1
|
Tichelaar JG, Hezemans F, Bloem BR, Helmich RC, Cools R. Neural Reinforcement Learning Signals Predict Recovery From Impulse Control Disorder Symptoms in Parkinson's Disease. Biol Psychiatry 2024:S0006-3223(24)01434-3. [PMID: 39002875 DOI: 10.1016/j.biopsych.2024.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 05/26/2024] [Accepted: 06/20/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND Impulse control disorders (ICDs) in Parkinson's disease are associated with a heavy burden on patients and caretakers. While recovery can occur, ICDs persist in many patients despite optimal management. The basis for this interindividual variability in recovery is unclear and poses a major challenge to personalized health care. METHODS We adopted a computational psychiatry approach and leveraged the longitudinal, prospective Personalized Parkinson Project (136 people with Parkinson's disease, within 5 years of diagnosis) to combine dopaminergic learning theory-informed functional magnetic resonance imaging with machine learning (at baseline) to predict ICD symptom recovery after 2 years of follow-up. We focused on change in Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease Rating Scale scores in the entire sample regardless of an ICD diagnosis. RESULTS Greater reinforcement learning signals during gain trials but not loss trials at baseline, including those in the ventral striatum and medial prefrontal cortex, and the behavioral accuracy score measured while on medication were associated with greater recovery from impulse control symptoms 2 years later. These signals accounted for a unique proportion of the relevant variability over and above that explained by other known factors, such as decreases in dopamine agonist use. CONCLUSIONS Our results provide a proof of principle for combining generative model-based inference of latent learning processes with machine learning-based predictive modeling of variability in clinical symptom recovery trajectories. We showed that reinforcement learning modeling parameters predicted recovery from ICD symptoms in Parkinson's disease.
Collapse
Affiliation(s)
- Jorryt G Tichelaar
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Neurology, Centre of Expertise for Parkinson and Movement Disorders, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Frank Hezemans
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Bastiaan R Bloem
- Department of Neurology, Centre of Expertise for Parkinson and Movement Disorders, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Rick C Helmich
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Neurology, Centre of Expertise for Parkinson and Movement Disorders, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Roshan Cools
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands
| |
Collapse
|
2
|
Carbone F, Djamshidian A. Impulse Control Disorders in Parkinson's Disease: An Overview of Risk Factors, Pathogenesis and Pharmacological Management. CNS Drugs 2024; 38:443-457. [PMID: 38613665 PMCID: PMC11098885 DOI: 10.1007/s40263-024-01087-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2024] [Indexed: 04/15/2024]
Abstract
Impulse control disorders in Parkinson's disease are relatively common drug-induced addictive behaviours that are usually triggered by the dopamine agonists pramipexole, ropinirole and rotigotine. This narrative review aimed to provide a comprehensive overview of the current knowledge of impulse control disorders in Parkinson's disease. We summarised the prevalence, clinical features, risk factors and potential underlying mechanisms of impulse control disorders in Parkinson's disease. Moreover, recent advances in behavioural and imaging characteristics and management strategies are discussed. Early detection as well as a tailored multidisciplinary approach, which typically includes careful adjustment of the dopaminergic therapy and the treatment of associated neuropsychiatric symptoms, are necessary. In some cases, a continuous delivery of levodopa via a pump or the dopamine D1 receptor agonist, apomorphine, can be considered. In selected patients without cognitive or speech impairment, deep brain stimulation of the subthalamic nucleus can also improve addictions. Finding the right balance of tapering dopaminergic dose (usually dopamine agonists) without worsening motor symptoms is essential for a beneficial long-term outcome.
Collapse
Affiliation(s)
- Federico Carbone
- Department of Neurology, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Atbin Djamshidian
- Department of Neurology, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.
| |
Collapse
|
3
|
Spencer H, Anderton RS. Trait Impulsivity as a Feature of Parkinson's Disease Treatment and Progression. PARKINSON'S DISEASE 2024; 2024:8770997. [PMID: 38766569 PMCID: PMC11102119 DOI: 10.1155/2024/8770997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 04/15/2024] [Accepted: 04/17/2024] [Indexed: 05/22/2024]
Abstract
Heightened trait impulsivity in both subclinical and pathological senses is becoming increasingly recognised in Parkinson's disease (PD). Impulsive behaviours and impulse control disorders (ICDs) are a consequence of perturbation to the rewards pathway leading individuals to conduct activities in a repetitive, excessive, and maladaptive fashion. Commonly linked to PD, heightened trait impulsivity has been found to primarily manifest in the forms of hypersexuality, pathological gambling, compulsive shopping, and binge eating, all of which may significantly impact social and financial standing. Subsequent burden to quality of life for both individuals with PD and caregivers are common. Although risk factors and indicators for ICDs in PD are currently lacking, it is recognised that the condition is often precipitated by dopamine replacement therapies, primarily dopamine agonist administration. While this nonmotor symptom is being increasingly diagnosed in PD populations, it remains relatively elusive in comparison to its motor counterparts. Through discussion of impulsivity characteristics, neuroanatomy, and neurochemistry, in addition to reviewing existing research on the potential contributing factors to impulsivity in PD, this review highlights impulsivity as a significant and detrimental PD symptom. Thus, emphasising the imperative need to establish efficacious diagnostic tools and treatments.
Collapse
Affiliation(s)
- Holly Spencer
- School of Health Sciences, University of Notre Dame Australia, Fremantle, WA, Australia
| | - Ryan S. Anderton
- School of Health Sciences, University of Notre Dame Australia, Fremantle, WA, Australia
| |
Collapse
|
4
|
Wirth T, Goetsch T, Corvol JC, Roze E, Mariani LL, Vidailhet M, Grabli D, Mallet L, Pelissolo A, Rascol O, Brefel-Courbon C, Ory-Magne F, Arbus C, Bekadar S, Krystkowiak P, Marques A, Llorca M, Krack P, Castrioto A, Fraix V, Maltete D, Defebvre L, Kreisler A, Houeto JL, Tranchant C, Meyer N, Anheim M. Prognosis of impulse control disorders in Parkinson's disease: a prospective controlled study. J Neurol 2024; 271:2412-2422. [PMID: 38214756 DOI: 10.1007/s00415-023-12170-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 12/21/2023] [Accepted: 12/23/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND The long-term prognosis of impulsive compulsive disorders (ICD) remains poorly studied in Parkinson's disease (PD). OBJECTIVE Evaluating the natural history of ICD and its impact on PD symptoms including cognition and treatment adjustments. MATERIALS AND METHODS We assessed PD patients at baseline (BL) with (BL-ICD+) or without (BL-ICD-) ICD despite dopamine agonist (DA) exposure of > 300 mg levodopa-equivalent daily dose for > 12 months at baseline and after more than two years of follow-up. ICD were assessed using the Ardouin's Scale of Behaviors in PD (ASBPD), cognition using the Mattis scale, and PD symptoms using the UPDRS score. Treatment adjustments, DA withdrawal-associated symptoms, and ICDs social consequences were recorded. RESULTS 149 patients were included (78 cases and 71 controls), mean duration of follow-up was 4.4 ± 1 years. At baseline, psychiatric disorders were more common among BL-ICD + (42.3 vs 12.3% among BL-ICD-, p < 0.01). At follow-up, 53.8% of BL-ICD + were not ICD-free while 21.1% of BL-ICD- had developed ICD. BL-ICD + more frequently experienced akinesia (21.8 vs 8.5%, p = 0.043) and rigidity worsening (11.5 vs 1.4%, p = 0.019) following therapeutic modifications. Decision to decrease > 50% DA doses (12.8 vs 1.4%, p = 0.019) or to withdraw DA (19.2 vs 5.6%, p = 0.025) was more frequently considered among BL-ICD+ . At follow-up, the prevalence of cognitive decline was lower among BL-ICD + (19.2 vs 37.1%, p = 0.025). CONCLUSION ICDs were associated with increased psychiatric burden at baseline and better cognitive prognosis. Most patients were still showing ICDs at the follow-up visit, suggesting ICD to be considered as a chronic, neuropsychiatric disorder.
Collapse
Affiliation(s)
- Thomas Wirth
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, 67098, Strasbourg, France.
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch-Graffenstaden, France.
- Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France.
| | - Thibaut Goetsch
- Service de santé Publique, GMRC, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Jean-Christophe Corvol
- Assistance Publique Hôpitaux de Paris, Paris Brain Institute-ICM, Inserm, CNRS, Departement de neurology, Clinical Investigation Center for neurosciences, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Emmanuel Roze
- Assistance Publique Hôpitaux de Paris, Paris Brain Institute-ICM, Inserm, CNRS, Departement de neurology, Clinical Investigation Center for neurosciences, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Louise-Laure Mariani
- Assistance Publique Hôpitaux de Paris, Paris Brain Institute-ICM, Inserm, CNRS, Departement de neurology, Clinical Investigation Center for neurosciences, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Marie Vidailhet
- Assistance Publique Hôpitaux de Paris, Paris Brain Institute-ICM, Inserm, CNRS, Departement de neurology, Clinical Investigation Center for neurosciences, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - David Grabli
- Assistance Publique Hôpitaux de Paris, Paris Brain Institute-ICM, Inserm, CNRS, Departement de neurology, Clinical Investigation Center for neurosciences, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Luc Mallet
- Assistance Publique Hôpitaux de Paris, Paris Brain Institute-ICM, Inserm, CNRS, Departement de neurology, Clinical Investigation Center for neurosciences, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
- Department of Mental Health and Psychiatry, University of Geneva, Geneva, Switzerland
| | - Antoine Pelissolo
- INSERM U955, Laboratoire Neuro-Psychiatrie Translationnelle, Créteil, France
- AP-HP, DMU IMPACT, Service de Psychiatrie, Hôpitaux Universitaires Henri-Mondor, Créteil, France
| | - Olivier Rascol
- Service de neurologie B8, CHU Toulouse, Toulouse, France
- Centre d'investigations Clinique, CHU Toulouse, Toulouse, France
| | | | | | - Christophe Arbus
- Pôle de psychiatrie, Universitaire, CHU de Toulouse, Université Paul Sabatier Toulouse, Toulouse, France
| | - Samir Bekadar
- Assistance Publique Hôpitaux de Paris, Paris Brain Institute-ICM, Inserm, CNRS, Departement de neurology, Clinical Investigation Center for neurosciences, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Pierre Krystkowiak
- Service de Neurologie, Centre Hospitalo-Universitaire d'Amiens, Amiens, France
| | - Ana Marques
- CHU, CNRS, Clermont Auvergne INP, Institut Pascal, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Michel Llorca
- Service de Psychiatrie, Centre Hospitalo-universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Paul Krack
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Anna Castrioto
- Neurology Department, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, University Grenoble Alpes, 38000, Grenoble, France
| | - Valérie Fraix
- Neurology Department, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, University Grenoble Alpes, 38000, Grenoble, France
| | - David Maltete
- Service de Neurologie, Centre Hospitalier Universitaire, Rouen, France
| | - Luc Defebvre
- Neurologie and Pathologie du Mouvement, CHU de Lille, Lille, France
| | | | | | - Christine Tranchant
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, 67098, Strasbourg, France
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch-Graffenstaden, France
- Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Nicolas Meyer
- Service de santé Publique, GMRC, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Mathieu Anheim
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, 67098, Strasbourg, France
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch-Graffenstaden, France
- Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| |
Collapse
|
5
|
Debove I, Paschen S, Amstutz D, Cardoso F, Corvol JC, Fung VSC, Lang AE, Martinez Martin P, Rodríguez-Oroz MC, Weintraub D, Krack P, Deuschl G. Management of Impulse Control and Related Disorders in Parkinson's Disease: An Expert Consensus. Mov Disord 2024; 39:235-248. [PMID: 38234035 DOI: 10.1002/mds.29700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/23/2023] [Accepted: 12/13/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Impulse-control and related behavioral disorders (ICBDs) significantly impact the lives of Parkinson's disease (PD) patients and caregivers, with lasting consequences if undiagnosed and untreated. While ICBD pathophysiology and risk factors are well-studied, a standardized severity definition and treatment evidence remain elusive. OBJECTIVE This work aimed to establish international expert consensus on ICBD treatment strategies. To comprehensively address diverse treatment availabilities, experts from various continents were included. METHODS From 2021 to 2023, global movement disorders specialists engaged in a Delphi process. A core expert group initiated surveys, involving a larger panel in three iterations, leading to refined severity definitions and treatment pathways. RESULTS Experts achieved consensus on defining ICBD severity, emphasizing regular PD patient screenings for early detection. General treatment recommendations focused on continuous monitoring, collaboration with significant others, and seeking specialist advice for legal or financial challenges. For mild to severe ICBDs, gradual reduction in dopamine agonists was endorsed, followed by reductions in other PD medications. Second-line treatment strategies included diverse approaches like reversing the last medication change, cognitive behavior therapy, subthalamic nucleus deep brain stimulation, and specific medications like quetiapine, clozapine, and antidepressants. The panel reached consensus on distinct treatment pathways for punding and dopamine dysregulation syndrome, formulating therapy recommendations. Comprehensive discussions addressed management strategies for the exacerbation of either motor or non-motor symptoms following the proposed treatments. CONCLUSION The consensus offers in-depth insights into ICBD management, presenting clear severity criteria and expert consensus treatment recommendations. The study highlights the critical need for further research to enhance ICBD management. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Ines Debove
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Steffen Paschen
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| | - Deborah Amstutz
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Francisco Cardoso
- Movement Disorders Unit, Neurology Service, Internal Medicine Department, The Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Jean-Christophe Corvol
- Department of Neurology, Sorbonne Université, Paris Brain Institute (ICM), Inserm, CNRS, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Victor S C Fung
- Movement Disorders Unit, Department of Neurology, Westmead Hospital and Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Anthony E Lang
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Pablo Martinez Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | | | - Daniel Weintraub
- Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Parkinson's Disease Research, Education and Clinical Center (PADRECC and MIRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Paul Krack
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Günther Deuschl
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| |
Collapse
|
6
|
Staubo SC, Fuskevåg OM, Toft M, Lie IH, Alvik KMJ, Jostad P, Tingvoll SH, Lilleng H, Rosqvist K, Størset E, Odin P, Dietrichs E, Dietrichs ES. Dopamine agonist serum concentrations and impulse control disorders in Parkinson's disease. Eur J Neurol 2024; 31:e16144. [PMID: 37955562 PMCID: PMC11235607 DOI: 10.1111/ene.16144] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/18/2023] [Accepted: 10/26/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND AND PURPOSE Impulse control disorders (ICDs) are common among Parkinson's disease patients using dopamine agonists. We wanted to determine whether ICD patients have higher dopamine agonist serum concentrations than those without any sign of ICD. METHODS Patients who used either pramipexole or ropinirole depot once daily were screened for ICDs using the validated Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale. Those who scored above the cut-off for one or more of the four defined ICDs (gambling, compulsive sexual behavior, compulsive shopping, and binge-eating) were compared in a case-control study to patients who scored zero points (no evidence of ICD) on the same items. They were examined clinically and evaluated using relevant scales. Three blood samples were taken on the same day: before daily dose, and then 6 and 12 h later. RESULTS Forty-six patients were included: 19 ICD-positive and 27 controls. Ropinirole serum concentrations 6 h after daily intake (Cmax ) were higher in the case group compared to the control group, as was the daily ropinirole dosage. No differences were observed in serum concentrations, dosage or total drug exposure for pramipexole. Disease duration and length of dopamine agonist treatment was significantly longer among ICD patients for ropinirole, but not for pramipexole. CONCLUSIONS The use of pramipexole may in itself confer high ICD risk, whereas ICDs among ropinirole users depend more on serum concentration and drug exposure. The pharmacokinetic properties of ropinirole make it challenging to predict its effects on patients, which supports the need for therapeutic drug monitoring to reduce risk of ICD.
Collapse
Affiliation(s)
- Sara C. Staubo
- Department of NeurologyOslo University HospitalOsloNorway
- Department of NeurologyAkershus University HospitalNordbyhagenNorway
| | - Ole Martin Fuskevåg
- Experimental and Clinical Pharmacology, Institute of Medical BiologyUiT The Arctic University of NorwayTromsøNorway
- Department of Laboratory Medicine, Division of Diagnostic ServicesUniversity Hospital of Northern NorwayTromsøNorway
- Department of Clinical MedicineUiT The Arctic University of NorwayTromsøNorway
| | - Mathias Toft
- Department of NeurologyOslo University HospitalOsloNorway
- Institute of Clinical MedicineUniversity of OsloOsloNorway
| | | | | | | | | | - Hallvard Lilleng
- Department of Clinical MedicineUiT The Arctic University of NorwayTromsøNorway
- Department of NeurologyUniversity Hospital of Northern NorwayTromsøNorway
| | - Kristina Rosqvist
- Division of Neurology, Department of Clinical SciencesLund University, Skåne University HospitalLundSweden
| | | | - Per Odin
- Division of Neurology, Department of Clinical SciencesLund University, Skåne University HospitalLundSweden
| | - Espen Dietrichs
- Department of NeurologyOslo University HospitalOsloNorway
- Institute of Clinical MedicineUniversity of OsloOsloNorway
| | - Erik Sveberg Dietrichs
- Experimental and Clinical Pharmacology, Institute of Medical BiologyUiT The Arctic University of NorwayTromsøNorway
- Department of Laboratory Medicine, Division of Diagnostic ServicesUniversity Hospital of Northern NorwayTromsøNorway
- Center for PsychopharmacologyDiakonhjemmet HospitalOsloNorway
- Institute of Oral BiologyUniversity of OsloOsloNorway
| |
Collapse
|
7
|
Hu L, Lin C, Lin F, Wang L, Li Z, Cai Z, Liu X, Ye Q, Wu Y, Cai G. Different impulse control disorder evolution patterns and white matter microstructural damage in the progression of Parkinson's disease. Front Aging Neurosci 2023; 15:1260630. [PMID: 38187360 PMCID: PMC10768538 DOI: 10.3389/fnagi.2023.1260630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/25/2023] [Indexed: 01/09/2024] Open
Abstract
Background The course of impulse control disorders (ICD) varies in the early stage of Parkinson's disease (PD). Aim We aimed to delineate the association between the evolution pattern of ICD and the progression of PD. Methods A total of 321 de novo PD patients from the Parkinson's Progression Markers Initiative database were included. Patients were followed up for a mean of 6.8 years and were classified into different groups according to the evolution patterns of ICD. Disease progression was compared among groups using survival analysis, in which the endpoint was defined as progression to Hoehn and Yahr stage 3 or higher for motor progression and progression to mild cognitive impairment for cognitive decline. In the fourth year of follow-up, four types of ICD evolution patterns were identified: (1) non-ICD-stable (68.2%), a patient who is consistently free of ICD; (2) late-ICD (14.6%), ICD developed during the follow-up of patients; (3) ICD-stable (11.5%), patients showed persistent ICD; and (4) ICD-reversion (5.6%), baseline ICD disappeared during the follow-up of patients with ICD. Results The ICD-reversion type shows daily life non-motor symptoms [Movement Disorder Society-Unified Parkinson Disease Rating Scale (MDS-UPDRS) part I], daily life motor symptoms (MDS-UPDRS part II), rapid eye movement sleep behavior disorder, and anxiety symptoms has a greater impact. PD patients with different ICD evolution patterns had different changes in white matter microstructure at the onset of the disease. Those relevant brain regions are involved in ICD and non-motor functions. Conclusion Four early ICD evolution patterns are identified in de novo PD, with different prognoses and brain white matter microstructural damage patterns, and they may predict motor progression and cognitive decline in PD patients.
Collapse
Affiliation(s)
- Ling Hu
- Department of Neurology, Ganzhou People’s Hospital, Ganzhou, China
| | - Changfu Lin
- Department of Medicine, Zhangzhou Fifth Hospital, Zhangzhou, China
| | - Fabin Lin
- Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Lingling Wang
- Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhenzhen Li
- Department of Medicine, Zhangzhou Fifth Hospital, Zhangzhou, China
| | - Zhijun Cai
- Department of Medicine, Zhangzhou Fifth Hospital, Zhangzhou, China
| | - Xianghong Liu
- Department of Neurology, Ganzhou People’s Hospital, Ganzhou, China
| | - Qinyong Ye
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fujian Medical University Union Hospital, Fujian, China
- Fujian Key Laboratory of Molecular Neurology, Institute of Neuroscience, Fujian Medical University, Fuzhou, China
| | - Yiwen Wu
- Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Guoen Cai
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fujian Medical University Union Hospital, Fujian, China
- Fujian Key Laboratory of Molecular Neurology, Institute of Neuroscience, Fujian Medical University, Fuzhou, China
| |
Collapse
|
8
|
Hamblin R, Karavitaki N. Impulse Control Disorders in Patients with Pituitary Tumors Treated with Dopamine Agonists: A Systematic Review. Arch Med Res 2023; 54:102910. [PMID: 37985276 DOI: 10.1016/j.arcmed.2023.102910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/26/2023] [Accepted: 10/31/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND The increased prevalence of Impulse Control Disorders (ICDs) in dopamine agonist (DA) treated patients with Parkinson's disease is well described. Despite the frequent use of DAs in the management of pituitary tumors, the relationship between DAs and prevalence of ICDs in patients with pituitary tumours is unclear. AIMS To establish the prevalence of ICDs in patients with prolactinoma or acromegaly and determine whether prevalence differs in those on DAs to those treated without. METHODS Systematic review of the literature (registered a priori) reporting prevalence of ICDs in patients with prolactinoma or acromegaly (conducted June 2023). A narrative synthesis describing prevalence of ICDs according to assessment method was performed. Prevalence comparisons between patients with prolactinoma or acromegaly treated with DAs, to patients treated without, were summarised. RESULTS Studies were largely retrospective, observational and heterogenous, with few patients with prolactinoma and acromegaly treated without DA. Prevalence of ICDs varied between 0-60% in patients with prolactinoma, and from 5-23% in studies with at least five patients with acromegaly. In most studies comparing DA exposed to non-DA exposed cases, DA use was not associated with ICDs. CONCLUSIONS Reported prevalence of ICDs in patients with prolactinoma and acromegaly varies considerably. Given ICDs were reported to be highly prevalent in some studies, clinicians should be mindful of these potentially serious disorders. ICD screening tools validated for use in patients with pituitary tumors combined with prospective studies including appropriate controls, are necessary to accurately establish prevalence of ICDs and true impact of DAs in their development.
Collapse
Affiliation(s)
- Ross Hamblin
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK; Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK; Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Niki Karavitaki
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK; Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK; Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
| |
Collapse
|
9
|
Ren W, Qi Y, Liu Y, Yan Y, Zheng X, Jin S, Chang Y. Evaluation of risk factors for impulse control disorder in Parkinson's disease in northern China. Front Aging Neurosci 2023; 15:1257618. [PMID: 38076540 PMCID: PMC10702947 DOI: 10.3389/fnagi.2023.1257618] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/23/2023] [Indexed: 09/05/2024] Open
Abstract
INTRODUCTION Impulse control disorder (ICD) is a common non-motor symptom of Parkinson's disease (PD), but its risk factors are still controversial. This study aimed to determine the prevalence of ICD in northern China and analyze the risk factors associated with ICD, multiple ICDs, and four subtypes. METHODS A total of 285 PD patients were enrolled in this study. Each patient was screened using the Questionnaire for Impulse and Compulsive Control Disorders (QUIP). Stepwise regression analysis was performed to identify independent risk factors, and a prediction model was developed. RESULTS The prevalence of ICD in the study population was 11.6%. Stepwise regression analysis showed that ICD was associated with disease duration, motor symptoms, dyskinesia, depression, REM sleep behavior disorder (RBD) and cognitive decline; multiple ICDs were related to coffee history, motor symptoms, dyskinesia, depression, apathy and RBD. The prediction model demonstrated good performance with AUC values of 0.93, 0.88, and 0.66 on the balanced train set, balanced test set, and the original imbalanced data set, respectively. CONCLUSION The risk factors for PD-ICD are complex and influenced by regional economic and cultural backgrounds. Clarifying these factors and developing predictive models can help to delay or even prevent the development of ICD through early screening and intervention.
Collapse
Affiliation(s)
- Wenhua Ren
- The Department of Neurology, China-Japan Union Hospital, Jilin University, Changchun, China
| | - Yumeng Qi
- Departments of Biostatistics, Columbia University, New York, NY, United States
| | - Yan Liu
- The Department of Neurology, Binzhou People Hospital, Shandong, China
| | - YaYun Yan
- The Department of Neurology, China-Japan Union Hospital, Jilin University, Changchun, China
| | - Xiaoqi Zheng
- The Department of Neurology, China-Japan Union Hospital, Jilin University, Changchun, China
| | - ShuXian Jin
- The Department of Neurology, China-Japan Union Hospital, Jilin University, Changchun, China
| | - Ying Chang
- The Department of Neurology, China-Japan Union Hospital, Jilin University, Changchun, China
| |
Collapse
|
10
|
Sako W, Kogo Y, Koebis M, Kita Y, Yamakage H, Ishida T, Hattori N. Comparative efficacy and safety of adjunctive drugs to levodopa for fluctuating Parkinson's disease - network meta-analysis. NPJ Parkinsons Dis 2023; 9:143. [PMID: 37853009 PMCID: PMC10584871 DOI: 10.1038/s41531-023-00589-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/06/2023] [Indexed: 10/20/2023] Open
Abstract
It remains unclear which adjunctive drug for Parkinson's disease (PD) in combination with levodopa is more effective, tolerable, and safe. We aimed to compare the efficacy, tolerability, and safety among anti-PD drugs from several classes in patients with fluctuating PD who received levodopa through network meta-analysis (NMA). Twelve anti-PD drugs belonging to 4 different drug classes (dopamine agonists, monoamine oxidase type B inhibitors, catechol-O-methyl transferase inhibitors, and an adenosine A2A receptor antagonist) were selected. We systematically searched PubMed, Embase, and the Cochrane Library for eligible randomized controlled trials (RCTs) comparing placebo with anti-PD drug or among anti-PD drugs in patients with PD who experienced motor fluctuations or wearing-off and received levodopa. We included 54 RCTs in the analysis. The NMA was performed under a frequentist framework using a random-effects model. The efficacy outcome was change in daily off-time, and the tolerability outcome was discontinuation due to all causes. Safety outcomes included discontinuation due to adverse events (AEs) and the incidence of AEs, dyskinesia, hallucination, and orthostatic hypotension. According to the surface under the cumulative ranking curve (SUCRA) in the NMA, ropinirole transdermal patch (SUCRA, 0.861) ranked the highest in efficacy, followed by pramipexole (0.762), ropinirole extended release (ER) (0.750), and safinamide (0.691). In terms of tolerability, ropinirole (0.954) ranked the highest, followed by pramipexole (0.857), safinamide (0.717), and ropinirole ER (0.708). Each anti-PD drug had different SUCRA ranking profiles for the safety outcomes. These findings suggest that ropinirole, pramipexole, and safinamide are well-balanced anti-PD drugs that satisfy both efficacy and tolerability outcomes.
Collapse
Affiliation(s)
- Wataru Sako
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Yuki Kogo
- Medical Headquarters, Eisai Co., Ltd., Tokyo, Japan
| | | | - Yoshiaki Kita
- Publication Business, Medical Professional Relations Inc., Osaka, Japan
| | - Hajime Yamakage
- Department of Medical Statistics, Satista Co., Ltd., Kyoto, Japan
| | | | - Nobutaka Hattori
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| |
Collapse
|
11
|
Toś M, Grażyńska A, Antoniuk S, Siuda J. Impulse Control Disorders in the Polish Population of Patients with Parkinson's Disease. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1468. [PMID: 37629758 PMCID: PMC10456804 DOI: 10.3390/medicina59081468] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/09/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023]
Abstract
Background and Objectives: Parkinson's disease (PD) is one of the most common neurodegenerative diseases in the world. It is characterized by the presence of not only typical motor symptoms but also several less known and aware non-motor symptoms (NMS). The group of disorders included in the NMS is Impulse Control Disorders (ICDs). ICDs are a group of disorders in which patients are unable to resist temptations and feel a strong, pressing desire for specific activities such as gambling, hypersexuality, binge eating, and compulsive buying. The occurrence of ICDs is believed to be associated primarily with dopaminergic treatment, with the use of dopamine agonists (DA), and to a lesser extent with high doses of L-dopa. The aim of our study was to develop a profile of Polish ICDs patients and assess the frequency of occurrence of ICDs, as well as determine the risk factors associated with these disorders against the background of the PD population from other countries. Materials and Methods: Our prospective study included 135 patients with idiopathic PD who were hospitalized between 2020 and 2022 at the Neurological Department of University Central Hospital in Katowice. In the assessment of ICDs, we used the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP). Other scales with which we assessed patients with PD were as follows: MDS-UPDRS part III and modified Hoehn-Yahr staging. Clinical data on age, gender, disease duration and onset, motor complications, and medications were collected from electronic records. Results: ICDs were detected in 27.41% of PD patients (binge eating in 12.59%, hypersexuality in 11.11%, compulsive buying in 10.37%, and pathological gambling occurred in only 5.19% of patients. In total, 8.89% had two or more ICDs). The major finding was that ICDs were more common in patients taking DA than in those who did not use medication from this group (83.78% vs. 54.07%, respectively; p = 0.0015). Patients with ICDs had longer disease duration, the presence of motor complications, and sleep disorders. An important finding was also a very low detection of ICDs in a routine medical examination; only 13.51% of all patients with ICDs had a positive medical history of this disorder. Conclusions: ICDs are relatively common in the population of Polish PD patients. The risk factors for developing ICDs include longer duration of the disease, presence of motor complications, sleep disorders, and use of DA and L-dopa. Due to the low detectability of ICDs in routine medical history, it is essential for physicians to pay more attention to the possibility of the occurrence of these symptoms, especially in patients with several risk factors. Further prospective studies on a larger group of PD patients are needed to establish a full profile of Polish PD patients with ICDs.
Collapse
Affiliation(s)
- Mateusz Toś
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland;
| | - Anna Grażyńska
- Department of Imaging Diagnostics and Interventional Radiology, Kornel Gibiński Independent Public Central Clinical Hospital, Medical University of Silesia, 40-055 Katowice, Poland;
| | - Sofija Antoniuk
- St. Barbara Regional Specialist Hospital No. 5, 41-200 Sosnowiec, Poland;
| | - Joanna Siuda
- Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland;
| |
Collapse
|
12
|
Sulu C, Gul N, Tanrikulu S, Ciftci S, Yener Ozturk F, Sarac B, Ersungur EB, Tanriover E, Sahin S, Ozkaya HM, Poyraz BC, Kadioglu P. Risk of impulse control disorders in patients with Cushing's disease: do not blame cabergoline but do not give up caution. Pituitary 2023:10.1007/s11102-023-01342-3. [PMID: 37474846 DOI: 10.1007/s11102-023-01342-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/12/2023] [Indexed: 07/22/2023]
Abstract
PURPOSE To asses risk of new-onset impulse control disorders (ICDs) in patients with Cushing's disease (CD) who initiated cabergoline (CBG) and to determine frequency of ICDs in CBG-treated patients with CD. METHODS This naturalistic observational study had prospective and cross-sectional arms which included patients at five referral centers based in Istanbul. Patients who were scheduled for CBG were assigned to prospective arm. These patients underwent neuropsychological tests (Barratt Impulsiveness Scale, Minnesota Impulsive Disorders Interview, Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale, Go/No-Go Task, Iowa Gambling Task, and Short Penn Continuous Performance Test) for assessment of impulsivity and psychiatric evaluations at baseline, 3, 6, and 12 months of CBG treatment. Impulsivity and new-onset ICDs were prospectively assessed. Patients with CD with current CBG treatment for ≥ 3 months and matched CBG-naïve patients with CD were included in cross-sectional arm. These patients underwent the same neuropsychological and psychiatric assessments. The impulsivity and frequency of ICDs were compared between CBG-treated and CBG-naïve patients with CD. RESULTS The follow-up duration of prospective cohort (n = 14) was 7.3 ± 2.3 months. One patient developed major depressive episode and another patient developed compulsive gambling after CBG. We observed no significant changes in impulsivity scores during follow-up. In cross-sectional arm, CBG-treated (n = 34) and CBG-naïve patients (n = 34) were similar in impulsivity scores and frequency of ICDs [3 patients (8.8%) vs. 2 patients (5.9%) respectively, p = 1.0]. CONCLUSION CBG-treated patients with CD appeared to have a low risk of ICDs, suggesting that CBG still holds promise as a safe agent in CD.
Collapse
Affiliation(s)
- Cem Sulu
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street No:53, Fatih, 34098, Istanbul, Turkey
| | - Nurdan Gul
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Seher Tanrikulu
- Division of Endocrinology, Department of Internal Medicine, Acibadem Hospital, Istanbul, Turkey
| | - Sema Ciftci
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Feyza Yener Ozturk
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Betul Sarac
- Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Elif Burcu Ersungur
- Department of Psychiatry, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | | | - Serdar Sahin
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street No:53, Fatih, 34098, Istanbul, Turkey
| | - Hande Mefkure Ozkaya
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street No:53, Fatih, 34098, Istanbul, Turkey
| | - Burc Cagri Poyraz
- Department of Psychiatry, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Pinar Kadioglu
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street No:53, Fatih, 34098, Istanbul, Turkey.
| |
Collapse
|
13
|
Hall A, Weightman M, Jenkinson N, MacDonald HJ. Performance on the balloon analogue risk task and anticipatory response inhibition task is associated with severity of impulse control behaviours in people with Parkinson's disease. Exp Brain Res 2023; 241:1159-1172. [PMID: 36894682 PMCID: PMC10082127 DOI: 10.1007/s00221-023-06584-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 02/24/2023] [Indexed: 03/11/2023]
Abstract
Dopamine agonist medication is one of the largest risk factors for development of problematic impulse control behaviours (ICBs) in people with Parkinson's disease. The present study investigated the potential of dopamine gene profiling and individual performance on impulse control tasks to explain ICB severity. Clinical, genetic and task performance data were entered into a mixed-effects linear regression model for people with Parkinson's disease taking (n = 50) or not taking (n = 25) dopamine agonist medication. Severity of ICBs was captured via the Questionnaire for Impulsive-compulsive disorders in Parkinson's disease Rating Scale. A cumulative dopamine genetic risk score (DGRS) was calculated for each participant from variance in five dopamine-regulating genes. Objective measures of impulsive action and impulsive choice were measured on the Anticipatory Response Inhibition Task and Balloon Analogue Risk Task, respectively. For participants on dopamine agonist medication, task performance reflecting greater impulsive choice (p = 0.014), and to a trend level greater impulsive action (p = 0.056), as well as a longer history of DA medication (p < 0.001) all predicted increased ICB severity. DGRS however, did not predict ICB severity (p = 0.708). No variables could explain ICB severity in the non-agonist group. Our task-derived measures of impulse control have the potential to predict ICB severity in people with Parkinson's and warrant further investigation to determine whether they can be used to monitor ICB changes over time. The DGRS appears better suited to predicting the incidence, rather than severity, of ICBs on agonist medication.
Collapse
Affiliation(s)
- Alison Hall
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.,Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Matthew Weightman
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.,Centre for Human Brain Health, University of Birmingham, Birmingham, UK.,Wellcome Centre for Integrative Neuroimaging, Department of Clinical Neurosciences, FMRIB, Nuffield, University of Oxford, Oxford, UK
| | - Ned Jenkinson
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.,Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Hayley J MacDonald
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK. .,Centre for Human Brain Health, University of Birmingham, Birmingham, UK. .,Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.
| |
Collapse
|
14
|
Jing XZ, Yang HJ, Taximaimaiti R, Wang XP. Advances in the Therapeutic Use of Non-Ergot Dopamine Agonists in the Treatment of Motor and Non-Motor Symptoms of Parkinson's Disease. Curr Neuropharmacol 2023; 21:1224-1240. [PMID: 36111769 PMCID: PMC10286583 DOI: 10.2174/1570159x20666220915091022] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/25/2022] [Accepted: 07/18/2022] [Indexed: 11/22/2022] Open
Abstract
Dopamine (DA) agonists, as an excellent dopamine replacement therapy for patients with early and advanced Parkinson's disease (PD), play a vital role in controlling motor and several nonmotor symptoms. Besides, the application of DA agonists may delay levodopa therapy and the associated risk of motor complications. Indeed, each DA agonist has unique pharmacokinetic and pharmacodynamic characteristics and therefore has different therapeutic efficacy and safety profile. The comorbidities, significant non-motor manifestations, concomitant medications, and clinical features of PD individuals should guide the selection of a specific DA agonist to provide a more patient-tailored treatment option. Thorough knowledge of DA agonists helps clinicians better balance clinical efficacy and side effects. Therefore, this review refers to recent English-written articles on DA agonist therapy for PD patients and summarizes the latest findings on non-ergot DA agonists as well as the advantages and disadvantages of each compound to help clinicians in the selection of a specific DA agonist. In addition, novel D1/D5 partial agonists and new formulations of DA agonists are also discussed.
Collapse
Affiliation(s)
- Xiao-Zhong Jing
- Department of Neurology, Jiading Branch of Shanghai General Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
- Department of Neurology, TongRen Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Hui-Jia Yang
- Center for Clinical Research on Neurological Diseases, The First Affiliated Hospital, Dalian Medical University, Dalian 116021, China
| | - Reyisha Taximaimaiti
- Department of Neurology, Jiading Branch of Shanghai General Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Xiao-Ping Wang
- Department of Neurology, Jiading Branch of Shanghai General Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
- Department of Neurology, TongRen Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| |
Collapse
|
15
|
Wolfschlag M, Håkansson A. Drug-Induced Gambling Disorder: Epidemiology, Neurobiology, and Management. Pharmaceut Med 2023; 37:37-52. [PMID: 36611111 PMCID: PMC9825131 DOI: 10.1007/s40290-022-00453-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2022] [Indexed: 01/09/2023]
Abstract
Problematic gambling has been suggested to be a possible consequence of dopaminergic medications used mainly in neurological conditions, i.e. pramipexole and ropinirole, and possibly by one antipsychotic compound, aripiprazole. Patients with Parkinson's disease, restless legs syndrome and other conditions potentially treated with dopamine agonists, as well as patients treated for psychotic disorders, are vulnerable patient groups with theoretically increased risk of developing gambling disorder (GD), for example due to higher rates of mental ill-health in these groups. The aim of the present paper is to review the epidemiological, clinical, and neurobiological evidence of the association between dopaminergic medications and GD, and to describe risk groups and treatment options. The neurobiology of GD involves the reward and reinforcement system, based mainly on mesocorticolimbic dopamine projections, with the nucleus accumbens being a crucial area for developing addictions to substances and behaviors. The addictive properties of gambling can perhaps be explained by the reward uncertainty that activates dopamine signaling in a pathological manner. Since reward-related learning is mediated by dopamine, it can be altered by dopaminergic medications, possibly leading to increased gambling behavior and a decreased impulse control. A causal relationship between the medications and GD seems likely, but the molecular mechanisms behind this association have not been fully described yet. More research is needed in order to fully outline the clinical picture of GD developing in patient groups with dopaminergic medications, and data are needed on the differentiation of risk in different compounds. In addition, very few interventional studies are available on the management of GD induced by dopaminergic medications. While GD overall can be treated, there is need for treatment studies testing the effectiveness of tapering of the medication or other gambling-specific treatment modalities in these patient groups.
Collapse
Affiliation(s)
- Mirjam Wolfschlag
- Malmö-Trelleborg Addiction Center, Competence Center Addiction, Region Skåne, Södra Förstadsgatan 35, plan 4, S-205 02 Malmö, Sweden ,Faculty of Medicine, Dept of Clinical Sciences Lund, Lund University, Psychiatry, Lund, Sweden
| | - Anders Håkansson
- Malmö-Trelleborg Addiction Center, Competence Center Addiction, Region Skåne, Södra Förstadsgatan 35, plan 4, S-205 02, Malmö, Sweden. .,Faculty of Medicine, Dept of Clinical Sciences Lund, Lund University, Psychiatry, Lund, Sweden.
| |
Collapse
|
16
|
Hamidianjahromi A, Tritos NA. Impulse control disorders in hyperprolactinemic patients on dopamine agonist therapy. Rev Endocr Metab Disord 2022; 23:1089-1099. [PMID: 36125673 DOI: 10.1007/s11154-022-09753-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/26/2022] [Indexed: 11/28/2022]
Abstract
Dopamine agonists (DAs) represent a mainstay of therapy for hyperprolactinemia and prolactinomas. The widespread use of DAs, including bromocriptine, cabergoline and (in some countries) quinagolide, has led to the emergence and recognition of impulse control disorders (ICDs) that may occur in association with DA therapy.Such ICDs include pathological gambling, compulsive shopping, hypersexuality and punding (the performance of repetitive tasks), among others. These manifestations can lead to substantial harms to patients and their families, if left undiagnosed and untreated. Several risk factors that may increase the risk of ICDs have been proposed, including younger age, male gender, smoking and alcohol use and history of depression.The diagnosis of ICDs in hyperprolactinemic patients treated with DAs requires a high index of suspicion and a systematic approach, using available screening questionnaires. However, it should be noted that available test instruments, including questionnaires and computerized tasks, have not been validated specifically in hyperprolactinemic patients. Hyperprolactinemic patients who develop ICDs should be withdrawn from DA therapy or, at a minimum, undergo a DA dose reduction, and considered for psychiatric consultation and cognitive behavioral therapy. However, the role of psychopharmacotherapy in hyperprolactinemic patients with ICDs remains incompletely characterized.Patient counseling regarding the risk of ICDs occurring in association with DA therapy, early detection and prompt intervention may mitigate potential harms associated with ICDs. Additional studies are needed to fully characterize risk factors, underlying mechanisms and identify effective therapies for ICDs in patients with hyperprolactinemia receiving DAs.
Collapse
Affiliation(s)
- Anahid Hamidianjahromi
- Neuroendocrine Unit and Neuroendocrine and Pituitary Tumor Clinical Center, Massachusetts General Hospital, 100 Blossom Street, Suite 140, 02114, Boston, MA, USA
| | - Nicholas A Tritos
- Neuroendocrine Unit and Neuroendocrine and Pituitary Tumor Clinical Center, Massachusetts General Hospital, 100 Blossom Street, Suite 140, 02114, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
17
|
Marín‐Lahoz J, Martinez‐Horta S, Pagonabarraga J, Horta‐Barba A, Aracil‐Bolaños I, Bejr‐kasem H, Sampedro F, Campolongo A, Kulisevsky J. Predicting Impulse Control Disorders in Parkinson’s disease through incentive biomarkers. Ann Neurol 2022; 92:974-984. [DOI: 10.1002/ana.26486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Juan Marín‐Lahoz
- Neurology Department Miguel Servet University Hospital Zaragoza Spain
- Instituto de Investigación Sanitaria de Aragón Zaragoza Spain
- Universitat Autònoma de Barcelona (U.A.B.), Medicine Department Barcelona Spain
| | - Saül Martinez‐Horta
- Universitat Autònoma de Barcelona (U.A.B.), Medicine Department Barcelona Spain
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital Barcelona Spain
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
| | - Javier Pagonabarraga
- Universitat Autònoma de Barcelona (U.A.B.), Medicine Department Barcelona Spain
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital Barcelona Spain
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
| | - Andrea Horta‐Barba
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital Barcelona Spain
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
| | - Ignacio Aracil‐Bolaños
- Universitat Autònoma de Barcelona (U.A.B.), Medicine Department Barcelona Spain
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital Barcelona Spain
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
| | - Helena Bejr‐kasem
- Universitat Autònoma de Barcelona (U.A.B.), Medicine Department Barcelona Spain
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital Barcelona Spain
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
| | - Frederic Sampedro
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
| | - Antonia Campolongo
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital Barcelona Spain
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
| | - Jaime Kulisevsky
- Universitat Autònoma de Barcelona (U.A.B.), Medicine Department Barcelona Spain
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital Barcelona Spain
- Institut d´Investigacions Biomèdiques‐ Sant Pau (IIB‐Sant Pau) Barcelona Spain
- Centro de Investigación en Red‐Enfermedades Neurodegenerativas (CIBERNED) Spain
| |
Collapse
|
18
|
Weintraub D, Posavi M, Fontanillas P, Tropea TF, Mamikonyan E, Suh E, Trojanowski JQ, Cannon P, Van Deerlin VM, Chen‐Plotkin AS. Genetic prediction of impulse control disorders in Parkinson's disease. Ann Clin Transl Neurol 2022; 9:936-949. [PMID: 35762106 PMCID: PMC9268896 DOI: 10.1002/acn3.51569] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE To develop a clinico-genetic predictor of impulse control disorder (ICD) risk in Parkinson's disease (PD). METHODS In 5770 individuals from three PD cohorts (the 23andMe, Inc.; the University of Pennsylvania [UPenn]; and the Parkinson's Progression Markers Initiative [PPMI]), we used a discovery-replication strategy to develop a clinico-genetic predictor for ICD risk. We first performed a Genomewide Association Study (GWAS) for ICDs anytime during PD in 5262 PD individuals from the 23andMe cohort. We then combined newly discovered ICD risk loci with 13 ICD risk loci previously reported in the literature to develop a model predicting ICD in a Training dataset (n = 339, from UPenn and PPMI cohorts). The model was tested in a non-overlapping Test dataset (n = 169, from UPenn and PPMI cohorts) and used to derive a continuous measure, the ICD-risk score (ICD-RS), enriching for PD individuals with ICD (ICD+ PD). RESULTS By GWAS, we discovered four new loci associated with ICD at p-values of 4.9e-07 to 1.3e-06. Our best logistic regression model included seven clinical and two genetic variables, achieving an area under the receiver operating curve for ICD prediction of 0.75 in the Training and 0.72 in the Test dataset. The ICD-RS separated groups of PD individuals with ICD prevalence of nearly 40% (highest risk quartile) versus 7% (lowest risk quartile). INTERPRETATION In this multi-cohort, international study, we developed an easily computed clinico-genetic tool, the ICD-RS, that substantially enriches for subgroups of PD at very high versus very low risk for ICD, enabling pharmacogenetic approaches to PD medication selection.
Collapse
Affiliation(s)
- Daniel Weintraub
- Department of Psychiatry Perelman School of Medicine, University of Pennsylvania Philadelphia Pennsylvania USA
- Department of Neurology Perelman School of Medicine, University of Pennsylvania Philadelphia Pennsylvania USA
- Parkinson’s Disease Research, Education and Clinical Center (PADRECC) Philadelphia Veterans Affairs Medical Center Philadelphia Pennsylvania USA
| | - Marijan Posavi
- Department of Neurology Perelman School of Medicine, University of Pennsylvania Philadelphia Pennsylvania USA
| | | | - Thomas F. Tropea
- Department of Neurology Perelman School of Medicine, University of Pennsylvania Philadelphia Pennsylvania USA
| | - Eugenia Mamikonyan
- Department of Psychiatry Perelman School of Medicine, University of Pennsylvania Philadelphia Pennsylvania USA
| | - Eunran Suh
- Department of Pathology and Laboratory Medicine Perelman School of Medicine, University of Pennsylvania Philadelphia Pennsylvania USA
| | - John Q. Trojanowski
- Department of Pathology and Laboratory Medicine Perelman School of Medicine, University of Pennsylvania Philadelphia Pennsylvania USA
| | | | - Vivianna M. Van Deerlin
- Department of Pathology and Laboratory Medicine Perelman School of Medicine, University of Pennsylvania Philadelphia Pennsylvania USA
| | - Alice S. Chen‐Plotkin
- Department of Neurology Perelman School of Medicine, University of Pennsylvania Philadelphia Pennsylvania USA
| | | |
Collapse
|
19
|
Buhmann C. Prevalence, clinical presentations and impact on relationship of sexual dysfunction in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 162:1-19. [PMID: 35397782 DOI: 10.1016/bs.irn.2021.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Sexual dysfunction is one of the commonest non-motor symptoms in Parkinson's disease (PD) and has been found about twice as high in PD patients compared to age-matched controls. The quality of sexual life is reduced in PD patients compared to healthy peers and impairment affects wide aspects of physical sexual function as well as sexual desire, sexual satisfaction and sexual partnership. Overall, male PD patients are more frequently affected by sexual disorders than females and seem to suffer more from sexual impairment. The reported frequencies and presentations of various sexual dysfunctions vary widely in the literature, which is likely related to the patient cohorts examined, in particular with regard to age and gender, duration and severity of disease and applied measurement instruments. This chapter gives an overview of the prevalence, phenotype and clinical presentation of sexual dysfunction in PD and its influence on the partnership.
Collapse
Affiliation(s)
- Carsten Buhmann
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| |
Collapse
|
20
|
Ke X, Wang L, Chen M, Liu S, Yu N, Duan L, Gong F, Zhu H. The side effects of dopamine receptor agonist drugs in Chinese prolactinoma patients: a cross sectional study. BMC Endocr Disord 2022; 22:97. [PMID: 35410236 PMCID: PMC9004168 DOI: 10.1186/s12902-022-01009-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 03/25/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Recently, side effects from Dopamine Receptor Agonist Drugs (DAs) in treating pituitary prolactinoma have raised widespread concern. This study explores the incidence and influencing factors of DAs-related side effects in Chinese prolactinoma patients. METHODS A cross-sectional study was conducted. 51 prolactinoma patients treated with DAs, 12 prolactinoma or pituitary microadenoma patients without DAs treatment, and 33 healthy controls were included. The Barratt impulsivity scale-11, Patient Health Questionnaire 9, and the ICD screening questionnaire were all used to evaluate the psychological and physical side effects of DAs. Clinical data of all subjects were collected from their electronic medical records. RESULTS The incidence of ICDs in the treated group, the untreated group, and control group was 9.8% (5/51), 16.7% (2/12), and 9.1% (3/33), respectively. In the treated group in particular, there were 1 patient (2%, 1/51), 2 patients (3.9%, 2/51), and 2 patients (3.9%, 2/51) with positive screening for punding, compulsive shopping, and hypersexuality, respectively. In terms of depression, the incidence of "minimal", "mild" and "moderate" depression in the treated group was 62.8% (32/51), 25.5% (13/51), and 5.9% (3/51), respectively. The incidence of physical symptoms was 51.0% (26/51) in the treated group and gastrointestinal symptoms were the most common symptoms (33.3%, 17/51). In addition, we found that the various parameters of DAs treatment had no association with the occurrence of physical symptoms or ICDs (all P > 0.05). CONCLUSIONS Chinese prolactinoma patients treated with DAs had a lower incidence of ICDs (9.8%), while gastrointestinal symptoms were common. In this way, more attention should be paid to side effects, especially physical symptoms, in Chinese prolactinoma patients with DAs therapy during follow-up regardless of dose.
Collapse
Affiliation(s)
- Xiaoan Ke
- Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Key Laboratory of Endocrinology of National Health Commission, Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1 Shuaifuyuan, PekingBeijing, 100730, China
| | - Linjie Wang
- Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Key Laboratory of Endocrinology of National Health Commission, Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1 Shuaifuyuan, PekingBeijing, 100730, China
| | - Meiping Chen
- Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Key Laboratory of Endocrinology of National Health Commission, Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1 Shuaifuyuan, PekingBeijing, 100730, China
| | - Shanshan Liu
- Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Key Laboratory of Endocrinology of National Health Commission, Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1 Shuaifuyuan, PekingBeijing, 100730, China
| | - Na Yu
- Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Key Laboratory of Endocrinology of National Health Commission, Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1 Shuaifuyuan, PekingBeijing, 100730, China
| | - Lian Duan
- Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Key Laboratory of Endocrinology of National Health Commission, Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1 Shuaifuyuan, PekingBeijing, 100730, China
| | - Fengying Gong
- Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Key Laboratory of Endocrinology of National Health Commission, Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1 Shuaifuyuan, PekingBeijing, 100730, China
| | - Huijuan Zhu
- Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Key Laboratory of Endocrinology of National Health Commission, Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1 Shuaifuyuan, PekingBeijing, 100730, China.
| |
Collapse
|
21
|
Parkinson's disease and Behavioural Addiction: The susceptibilities and risks. Asian J Psychiatr 2022; 68:102960. [PMID: 34896771 DOI: 10.1016/j.ajp.2021.102960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/27/2021] [Accepted: 11/29/2021] [Indexed: 11/02/2022]
|
22
|
Wojciechowski T. Exposure to Violence Variety as a Risk Factor for Cigarette Smoking: Relevance of Sensation-Seeking and Impulsivity as Mediators. Subst Use Misuse 2022; 57:239-248. [PMID: 34789055 DOI: 10.1080/10826084.2021.2002901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Prior research has indicated that exposure to violence is a risk factor associated with cigarette smoking. However, the relevance of variety of exposure for predicting this outcome has remained underexplored. This is problematic, as increased variety of exposure may represent a measure of severity of trauma exposure with less recall bias than other measures. Further, related constructs of sensation-seeking and impulsivity have yet to be investigated as mediators of this relationship. It is predicted that increased variety of exposure to violence results in dysfunctional variation in these constructs, leading to increased daily cigarette use. METHODS The present study utilizes data from the first three waves of the Pathways to Desistance study to examine these relationships. Generalized structural equation modeling is used to identify direct and indirect effects of interest. A bootstrap resampling process was used to compute normalized standard errors so that indirect effects were not biased. RESULTS Results indicated that lifetime exposure to violence variety prior to baseline predicted increased daily cigarette use at follow-up. Neither sensation-seeking nor impulsivity were significant mediators when both constructs were included in the model, but impulsivity emerged as a significant mediator when separate mediation models were estimated for each construct. CONCLUSIONS The findings indicate the potential utility of screening for variety of exposure to violence to determine adolescents who may be at-risk for high frequency cigarette smoking. Programming focused on impulsivity may play a role in addressing cigarette smoking issues stemming from exposure to violence.
Collapse
Affiliation(s)
- Thomas Wojciechowski
- School of Criminal Justice, Michigan State University, East Lansing, Michigan, USA
| |
Collapse
|
23
|
Unlucky punches: the vulnerability-stress model for the development of impulse control disorders in Parkinson's disease. NPJ Parkinsons Dis 2021; 7:112. [PMID: 34880241 PMCID: PMC8654901 DOI: 10.1038/s41531-021-00253-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 11/04/2021] [Indexed: 01/09/2023] Open
Abstract
Impulse-control disorders are commonly observed during dopamine-replacement therapy in Parkinson’s disease, but the majority of patients seems “immune” to this side effect. Epidemiological evidence suggests that a major risk factor may be a specific difference in the layout of the dopaminergic-reinforcement system, of which the ventral striatum is a central player. A series of imaging studies of the dopaminergic system point toward a presynaptic reduction of dopamine-reuptake transporter density and dopamine synthesis capacity. Here, we review current evidence for a vulnerability-stress model in which a relative reduction of dopaminergic projections to the ventral striatum and concomitant sensitization of postsynaptic neurons represent a predisposing (hypodopaminergic) vulnerability. Stress (hyperdopaminergic) is delivered when dopamine replacement therapy leads to a relative overdosing of the already-sensitized ventral striatum. These alterations are consistent with consecutive changes in reinforcement mechanisms, which stimulate learning from reward and impede learning from punishment, thereby fostering the development of impulse-control disorders. This vulnerability-stress model might also provide important insights into the development of addictions in the non-Parkinsonian population.
Collapse
|
24
|
Barbosa P, Lees AJ. Dopamine devils. ARQUIVOS DE NEURO-PSIQUIATRIA 2021; 79:941-942. [PMID: 34817000 DOI: 10.1590/0004-282x-anp-2021-e011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 11/22/2022]
Affiliation(s)
- Pedro Barbosa
- University College London, Institute of Neurology, Department of Clinical Movement Disorder and Neuroscience, Reta Lila Weston Institute of Neurological Studies, London, UK.,Universidade de São Paulo, São Paulo SP, Brazil
| | - Andrew John Lees
- University College London, Institute of Neurology, Department of Clinical Movement Disorder and Neuroscience, Reta Lila Weston Institute of Neurological Studies, London, UK
| |
Collapse
|
25
|
Martín-Bastida A, Delgado-Alvarado M, Navalpotro-Gómez I, Rodríguez-Oroz MC. Imaging Cognitive Impairment and Impulse Control Disorders in Parkinson's Disease. Front Neurol 2021; 12:733570. [PMID: 34803882 PMCID: PMC8602579 DOI: 10.3389/fneur.2021.733570] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/28/2021] [Indexed: 12/04/2022] Open
Abstract
Dementia and mild forms of cognitive impairment as well as neuropsychiatric symptoms (i. e., impulse control disorders) are frequent and disabling non-motor symptoms of Parkinson's disease (PD). The identification of changes in neuroimaging studies for the early diagnosis and monitoring of the cognitive and neuropsychiatric symptoms associated with Parkinson's disease, as well as their pathophysiological understanding, are critical for the development of an optimal therapeutic approach. In the current literature review, we present an update on the latest structural and functional neuroimaging findings, including high magnetic field resonance and radionuclide imaging, assessing cognitive dysfunction and impulse control disorders in PD.
Collapse
Affiliation(s)
- Antonio Martín-Bastida
- Department of Neurology, Clínica Universidad de Navarra, Pamplona, Spain.,CIMA, Center of Applied Medical Research, Universidad de Navarra, Neurosciences Program, Pamplona, Spain
| | | | - Irene Navalpotro-Gómez
- Cognitive Impairment and Movement Disorders Unit, Neurology Department, Hospital del Mar, Barcelona, Spain.,Clinical and Biological Research in Neurodegenerative Diseases, Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital del Mar Research Institute (IMIM), Barcelona, Spain.,Barcelonabeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - María Cruz Rodríguez-Oroz
- Department of Neurology, Clínica Universidad de Navarra, Pamplona, Spain.,CIMA, Center of Applied Medical Research, Universidad de Navarra, Neurosciences Program, Pamplona, Spain.,IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| |
Collapse
|
26
|
Hall A, Weaver SR, Compton LJ, Byblow WD, Jenkinson N, MacDonald HJ. Dopamine genetic risk score predicts impulse control behaviors in Parkinson's disease. Clin Park Relat Disord 2021; 5:100113. [PMID: 34765965 PMCID: PMC8569744 DOI: 10.1016/j.prdoa.2021.100113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/09/2021] [Accepted: 10/20/2021] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION Up to 40% of Parkinson's disease patients taking dopamine agonist medication develop impulse control behaviors which can have severe negative consequences. The current study aimed to utilize dopamine genetics to identify patients most at risk of developing these behaviors. METHODS Demographic, clinical, and genetic data were obtained from the Parkinson's Progression Markers Initiative for de novo patients (n = 327), patients taking dopamine agonists (n = 146), and healthy controls (n = 160). Impulsive behaviors were identified using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease. A dopamine genetic risk score was calculated for each patient according to polymorphisms in genes coding for dopamine D1, D2 and D3 receptors, and catechol-O-methyltransferase. A higher score reflected higher central dopamine neurotransmission. RESULTS Patients on agonists with a low dopamine genetic risk score were over 18 times more likely to have an impulsive behavior compared to higher scores (p = 0.04). The 38% of patients taking agonists who had at least one impulsive behavior were more likely to be male and report higher Unified Parkinson's Disease Rating Scale I&II scores. With increasing time on dopamine agonists (range 92-2283 days, mean 798 ± 565 standard deviation), only patients with a high dopamine genetic risk score showed an increase in number of impulsive behaviors (p = 0.033). Predictive effects of the gene score were not present in de novo or healthy control. CONCLUSIONS A dopamine genetic risk score can identify patients most at risk of developing impulsive behaviors on dopamine agonist medication and predict how these behaviors may worsen over time.
Collapse
Affiliation(s)
- Alison Hall
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Samuel R. Weaver
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | | | - Winston D. Byblow
- Department of Exercise Sciences, University of Auckland, Auckland, New Zealand
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Ned Jenkinson
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Hayley J. MacDonald
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| |
Collapse
|
27
|
Analysis of Impulse Control Disorders (ICDs) and Factors Associated with Their Development in a Parkinson's Disease Population. Healthcare (Basel) 2021; 9:healthcare9101263. [PMID: 34682943 PMCID: PMC8535407 DOI: 10.3390/healthcare9101263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/19/2021] [Accepted: 09/21/2021] [Indexed: 11/16/2022] Open
Abstract
Parkinson's Disease (PD) is a neurodegenerative disease in which non-motor symptoms may appear before motor phenomena, which include Impulse Control Disorders (ICDs). The objective of this study is to identify factors associated with the development of ICDs in PD. An analytical, cross-sectional study was conducted using clinical records from patients diagnosed with PD, both genders, from 40 to 80 years old. Clinical and demographic data were collected: 181 patients were recruited; 80 of them showed PD and ICDs, and they constituted the study group, whereas 101 patients with PD without ICDs constituted the control reference group. The duration of PD was longer in the group with ICDs (p < 0.008), and all patients showed at least one ICD: binge eating (61.29%), compulsive shopping (48.75%), hypersexuality (23.75%), gambling behavior (8.75%), and punding (3.75%). After logistic regression analysis, only the use of dopamine agonists remained associated with ICDs (p < 0.001), and the tremorgenic form was suggested to be a protective factor (p < 0.001). Positive associations were observed between the rigid-akinetic form and compulsive shopping (p < 0.007), between male and hypersexuality (p < 0.018), and between dopamine agonists and compulsive shopping (p < 0.004), and negative associations were observed between motor fluctuations and compulsive shopping (p < 0.031), between Deep Brain Stimulation and binge eating (p < 0.046), and between levodopa consumption and binge eating (p < 0.045). Binge eating, compulsive shopping, and hypersexuality were the most frequent ICDs. Complex forms and motor complications of PD were associated with the development of ICDs.
Collapse
|
28
|
Impulse control disorders and related behaviors in Parkinson's disease: risk factors, clinical and genetic aspects, and management. Curr Opin Neurol 2021; 34:547-555. [PMID: 33967198 DOI: 10.1097/wco.0000000000000955] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW To review recent findings and research directions on impulse control disorders and related behaviors (ICDRBs) in Parkinson's disease (PD). RECENT FINDINGS Longitudinal studies found that prevalence increases during PD progression, incident ICDRBs being around 10% per year in patients treated with dopaminergic therapies. Screening tools and severity scales already developed have been validated and are available in several countries and languages. The main clinical risk factors include young age, male gender, type, doses and duration of dopaminergic therapy, PD motor severity and dyskinesia, depression, anxiety, apathy, sleep disorders, and impulsivity traits. Genetic factors are suspected by a high estimated heritability, but individual genes and variants remain to be replicated. Management of ICDRBs is centered on dopamine agonist decrease, with the risk to develop withdrawal symptoms. Cognitive behavioral therapy and subthalamic nucleus deep brain stimulation also improve ICDRBs. In the perspective of precision medicine, new individual prediction models of these disorders have been proposed, but they need further independent replication. SUMMARY Regular monitoring of ICDRB during the course of PD is needed, particularly in the subject at high risk of developing these complications. Precision medicine will require the appropriate use of machine learning to be reached in the clinical setting.
Collapse
|
29
|
Grassi G, Albani G, Terenzi F, Razzolini L, Ramat S. New pharmacological and neuromodulation approaches for impulsive-compulsive behaviors in Parkinson's disease. Neurol Sci 2021; 42:2673-2682. [PMID: 33852081 DOI: 10.1007/s10072-021-05237-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/07/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION A significant proportion of patients with Parkinson's disease (PD) display a set of impulsive-compulsive behaviors at some point during the course of illness. These behaviors range from the so-called behavioral addictions to dopamine dysregulation syndrome, punding and hoarding disorders. These behaviors have been consistently linked to the use of dopaminergic medications used to treat PD motor symptoms (dopamine agonists, levodopa, and other agents) and less consistently to neuromodulation techniques such as deep brain stimulation (DBS). Since there are still no approved treatments for these conditions, their pharmacological management is still a big challenge for clinicians. METHODS We conducted an extensive review of current pharmacological and neuromodulation literature for the management of impulsive-compulsive disorders in PD patients. RESULTS Pharmacological treatment approaches for impulsive-compulsive behaviors and DDS in PD patients include reduction of levodopa (LD), reduction/cessation of dopamine agonist (DA), and initiation of infusion therapies (apomorphine infusion and duodopa). Also, atomoxetine, a noradrenergic agent approved for the treatment of attention deficit hyperactivity disorder, showed some interesting preliminary results but there is still a lack of controlled longitudinal studies. Finally, while DBS effects on impulsive-compulsive disorders are still controversial, non-invasive techniques (such as transcranial magnetic stimulation and transcranial direct current stimulation) could have a potential positive effect but, again, there is still a lack of controlled trials. CONCLUSION Managing impulsivity and compulsivity in PD patients is still a non-evidence-based challenge for clinicians. Controlled trials on promising approaches such as atomoxetine and non-invasive neuromodulation techniques are needed.
Collapse
Affiliation(s)
- Giacomo Grassi
- Brain Center Firenze, Viale Belfiore 36, 5014, Florence, Italy.
| | | | | | - Lorenzo Razzolini
- Brain Center Firenze, Viale Belfiore 36, 5014, Florence, Italy.,University of Florence, Florence, Italy
| | | |
Collapse
|
30
|
Parra‐Díaz P, Chico‐García JL, Beltrán‐Corbellini Á, Rodríguez‐Jorge F, Fernández‐Escandón CL, Alonso‐Cánovas A, Martínez‐Castrillo JC. Does the Country Make a Difference in Impulse Control Disorders? A Systematic Review. Mov Disord Clin Pract 2021; 8:25-32. [PMID: 33426155 PMCID: PMC7780950 DOI: 10.1002/mdc3.13128] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 10/29/2020] [Accepted: 11/08/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Impulse control disorders (ICDs) have an increased frequency in patients with Parkinson's disease (PD), mainly because of treatment with dopamine agonists (DA). Factors related with the country of origin (culture, economy, healthcare politics) may impact phenomenology. OBJECTIVES To explore phenomenology of ICDs depending on the country. METHODS A systematic review following PRISMA guidelines was performed using Pubmed database. Articles published up to 2018 in which the prevalence of ICDs was analyzed were selected. RESULTS Thirty-two studies from 22 countries worldwide were included. The highest prevalence of ICDs in each continent was found in UK (59%), USA (39.1%) and India (31.6%). Frequency of ICDs was higher in those studies with lower mean age, higher proportion of males, whenever a screening instrument was used and whenever prescription of DAs was more common. Prevalence of ICDs was higher in Western countries compared to Asian countries (20.8% vs. 12.8%, P < 0.001) as it was the proportion of patients treated with DAs (66% vs. 48.2%, P < 0.001). Hypersexuality was the most common ICD overall (up to 23.8%). The highest frequencies of compulsive buying and eating were found in Western countries. Gambling was less commonly diagnosed, but prevalence was relevant Japan (14%). CONCLUSION We observed a tendency towards a different ICD profile in different geographical areas, which may be attributable to socio-economical, cultural or political influences in the phenomenology of these disorders. Acknowledging these differences could help their early detection, which is critical for prognosis.
Collapse
Affiliation(s)
- Paloma Parra‐Díaz
- Department of NeurologyHospital Universitario Ramón y CajalMadridSpain
| | | | | | | | | | | | | |
Collapse
|
31
|
Ozkaya HM, Sahin S, Korkmaz OP, Durcan E, Sahin HR, Celik E, Poyraz BC, Kadioglu P. Patients with acromegaly might not be at higher risk for dopamine agonist-induced impulse control disorders than those with prolactinomas. Growth Horm IGF Res 2020; 55:101356. [PMID: 33010581 DOI: 10.1016/j.ghir.2020.101356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 09/07/2020] [Accepted: 09/10/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate the prevalence of impulse control disorders (ICD) and psychiatric symptoms in patients with acromegaly receiving dopamine agonists (DA) in comparison with those with prolactinoma, nonfunctioning pituitary adenomas (NFA), and healthy controls (HC). DESIGN Forty patients with acromegaly, 40 with prolactinoma, 38 with NFA, and 32 HCs were included. All patients and controls were evaluated using the revised version of the Minnesota Impulsive Disorders Interview (MIDI-R), Symptom Check List (SCL-90-R) questionnaire, Barratt Impulsiveness Scale (BIS-11), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). RESULTS We detected ICD associated with DAs in two patients with acromegaly (5%) and three patients (7.5%) with prolactinoma. All patients' symptoms resolved after discontinuation of the drug. While the mean DA dose was higher in patients with acromegaly than prolactinomas (p < 0.05), no difference was detected in terms of ICD prevalence between two groups (p > 0.05). SCL-90 depression and interpersonal sensitivity subscale positivity was higher in patients with NFA than HCs. Patients with prolactinoma had higher obsession and interpersonal sensitivity positivity and those with NFA had higher somatization, interpersonal sensitivity, and depression positivity as compared to patients with acromegaly (p < 0.05 for all). CONCLUSIONS Although DA dose was significantly higher in patients with acromegaly, there was no significant difference in the prevalence of DA-related ICD. The higher prevalence of positive screening in SCL-90 in patients with NFA in comparison to HCs supports the hypothesis that the presence of a pituitary adenoma per se might cause significant psychiatric symptoms.
Collapse
Affiliation(s)
- Hande Mefkure Ozkaya
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Serdar Sahin
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ozge Polat Korkmaz
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Emre Durcan
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Humeyra Rekali Sahin
- Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Emir Celik
- Division of Medical Oncology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Burc Cagri Poyraz
- Department of Psychiatry, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Pinar Kadioglu
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| |
Collapse
|
32
|
Binck S, Pauly C, Vaillant M, Hipp G, Gantenbein M, Krueger R, Diederich NJ. Contributing Factors and Evolution of Impulse Control Disorder in the Luxembourg Parkinson Cohort. Front Neurol 2020; 11:578924. [PMID: 33281714 PMCID: PMC7688665 DOI: 10.3389/fneur.2020.578924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/09/2020] [Indexed: 11/13/2022] Open
Abstract
Background: To establish the frequency of impulse control disorder (ICD) in Parkinson's disease (PD).Methods: Within the Luxembourg Parkinson's Study, PD patients were evaluated for ICD presence (score ≥ 1 on MDS-UPDRS I item 1.6), use of dopamine agonists (DA) and other medications.Results: 470 patients were enrolled. Among 217 patients without DA use, 6.9% scored positive for ICD, vs. 15.4% among 253 patients with DA use (p = 0.005). The regression analysis showed that age at PD diagnosis had only a minor impact on ICD occurrence, while there was no influence by gender or co-medications. The longitudinal study over 2 years in 156 patients demonstrated increasing ICD frequency in DA users (p = 0.005).Conclusion: This large and non-interventional study confirms that PD patients with DA treatment show higher frequency of ICD than patients without DA use. It newly demonstrates that ICD can develop independently from age, gender, or co-medications.
Collapse
Affiliation(s)
- Sylvia Binck
- Luxembourg Centre for System Biomedicine, University of Luxembourg, Luxembourg, Luxembourg
- Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
- *Correspondence: Sylvia Binck
| | - Claire Pauly
- Luxembourg Centre for System Biomedicine, University of Luxembourg, Luxembourg, Luxembourg
- Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | | | - Geraldine Hipp
- Luxembourg Centre for System Biomedicine, University of Luxembourg, Luxembourg, Luxembourg
| | | | - Rejko Krueger
- Luxembourg Centre for System Biomedicine, University of Luxembourg, Luxembourg, Luxembourg
- Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
- Luxembourg Institute of Health, Luxembourg, Luxembourg
| | | |
Collapse
|
33
|
Weintraub D. Management of psychiatric disorders in Parkinson's disease : Neurotherapeutics - Movement Disorders Therapeutics. Neurotherapeutics 2020; 17:1511-1524. [PMID: 32514891 PMCID: PMC7851231 DOI: 10.1007/s13311-020-00875-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Affective disorders (depression and anxiety), psychosis, impulse control disorders, and apathy are common and sometimes disabling psychiatric conditions in Parkinson disease (PD). Psychiatric aspects of PD are associated with numerous adverse outcomes, yet in spite of this and their high frequency, there remains incomplete understanding of epidemiology, presentation, risk factors, neural substrate, and management strategies. Psychiatric features are typically co- or multimorbid, and there is great intra- and interindividual variability in presentation [1]. The neuropathophysiological changes that occur in PD, as well as the association between PD treatment and particular psychiatric disorders, suggest a neurobiological contribution to many psychiatric symptoms. There is evidence that psychiatric disorders in PD are still under-recognized and undertreated, and although psychotropic medication use is common, randomized controlled trials demonstrating efficacy and tolerability are largely lacking. Future research on neuropsychiatric complications in PD should be oriented toward determining modifiable correlates or risk factors, and most importantly, establishing efficacious and well-tolerated treatment strategies.
Collapse
Affiliation(s)
- Daniel Weintraub
- Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
- Parkinson's Disease Research, Education and Clinical Center (PADRECC), Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA.
| |
Collapse
|
34
|
Scott BM, Eisinger RS, Burns MR, Lopes J, Okun MS, Gunduz A, Bowers D. Co-occurrence of apathy and impulse control disorders in Parkinson disease. Neurology 2020; 95:e2769-e2780. [PMID: 33004605 DOI: 10.1212/wnl.0000000000010965] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 07/22/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To empirically test whether apathy and impulse control disorders (ICDs) represent independent, opposite ends of a motivational spectrum. METHODS In this single-center, cross-sectional study, we obtained retrospective demographics and clinical data for 887 patients with idiopathic Parkinson disease (PD) seen at a tertiary care center. Mood and motivation disturbances were classified using recommended cutoff scores from self-reported measures of apathy, ICD, anxiety, and depression. RESULTS Prevalence rates included 29.0% of patients with PD with depression, 40.7% with anxiety, 41.3% with apathy, 27.6% with ICDs, and 17.0% with both apathy and ICD. The majority (61.6%) of people reporting clinically significant ICDs also reported clinically significant apathy, and more than a third of patients with apathy (41.3%) also reported elevated ICD. Anxiety and depression were highest in patients with both apathy and ≥1 ICDs. Dopamine agonist use was higher in people with only ICD compared to people with only apathy. Mood significantly interacted with demographic variables to predict motivational disturbances. CONCLUSIONS Motivational disturbances are common comorbid conditions in patients with PD. In addition, these complex behavioral syndromes interact with mood in clinically important ways that may influence the design of future clinical trials and the development of novel therapies. This study challenges the concept of apathy and ICD in PD as opposite ends of a spectrum.
Collapse
Affiliation(s)
- Bonnie M Scott
- From the Department of Clinical and Health Psychology (B.M.S., D.B.), Departments of Neuroscience (R.S.E., A.G.) and Neurology (M.R.B., J.L., M.S.O.), Norman Fixel Institute of Neurological Diseases, and J. Crayton Pruitt Department of Biomedical Engineering (A.G.), University of Florida, Gainesville.
| | - Robert S Eisinger
- From the Department of Clinical and Health Psychology (B.M.S., D.B.), Departments of Neuroscience (R.S.E., A.G.) and Neurology (M.R.B., J.L., M.S.O.), Norman Fixel Institute of Neurological Diseases, and J. Crayton Pruitt Department of Biomedical Engineering (A.G.), University of Florida, Gainesville
| | - Matthew R Burns
- From the Department of Clinical and Health Psychology (B.M.S., D.B.), Departments of Neuroscience (R.S.E., A.G.) and Neurology (M.R.B., J.L., M.S.O.), Norman Fixel Institute of Neurological Diseases, and J. Crayton Pruitt Department of Biomedical Engineering (A.G.), University of Florida, Gainesville
| | - Janine Lopes
- From the Department of Clinical and Health Psychology (B.M.S., D.B.), Departments of Neuroscience (R.S.E., A.G.) and Neurology (M.R.B., J.L., M.S.O.), Norman Fixel Institute of Neurological Diseases, and J. Crayton Pruitt Department of Biomedical Engineering (A.G.), University of Florida, Gainesville
| | - Michael S Okun
- From the Department of Clinical and Health Psychology (B.M.S., D.B.), Departments of Neuroscience (R.S.E., A.G.) and Neurology (M.R.B., J.L., M.S.O.), Norman Fixel Institute of Neurological Diseases, and J. Crayton Pruitt Department of Biomedical Engineering (A.G.), University of Florida, Gainesville
| | - Aysegul Gunduz
- From the Department of Clinical and Health Psychology (B.M.S., D.B.), Departments of Neuroscience (R.S.E., A.G.) and Neurology (M.R.B., J.L., M.S.O.), Norman Fixel Institute of Neurological Diseases, and J. Crayton Pruitt Department of Biomedical Engineering (A.G.), University of Florida, Gainesville
| | - Dawn Bowers
- From the Department of Clinical and Health Psychology (B.M.S., D.B.), Departments of Neuroscience (R.S.E., A.G.) and Neurology (M.R.B., J.L., M.S.O.), Norman Fixel Institute of Neurological Diseases, and J. Crayton Pruitt Department of Biomedical Engineering (A.G.), University of Florida, Gainesville
| |
Collapse
|
35
|
Fantini ML, Fedler J, Pereira B, Weintraub D, Marques A, Durif F. Is Rapid Eye Movement Sleep Behavior Disorder a Risk Factor for Impulse Control Disorder in Parkinson Disease? Ann Neurol 2020; 88:759-770. [DOI: 10.1002/ana.25798] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 05/23/2020] [Accepted: 05/26/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Maria Livia Fantini
- Neurology Department University Hospital Center Clermont‐Ferrand France
- Equipe d'Accueil 7280 Clermont Auvergne University Clermont‐Ferrand France
| | - Janel Fedler
- College of Public Health University of Iowa Iowa City Iowa USA
| | - Bruno Pereira
- Direction of Clinical Research and Innovation, Clinical Research Department University Hospital Center Clermont‐Ferrand France
| | - Daniel Weintraub
- Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania USA
- Parkinson's Disease Research, Education and Clinical Center Philadelphia Veterans Affairs Medical Center Philadelphia Pennsylvania USA
| | - Ana‐Raquel Marques
- Neurology Department University Hospital Center Clermont‐Ferrand France
- Equipe d'Accueil 7280 Clermont Auvergne University Clermont‐Ferrand France
| | - Franck Durif
- Neurology Department University Hospital Center Clermont‐Ferrand France
- Equipe d'Accueil 7280 Clermont Auvergne University Clermont‐Ferrand France
| |
Collapse
|
36
|
Jiménez-Urbieta H, Gago B, Quiroga-Varela A, Rodríguez-Chinchilla T, Merino-Galán L, Delgado-Alvarado M, Navalpotro-Gómez I, Belloso-Iguerategui A, Marin C, Rodríguez-Oroz MC. Motor impulsivity and delay intolerance are elicited in a dose-dependent manner with a dopaminergic agonist in parkinsonian rats. Psychopharmacology (Berl) 2020; 237:2419-2431. [PMID: 32440779 DOI: 10.1007/s00213-020-05544-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 04/30/2020] [Indexed: 10/24/2022]
Abstract
RATIONALE Impulse control disorders (ICD) and other impulsive-compulsive behaviours are frequently found in Parkinson's disease (PD) patients treated with dopaminergic agonists. To date, there are no available animal models to investigate their pathophysiology and determine whether they can be elicited by varying doses of dopaminergic drugs. In addition, there is some controversy regarding the predispositional pattern of striatal dopaminergic depletion. OBJECTIVES To study the effect of two doses of pramipexole (PPX) on motor impulsivity, delay intolerance and compulsive-like behaviour. METHODS Male rats with mild dopaminergic denervation in the dorsolateral striatum (bilateral injections of 6-hydroxidopamine (6-OHDA)) treated with two doses of PPX (0.25 mg/kg and 3 mg/kg) and tested in the variable delay-to-signal paradigm. RESULTS Partial (50%) dopaminergic depletion did not induce significant changes in motor impulsivity or delay intolerance. However, 0.25 mg/kg of PPX increased motor impulsivity, while 3 mg/kg of PPX increased both motor impulsivity and delay intolerance. These effects were independent of the drug's antiparkinsonian effects. Importantly, impulsivity scores before and after dopaminergic lesion were positively associated with the impulsivity observed after administering 3 mg/kg of PPX. No compulsive-like behaviour was induced by PPX administration. CONCLUSIONS We described a rat model, with a moderate dorsolateral dopaminergic lesion resembling that suffered by patients with early PD, that develops different types of impulsivity in a dose-dependent manner dissociated from motor benefits when treated with PPX. This model recapitulates key features of abnormal impulsivity in PD and may be useful for deepening our understanding of the pathophysiology of ICD.
Collapse
Affiliation(s)
| | - Belén Gago
- Instituto de Investigación Biomédica de Málaga, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
| | - Ana Quiroga-Varela
- Centro de Investigación Médica Aplicada (CIMA), Universidad de Navarra, Pamplona, Spain
| | | | - Leyre Merino-Galán
- Centro de Investigación Médica Aplicada (CIMA), Universidad de Navarra, Pamplona, Spain.,University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Manuel Delgado-Alvarado
- Neurology Department, Sierrallana Hospital, Torrelavega, Spain.,Psychiatry Research Area, IDIVAL, University Hospital Marqués de Valdecilla, Santander, Spain.,Biomedical Research Networking Center for Mental Health (CIBERSAM), Madrid, Spain
| | | | | | - Concepció Marin
- IRCE, Institut d' investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - María C Rodríguez-Oroz
- Centro de Investigación Médica Aplicada (CIMA), Universidad de Navarra, Pamplona, Spain. .,Ikerbasque Foundation, Bilbao, Spain. .,Basque Center on Cognition, Brain and Language (BCBL), San Sebastián, Spain. .,Servicio de Neurología, Clínica Universidad de Navarra, Pamplona, Spain.
| |
Collapse
|
37
|
Kelly MJ, Baig F, Hu MTM, Okai D. Spectrum of impulse control behaviours in Parkinson's disease: pathophysiology and management. J Neurol Neurosurg Psychiatry 2020; 91:703-711. [PMID: 32354771 DOI: 10.1136/jnnp-2019-322453] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 12/27/2022]
Abstract
Impulse control behaviours (ICBs) are a range of behaviours linked by their reward-based, repetitive natures. They can be precipitated in Parkinson's disease (PD) by dopamine replacement therapy, often with detrimental consequences for patients and caregivers. While now a well-recognised non-motor feature of treated PD, much remains unknown about the influence of risk factors, pathophysiological mechanisms, vulnerability factors for specific types of behaviour and the optimal management strategies. Imaging studies have identified structural and functional changes in striatal and prefrontal brain regions, among others. Gene association studies indicate a role for genetic predisposition to PD-ICB. Clinical observational studies have identified potential modifiable and non-modifiable risk factors. Psychological studies shed light on the neurocognitive domains implicated in PD-ICBs and identify psychosocial determinants that may perpetuate the cycle of impulsive and harm-avoidance behaviours. Based on these results, a range of pharmacological and non-pharmacological management strategies have been trialled in PD-ICBs with varying success. The purpose of this review is to update clinicians on the evidence around the pathophysiology of PD-ICB. We aim to translate our findings into an interpretable biopsychosocial model that can be applied to the clinical assessment and management of individual cases of PD-ICB.
Collapse
Affiliation(s)
- Mark John Kelly
- School of Medicine, Trinity Centre for Health Sciences, Tallaght University Hospital, Trinity College, Dublin, Ireland .,Oxford Parkinson's Disease Centre, Division of Neurology, Nuffield Department of Clinical Neurosciences, Oxford, Oxfordshire, UK
| | - Fahd Baig
- Molecular and Clinical Sciences Research Centre, London, UK, University of London Saint George's, London, London, UK
| | - Michele Tao-Ming Hu
- Oxford Parkinson's Disease Centre, Division of Neurology, Nuffield Department of Clinical Neurosciences, Oxford, Oxfordshire, UK
| | - David Okai
- Neuropsychiatry Department, South London and Maudsley NHS Foundation Trust, London, London, UK.,Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, London, UK
| |
Collapse
|
38
|
Parkinsonism and subthalamic deep brain stimulation dysregulate behavioral motivation in a rodent model. Brain Res 2020; 1736:146776. [PMID: 32171706 DOI: 10.1016/j.brainres.2020.146776] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/18/2020] [Accepted: 03/10/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Apathy and impulsivity constitute opposite poles of a behavioral motivation spectrum often disrupted by both the symptoms and therapies for Parkinson's Disease (PD). Upwards of 70% of PD patients experience symptoms of apathy, frequently unresolved or worsened by deep brain stimulation (DBS) of the subthalamic nucleus (STN). Worse, more than half of patients receiving DBS for PD experience new-onset impulse control disorders of varying severity following therapy initiation. While these symptoms and side-effects have been widely reported in clinical studies, they are largely unexplored in animal models. METHODS We applied high-frequency DBS in a 6-OHDA hemiparkinsonian rat model. We trained rats on a series of go/stop and go/no-go behavioral paradigms and examined how parkinsonism and DBS modulated task responses. RESULTS STN DBS in healthy rodents drove impulsive behavior in the form of stop and no-go task failure, impulsive reward seeking, and noninstructed task attempts. While trained rats without DBS only tended to fail stop and no-go cues very shortly after the cue, DBS led to failures at significantly later time points. Hemiparkinsonism slowed response times and reduced response rates, not alleviated by effective DBS. INTERPRETATIONS PD interrupts neural signaling responsible for healthy action selection, not restored by DBS. PD may be associated with a dearth of action commands, manifesting as apathy. Conversely, effective DBS may bias the system toward the impulsive end of the behavioral motivation spectrum without restoring behaviorally reasonable actions, mis-weighting reward-based action selection and manifesting as impulsivity, aided by DBS interfering with stop signaling.
Collapse
|
39
|
Marín-Lahoz J, Sampedro F, Horta-Barba A, Martínez-Horta S, Aracil-Bolaños I, Camacho V, Bejr-kasem H, Pascual-Sedano B, Pérez-Pérez J, Gironell A, Pagonabarraga J, Carrió I, Kulisevsky J. Preservation of brain metabolism in recently diagnosed Parkinson’s impulse control disorders. Eur J Nucl Med Mol Imaging 2020; 47:2165-2174. [DOI: 10.1007/s00259-019-04664-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 12/16/2019] [Indexed: 12/16/2022]
|
40
|
Choi JH, Lee JY, Cho JW, Ko SB, Ahn TB, Kim SJ, Cheon SM, Kim JS, Kim YJ, Ma HI, Baik JS, Lee PH, Chung SJ, Kim JM, Song IU, Kim HJ, Sung YH, Kwon DY, Lee JH, Kim JY, Kim JS, Yun JY, Kim HJ, Hong JY, Kim MJ, Youn J, Kim JS, Oh ES, Yang HJ, Yoon WT, You S, Kwon KY, Park HE, Lee SY, Kim Y, Kim HT, Park MY. Validation of the Korean Version of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease Rating Scale. J Clin Neurol 2020; 16:245-253. [PMID: 32319241 PMCID: PMC7174122 DOI: 10.3988/jcn.2020.16.2.245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 10/26/2019] [Accepted: 10/28/2019] [Indexed: 12/28/2022] Open
Abstract
Background and Purpose Impulse-control disorder is an important nonmotor symptom of Parkinson's disease (PD) that can lead to financial and social problems, and be related to a poor quality of life. A nationwide multicenter prospective study was performed with the aim of validating the Korean Version of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease Rating Scale (K-QUIP-RS). Methods The K-QUIP-RS was constructed using forward and backward translation, and pretesting of the prefinal version. PD patients on stable medical condition were recruited from 27 movement-disorder clinics. Participants were assessed using the K-QUIP-RS and evaluated for parkinsonian motor and nonmotor statuses and for PD-related quality of life using a predefined evaluation battery. The test–retest reliability of the K-QUIP-RS was assessed over an interval of 10–14 days, and correlations between the KQUIP-RS and other clinical scales were analyzed. Results This study enrolled 136 patients. The internal consistency of the K-QUIP-RS was indicated by a Cronbach's α coefficient of 0.846, as was the test–retest reliability by a Guttman split-half coefficient of 0.808. The total K-QUIP-RS score was positively correlated with the scores for depression and motivation items on the Unified PD Rating Scale (UPDRS), Montgomery-Asberg Depression Scale, and Rapid-Eye-Movement Sleep-Behavior-Disorders Questionnaire. The total K-QUIP-RS score was also correlated with the scores on part II of the UPDRS and the PD Quality of Life-39 questionnaire, and the dopaminergic medication dose. Conclusions The K-QUIP-RS appears to be a reliable assessment tool for impulse-control and related behavioral disturbances in the Korean PD population.
Collapse
Affiliation(s)
- Ji Hyun Choi
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jee Young Lee
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Whan Cho
- Department of Neurology and Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Seong Beom Ko
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Tae Beom Ahn
- Department of Neurology, Kyung Hee University College of Medicine, Seoul, Korea
| | - Sang Jin Kim
- Department of Neurology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Sang Myung Cheon
- Department of Neurology, Dong-A University College of Medicine, Busan, Korea
| | - Joong Seok Kim
- Department of Neurology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Yoon Joong Kim
- Department of Neurology, Hallym University College of Medicine, Anyang, Korea
| | - Hyeo Il Ma
- Department of Neurology, Hallym University College of Medicine, Anyang, Korea
| | - Jong Sam Baik
- Department of Neurology, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Phil Hyu Lee
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sun Ju Chung
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong Min Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - In Uk Song
- Department of Neurology, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea
| | - Han Joon Kim
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Young Hee Sung
- Department of Neurology, Gachon University Gil Hospital, Incheon, Korea
| | - Do Young Kwon
- Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Jae Hyeok Lee
- Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ji Young Kim
- Department of Neurology, Inje University Seoul Paik Hospital, Seoul, Korea
| | - Ji Sun Kim
- Department of Neurology and Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Young Yun
- Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hee Jin Kim
- Department of Neurology, Konkuk University School of Medicine, Seoul, Korea
| | - Jin Yong Hong
- Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Mi Jung Kim
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jinyoung Youn
- Department of Neurology and Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Seon Kim
- Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Korea
| | - Eung Seok Oh
- Department of Neurology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
| | - Hui Jun Yang
- Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Won Tae Yoon
- Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sooyeoun You
- Department of Neurology, Keimyung University School of Medicine, Daegu, Korea
| | - Kyum Yil Kwon
- Department of Neurology, Soonchunhyang University Seoul Hospital, Soonchunhyang University School of Medicine, Seoul, Korea
| | - Hyung Eun Park
- Department of Neurology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Su Yun Lee
- Department of Neurology, Dong-A University College of Medicine, Busan, Korea
| | - Younsoo Kim
- Department of Neurology, Changwon Samsung Hospital, Changwon, Korea
| | - Hee Tae Kim
- Department of Neurology, Hanyang University College of Medicine, Seoul, Korea
| | - Mee Young Park
- Department of Neurology, Yeungnam University College of Medicine, Daegu, Korea.
| |
Collapse
|
41
|
Evolution of impulsive-compulsive behaviors and cognition in Parkinson's disease. J Neurol 2019; 267:259-266. [PMID: 31628533 PMCID: PMC6954890 DOI: 10.1007/s00415-019-09584-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 08/17/2019] [Accepted: 10/14/2019] [Indexed: 01/09/2023]
Abstract
The longitudinal course of ICBs in patients with Parkinson's disease (PwP) relative to controls has not been explored as of yet. The aim of this study is to determine the frequency, evolution and associated cognitive and clinical features of impulsive and compulsive behaviors (ICBs) over 4 years of prospective follow-up in a population-based cohort with early Parkinson's disease (PD). We recruited 124 cognitively intact participants with early PD and 156 matched controls from the Norwegian ParkWest study. ICBs were assessed using the self-report short form version of the Questionnaire for Impulsive-Compulsive Disorders in PD. Cognitive changes were examined in PwP with and without ICBs who completed the 4-year follow-up. Generalized linear mixed modelling and mixed linear regression were used to analyze clinical factors and cognitive changes associated with ICBs in PwP over time. ICBs were more common in PwP than controls at all visits, with an age-adjusted odds ratio (OR) varying between 2.5 (95% CI 1.1-5.6; p = 0.022) and 5.1 (95% CI 2.4-11.0; p < 0.001). The 4-year cumulative frequency of ICBs in PwP was 46.8% and 23.3% developed incident ICBs during the study period, but the presence of ICBs was non-persistent in nearly 30%. ICBs were independently associated with younger age (OR 0.95, 95% CI 0.91-0.99: p = 0.008) and use of dopamine agonist (OR 4.1, 95% CI 1.56-10.69). Cognitive changes over time did not differ between patients with and without ICBs. In conclusion, ICBs are common in PwP, but are often non-persistent and not associated with greater cognitive impairment over time.
Collapse
|
42
|
Barone P, Antonini A, Stanzione P, Annoni K, Asgharnejad M, Bonuccelli U. Risk factors for impulse control disorders and related behaviors in Parkinson's disease: secondary analyses of the ICARUS study. J Drug Assess 2019; 8:159-166. [PMID: 31700703 PMCID: PMC6830272 DOI: 10.1080/21556660.2019.1675670] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 09/25/2019] [Indexed: 11/06/2022] Open
Abstract
Objective: Impulse control disorders and related behaviors (ICDs) are common in patients with Parkinson’s disease (PD), yet incidence and predictive factors are not fully understood. We examined the epidemiology of ICDs in PD through secondary and post-hoc analyses of data from the ICARUS (SP0990) study, which enrolled >1000 patients. Methods: Using a modified-Minnesota Impulsive Disorders Interview (mMIDI), ICD incidence was calculated for patients who were ICD-negative at baseline but ICD-positive at year 1, and year 1 and/or 2 (cumulative 2-year ICD incidence). The proportion of “new cases” (ICD-negative at baseline, but ICD-positive at year 1 or 2), and “remitters” (ICD-positive at baseline but ICD-negative at year 1 or 2) was also calculated for the whole ICARUS population. Results: Among 709 patients ICD-negative at baseline, 97 screened ICD-positive (13.7%) at year 1. Among 712 patients who were ICD-negative at baseline, 147 were ICD-positive at ≥1 post-baseline visit (20.6%). Among patients who were ICD-negative at baseline who subsequently experienced an ICD, a higher proportion were male or smokers, younger at baseline, younger at disease/symptom onset, and had longer disease duration. Among the whole population, a similar proportion were “new cases” at years 1 (9.7%) and 2 (8.6%) versus the previous visit. The proportion of “remitters” was slightly higher at year 2 (11.0%) than 1 (9.1%) versus previous visit. Conclusions: The proportion of ICD-remitters approximately matched/exceeded new cases, suggesting patients with ICD are in a state of flux. Current data allow for a conservative estimate of 2-year ICD incidence in ICARUS of ∼21% of patients, not accounting for transient new ICD cases between visits.
Collapse
Affiliation(s)
- Paolo Barone
- Department of Medicine, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Baronissi, Italy
| | - Angelo Antonini
- Department of Neurosciences (DNS), Padova University, Padova, Italy
| | - Paolo Stanzione
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,IRCCS Fondazione S Lucia, Rome, Italy
| | | | | | - Ubaldo Bonuccelli
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| |
Collapse
|
43
|
Abstract
Psychotic and compulsive symptoms in Parkinson disease are highly prevalent and associated with poor outcomes and greater caregiver burden. When acute, delirium should be ruled out or treated accordingly. When chronic, comorbid systemic illnesses, dementia, and psychiatric disorders should be considered. Reduction and discontinuation of anticholinergics, amantadine, dopamine agonists, and levodopa as tolerated, as well as adjunctive clozapine or quetiapine are frequently effective to manage Parkinson disease psychosis. Pimavanserin appears effective but is not widely available, and more experience is needed. Dopamine agonist discontinuation is usually successful for impulse control disorders, but requires frequent monitoring, documentation, and caregiver involvement.
Collapse
|
44
|
Weintraub D, Mamikonyan E. The Neuropsychiatry of Parkinson Disease: A Perfect Storm. Am J Geriatr Psychiatry 2019; 27:998-1018. [PMID: 31006550 PMCID: PMC7015280 DOI: 10.1016/j.jagp.2019.03.002] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/04/2019] [Accepted: 03/04/2019] [Indexed: 12/16/2022]
Abstract
Affective disorders, cognitive decline, and psychosis have long been recognized as common in Parkinson disease (PD), and other psychiatric disorders include impulse control disorders, anxiety symptoms, disorders of sleep and wakefulness, and apathy. Psychiatric aspects of PD are associated with numerous adverse outcomes, yet in spite of this and their frequent occurrence, there is incomplete understanding of epidemiology, presentation, risk factors, neural substrate, and management strategies. Psychiatric features are typically multimorbid, and there is great intra- and interindividual variability in presentation. The hallmark neuropathophysiological changes that occur in PD, plus the association between exposure to dopaminergic medications and certain psychiatric disorders, suggest a neurobiological basis for many psychiatric symptoms, although psychological factors are involved as well. There is evidence that psychiatric disorders in PD are still under-recognized and undertreated and although psychotropic medication use is common, controlled studies demonstrating efficacy and tolerability are largely lacking. Future research on neuropsychiatric complications in PD should be oriented toward determining modifiable correlates or risk factors and establishing efficacious and well-tolerated treatment strategies.
Collapse
Affiliation(s)
- Daniel Weintraub
- Perelman School of Medicine (DW, EM), University of Pennsylvania, Philadelphia; Parkinson's Disease Research, Education and Clinical Center (PADRECC) (DW), Philadelphia Veterans Affairs Medical Center, Philadelphia.
| | - Eugenia Mamikonyan
- Perelman School of Medicine (DW, EM), University of Pennsylvania, Philadelphia
| |
Collapse
|
45
|
Marín‐Lahoz J, Sampedro F, Martinez‐Horta S, Pagonabarraga J, Kulisevsky J. Depression as a Risk Factor for Impulse Control Disorders in Parkinson Disease. Ann Neurol 2019; 86:762-769. [DOI: 10.1002/ana.25581] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 08/11/2019] [Accepted: 08/12/2019] [Indexed: 12/26/2022]
Affiliation(s)
- Juan Marín‐Lahoz
- Movement Disorders Unit, Neurology DepartmentHospital of Santa Creu and Sant Pau Barcelona
- Sant Pau Biomedical Research Institute Barcelona
- Neuroscience Institute, Autonomous University of Barcelona Barcelona
- Center for Biomedical Research on Neurodegenerative Diseases Madrid Spain
| | - Frederic Sampedro
- Movement Disorders Unit, Neurology DepartmentHospital of Santa Creu and Sant Pau Barcelona
- Sant Pau Biomedical Research Institute Barcelona
- Center for Biomedical Research on Neurodegenerative Diseases Madrid Spain
| | - Saül Martinez‐Horta
- Movement Disorders Unit, Neurology DepartmentHospital of Santa Creu and Sant Pau Barcelona
- Sant Pau Biomedical Research Institute Barcelona
- Center for Biomedical Research on Neurodegenerative Diseases Madrid Spain
| | - Javier Pagonabarraga
- Movement Disorders Unit, Neurology DepartmentHospital of Santa Creu and Sant Pau Barcelona
- Sant Pau Biomedical Research Institute Barcelona
- Neuroscience Institute, Autonomous University of Barcelona Barcelona
- Center for Biomedical Research on Neurodegenerative Diseases Madrid Spain
- Medicine DepartmentAutonomous University of Barcelona Barcelona
| | - Jaime Kulisevsky
- Movement Disorders Unit, Neurology DepartmentHospital of Santa Creu and Sant Pau Barcelona
- Sant Pau Biomedical Research Institute Barcelona
- Neuroscience Institute, Autonomous University of Barcelona Barcelona
- Center for Biomedical Research on Neurodegenerative Diseases Madrid Spain
- Medicine DepartmentAutonomous University of Barcelona Barcelona
| |
Collapse
|
46
|
Dogansen SC, Cikrikcili U, Oruk G, Kutbay NO, Tanrikulu S, Hekimsoy Z, Hadzalic A, Gorar S, Omma T, Mert M, Akbaba G, Yalin GY, Bayram F, Ozkan M, Yarman S. Dopamine Agonist-Induced Impulse Control Disorders in Patients With Prolactinoma: A Cross-Sectional Multicenter Study. J Clin Endocrinol Metab 2019; 104:2527-2534. [PMID: 30848825 DOI: 10.1210/jc.2018-02202] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 03/04/2019] [Indexed: 11/19/2022]
Abstract
CONTEXT Dopamine agonist (DA)-induced impulse control disorder (ICD) in patients with prolactinomas is not sufficiently known. OBJECTIVE To evaluate the prevalence of DA-induced ICDs and possible risk factors related to these disorders in patients with prolactinoma. DESIGN, SETTING, AND PARTICIPANTS This is a cross-sectional multicenter study involving 308 patients with prolactinoma followed up in tertiary referral centers who received at least three months of DA therapy. DA-induced ICDs (pathological gambling, hypersexuality, compulsive shopping, and compulsive eating) and impulsivity were assessed using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson Disease and the Barratt Impulsiveness Scale-11, respectively. Patients were evaluated in terms of parameters related to ICD development. RESULTS Any ICD prevalence was 17% (n = 51). Hypersexuality was most common (6.5%). Although any ICD and hypersexuality were more common in male patients (P = 0.009, P < 0.001, respectively), compulsive eating was more common in female patients (P = 0.046). Current smoking, alcohol use, and gambling history were more frequent (P = 0.033, P = 0.002, P = 0.008, respectively) in patients with any ICD. In Barratt Impulsiveness Scale-11 total, attentional, motor, and nonplanning scores were higher in patients with any ICD (P < 0.001). Current smoking and alcohol use were more frequent (P = 0.007, P = 0.003, respectively) and percentage increase of testosterone levels at last visit was higher (P = 0.021) in male patients with prolactinomas with hypersexuality. CONCLUSION Any ICD may be seen in one of six patients with prolactinoma who are receiving DA therapy. Endocrinology specialists should be aware of this side effect, particularly in male patients with a history of gambling, smoking, or alcohol use.
Collapse
Affiliation(s)
- Sema Ciftci Dogansen
- Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul University, Istanbul, Turkey
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ugur Cikrikcili
- Istanbul Faculty of Medicine, Department of Psychiatry, Istanbul University Istanbul, Turkey
| | - Gonca Oruk
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Izmir Ataturk Training and Research Hospital, Izmir, Turkey
| | - Nilufer Ozdemir Kutbay
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Seher Tanrikulu
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Zeliha Hekimsoy
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Celal Bayar University Medicine Faculty, Manisa, Turkey
| | - Aysa Hadzalic
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Erciyes University School of Medicine, Kayseri, Turkey
| | - Suheyla Gorar
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Antalya Training and Research Hospital, Antalya, Turkey
| | - Tulay Omma
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara Training and Research Hospital, Ankara, Turkey
| | - Meral Mert
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Gulhan Akbaba
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Mugla Sıtkı Kocman University School of Medicine, Mugla, Turkey
| | - Gulsah Yenidunya Yalin
- Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul University, Istanbul, Turkey
| | - Fahri Bayram
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Erciyes University School of Medicine, Kayseri, Turkey
| | - Mine Ozkan
- Istanbul Faculty of Medicine, Department of Psychiatry, Istanbul University Istanbul, Turkey
| | - Sema Yarman
- Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul University, Istanbul, Turkey
| |
Collapse
|
47
|
Impulse control disorders in Parkinson's disease: A systematic review on the psychometric properties of the existing measures. PLoS One 2019; 14:e0217700. [PMID: 31163065 PMCID: PMC6548365 DOI: 10.1371/journal.pone.0217700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 05/16/2019] [Indexed: 11/19/2022] Open
Abstract
Background A significant percentage of patients suffering from Parkinson’s Disease (PD) experience Impulse Control Disorders (ICDs), contributing to reduced quality of life. As they can be managed by reducing the dopamine dosage, the detection of their presence is crucial for PD treatment plan. Nevertheless, they tend to be under-recognized in clinical practice, since routine screening is not common–despite existing instruments that may support clinicians. This work presents a systematic review on the psychometric properties of instruments measuring ICDs in PD, to test whether clinicians dispose of valid tools that may help them in clinical assessment. Method A systematic literature search in three databases (EMBASE, MEDLINE, and PsycINFO) was conducted. Quality of the instruments’ psychometric properties was evaluated with Terwee et al.’s criteria, and methodological quality of the studies was evaluated with the COSMIN Checklist. Results Ten studies examining seven instruments were selected. The Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease (QUIP) and the Ardouin Scale of Behavior in Parkinson’s Disease (ASBPD) resulted to be the best from a psychometric point of view. Conclusions Though the gold standard for diagnosis remains a detailed diagnostic interview, this review will encourage clinicians to use validated tools to accurately assess ICDs.
Collapse
|
48
|
Liu B, Luo W, Mo Y, Wei C, Tao R, Han M. Meta-analysis of related factors of impulse control disorders in patients with Parkinson's disease. Neurosci Lett 2019; 707:134313. [PMID: 31167116 DOI: 10.1016/j.neulet.2019.134313] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/08/2019] [Accepted: 05/31/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND To explore the related factors of impulse control disorders (ICDs) in patients with Parkinson's disease (PD). METHODS We conducted a comprehensive search to identify studies on impulse control disorders in patients with Parkinson's disease. The related factors were compared to discriminate between PD patients with ICDs (PD-ICDs+)and PD patients without ICDs(PD-ICDs-)by a meta-analysis. RESULTS 96 full-texts were assessed, and 15 were included (PD-ICDs+: 999; PD-ICDs-: 3507). The results showed that PD-ICDs + were significantly associated with younger age (SMD =-0.39, 95% CI: -0.50 - -0.28, P < 0.01), male sex(OR = 1.64, 95% CI: 1.34-2.02, P < 0.01), smoking habit(OR = 2.28, 95% CI: 1.16-4.47,P = 0.02), dopamine receptor agonist use(DA use) (OR = 3.41, 95% CI: 1.86-6.26,P < 0.01), dopamine receptor agonist equivalent daily dose(DA LEDD) (SMD = 0.42, 95% CI: 0.14 - 0.70,P = 0.003), levodopa equivalent daily dose(total LEDD) (SMD = 0.32, 95% CI: 0.14 - 0.49,P < 0.01), and amantadine use(OR = 2.26, 95% CI: 1.67-3.06,P < 0.01). While levodopa dose (SMD = 0.05, 95% CI: -0.09 -0.19,P = 0.48), Hoehn and Yahr stage(H & Y stage) (SMD =-0.05, 95% CI: -0.14 - 0.04,P = 0.27), MDS-UPDRS Part III score(UPDRS III score) (SMD =-0.05, 95% CI: -0.13 - 0.03,P = 0.24), PD duration (SMD =-0.23, 95% CI: 0.10 - 0.37,P < 0.01)and Mini-Mental Status Examination score (MMSE score) (SMD = 0.10, 95% CI: -0.11 - 0.31,P = 0.33)were not related with PD-ICDs+. CONCLUSION Our study confirmed the previous results that younger age, male gender, smoking habit, longer PD duration, DA use, DA LEDD, total LEDD were high risk factors of PD-ICDs+.
Collapse
Affiliation(s)
- Bo Liu
- The Cadre Ward in Department of Neurology, The People's Hospital of Guangxi Zhuang Autonomous Region, No. 6, Tao Yuan Road, Nanning, Guangxi, 530021, China
| | - Wenjing Luo
- The Cadre Ward in Department of Neurology, The People's Hospital of Guangxi Zhuang Autonomous Region, No. 6, Tao Yuan Road, Nanning, Guangxi, 530021, China
| | - Yingmin Mo
- The Cadre Ward in Department of Neurology, The People's Hospital of Guangxi Zhuang Autonomous Region, No. 6, Tao Yuan Road, Nanning, Guangxi, 530021, China
| | - Chunying Wei
- The Cadre Ward in Department of Neurology, The People's Hospital of Guangxi Zhuang Autonomous Region, No. 6, Tao Yuan Road, Nanning, Guangxi, 530021, China
| | - Ran Tao
- The Cadre Ward in Department of Neurology, The People's Hospital of Guangxi Zhuang Autonomous Region, No. 6, Tao Yuan Road, Nanning, Guangxi, 530021, China
| | - Min Han
- The Cadre Ward in Department of Neurology, The People's Hospital of Guangxi Zhuang Autonomous Region, No. 6, Tao Yuan Road, Nanning, Guangxi, 530021, China.
| |
Collapse
|
49
|
Vitale C, Amboni M, Erro R, Picillo M, Pellecchia MT, Barone P, Trojano L, Santangelo G. Parkinson’s disease management and impulse control disorders: current state and future perspectives. Expert Rev Neurother 2019; 19:495-508. [DOI: 10.1080/14737175.2019.1620603] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Carmine Vitale
- Department of Motor Sciences and Health, University “Parthenope”, Naples, Italy
| | - Marianna Amboni
- Neurodegenerative Diseases Center, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Roberto Erro
- Neurodegenerative Diseases Center, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Marina Picillo
- Neurodegenerative Diseases Center, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Maria Teresa Pellecchia
- Neurodegenerative Diseases Center, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Paolo Barone
- Neurodegenerative Diseases Center, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Luigi Trojano
- Department of Psychology, University “Luigi Vanvitelli”, Caserta, Italy
| | | |
Collapse
|
50
|
Latt MD, Lewis S, Zekry O, Fung VSC. Factors to Consider in the Selection of Dopamine Agonists for Older Persons with Parkinson's Disease. Drugs Aging 2019; 36:189-202. [PMID: 30623310 DOI: 10.1007/s40266-018-0629-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Dopamine agonists (DAs) are frequently used in the management of Parkinson's disease (PD), a complex multisystem disorder influenced substantially by age-related factors. Over 80% of PD patients present after age 60 years and may have clinical features exacerbated by age-related comorbidities or decline in physiological compensatory mechanisms. Pharmacotherapy for motor symptoms in older persons is more likely to involve exclusive use of levodopa combined with a peripheral decarboxylase inhibitor throughout the course of the illness. Non-ergot DAs, such as pramipexole, rotigotine and ropinirole, may be used as de novo monotherapy for the control of motor symptoms in older persons, although they are less efficacious than levodopa therapy. DAs may also be considered as adjunct therapy in older persons when motor symptoms are no longer adequately controlled by levodopa or when motor fluctuations and dyskinesia appear. DAs may be used cautiously in older persons with cognitive impairment and orthostatic hypotension but should be avoided when there is a history or risk of psychosis or impulse control disorders.
Collapse
Affiliation(s)
- Mark Dominic Latt
- Geriatric Medicine Department, University of Sydney, Royal Prince Alfred Hospital, KGV Level 7, Missenden Road, Camperdown, NSW, 2050, Australia.
| | - Simon Lewis
- Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Olfat Zekry
- Department of Pharmacy, Royal Prince Alfred Hospital, University of Sydney, Sydney, NSW, Australia
| | - Victor S C Fung
- Department of Neurology, Westmead Hospital, University of Sydney, Sydney, NSW, Australia
| |
Collapse
|