Longitudinal analysis of impulse control disorders in Parkinson disease

Abstract

NCT01564992.

Depression as a Risk Factor for Impulse Control Disorders in Parkinson Disease

“…This association was strong (HR = 1.96), specific, and showed temporality (depression antecedes ICDs), all of which are required criteria to establish a causal relationship. 4 The relevance of these results is 2-fold. Both DA use and depression were independently associated with an increased risk for ICDs in the multivariate analysis.…”

“…10,40,41 We should emphasize that in our study, the model that includes DA-LEDD indirectly implies a relationship between cumulative incidence and cumulative doses of DA, a recently reported risk factor for ICDs. 4 The relevance of these results is 2-fold. On the one hand, that the risk of developing ICDs is increased in already depressed patients clearly indicates that PD depression is a state that predisposes to the development of ICDs.…”

“…1 Clinically relevant symptoms of depression occur in up to 35% 2 of patients, and impulse control disorders (ICDs) occur in up to 40% of patients over the course of their illness. 3,4 Thus, these 2 entities are among the most frequent and disabling nonmotor symptoms of PD. [5][6][7] Depression frequently appears before the onset of motor symptoms that lead to PD diagnosis, 8 and increases in prevalence with PD progression.…”

Suggestive association between OPRM1 and impulse control disorders in Parkinson's disease

“…In addition, these inclusion criteria made these individuals “supernormal” controls. Cumulative doses of dopamine agonists are indeed strongly associated with ICDs, with the cumulative incidence reaching up to 50% in patients treated with dopamine agonists at 5 years . Finally, although the medical history was carefully reviewed, we cannot exclude that some patients might have presented ICDs prior to inclusion and be misclassified as controls, which would attenuate the strength of associations.…”

“…Cumulative doses of dopamine agonists are indeed strongly associated with ICDs, with the cumulative incidence reaching up to 50% in patients treated with dopamine agonists at 5 years. 42 Finally, although the medical history was carefully reviewed, we cannot exclude that some patients might have presented ICDs prior to inclusion and be misclassified as controls, which would attenuate the strength of associations. Future studies should take into account these challenges of the transient and the dose-dependent nature of ICDs in PD, favoring analyses on longitudinal rather than cross-sectional studies whenever possible.…”