Weintraub Daniel, Siderowf Andrew D, Potenza Marc N, Goveas Joseph, Morales Knashawn H, Duda John E, Moberg Paul J, Stern Matthew B
Department of Psychiatry, University of Pennsylvania, and Parkinson's Disease Research, Education, and Clinical Center, USA.
Arch Neurol. 2006 Jul;63(7):969-73. doi: 10.1001/archneur.63.7.969.
To determine the frequency and correlates of impulse control disorders (ICDs) in Parkinson disease (PD).
An unstructured screening interview for ICDs (compulsive gambling, buying, and sexual behavior) followed by a telephone-administered structured interview for screen-positive patients.
Two university-affiliated movement disorders centers.
A convenience sample of 272 patients with idiopathic PD who were screened for psychiatric complications.
Presence of compulsive gambling, buying, or sexual behavior as assessed by the Minnesota Impulsive Disorders Interview.
Eighteen patients (6.6%) with PD met criteria for an ICD at some point during the course of PD, including 11 (4.0%) with an active ICD. Compulsive gambling and compulsive sexual behavior were equally common. In a multivariate model, treatment with a dopamine agonist (P = .01) and a history of ICD symptoms prior to PD onset (P = .02) predicted current ICD. There were no differences between the dopamine agonists in their association with ICDs (P = .21), and daily doses of dopamine agonists were higher in patients with an ICD than in dopamine agonist-treated patients without an ICD (P < .001).
Patients with PD treated with a dopamine agonist should be made aware of the risk of developing an ICD and monitored clinically. Because dopamine agonists are increasingly being used for other indications, future research should assess the dopamine agonist-associated risk for ICDs in other populations.
确定帕金森病（PD）中冲动控制障碍（ICD）的发生率及其相关因素。
对ICD（强迫性赌博、购物和性行为）进行非结构化筛查访谈，随后对筛查呈阳性的患者进行电话结构化访谈。
两个大学附属医院的运动障碍中心。
对272例特发性PD患者进行便利抽样，筛查其精神并发症。
通过明尼苏达冲动障碍访谈评估强迫性赌博、购物或性行为的存在情况。
18例（6.6%）PD患者在PD病程中的某个时间点符合ICD标准，其中11例（4.0%）患有活动性ICD。强迫性赌博和强迫性行为同样常见。在多变量模型中，多巴胺激动剂治疗（P = 0.01）和PD发病前有ICD症状史（P = 0.02）可预测当前的ICD。不同多巴胺激动剂与ICD的关联无差异（P = 0.21），且ICD患者的多巴胺激动剂每日剂量高于无ICD的多巴胺激动剂治疗患者（P < 0.001）。
接受多巴胺激动剂治疗的PD患者应意识到发生ICD的风险，并进行临床监测。由于多巴胺激动剂越来越多地用于其他适应证，未来研究应评估其他人群中多巴胺激动剂与ICD相关的风险。
