diagnosis of Parkinson's disease was performed. Results DDS was present in 8.8% of cases, was more prevalent in males, and was associated with younger age of onset, longer disease duration, and more dopa‐induced dyskinesias. Treatment approaches for DDS included: reduction of levodopa, reduction/cessation of dopamine agonist (DA), and initiation of infusion therapies. DDS had completely resolved in just over half the patients. DA peak l‐dopa equivalent daily dose (LEDD) was higher in patients who failed to achieve remission. Conclusion This is the first study to provide data on the course of DDS until death. Treatment strategies consisted mainly of reduction of dopaminergic treatment, and, despite the majority of patients showing some improvement, half remained symptomatic. Successful treatment was associated with a lower l‐dopa dosage at death.

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Impulsive and Compulsive Behaviors in Parkinson's Disease

Cited by 58 publications

References 169 publications

Jumping to conclusions in untreated patients with Parkinson's disease

Jumping to conclusions in untreated patients with Parkinson's disease

In a Rush to Decide: Deep Brain Stimulation and Dopamine Agonist Therapy in Parkinson's Disease

The Outcome of Dopamine Dysregulation Syndrome in Parkinson's Disease: A Retrospective Postmortem Study

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