Voon Valerie, Potenza Marc N, Thomsen Teri
Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, Maryland 20892-1428, USA.
Curr Opin Neurol. 2007 Aug;20(4):484-92. doi: 10.1097/WCO.0b013e32826fbc8f.
A range of impulse control and repetitive behaviors presumed to be related to dopaminergic medications has been recognized in Parkinson's disease. These behaviors are linked by their incentive or reward-based and repetitive natures and overlap with addictions. The behaviors include pathological gambling, hypersexuality, compulsive shopping, and compulsive eating and are related to punding and compulsive medication use. In patients on dopamine agonists, these behaviors as a group are relatively common, can have potentially devastating psychosocial consequences and are commonly hidden.
Recent studies have investigated prevalence rates and associated factors. The literature on these behaviors in Parkinson's disease, including definitions, epidemiology, pathophysiology and management, is reviewed. The relationship to medications, Parkinson's disease and individual susceptibility is examined.
These behaviors can affect up to 14% of Parkinson's disease patients on dopamine agonists. Clinicians should warn patients prior to initiating dopamine agonists and enquire about these behaviors during follow up.
帕金森病中已认识到一系列推测与多巴胺能药物相关的冲动控制和重复行为。这些行为因其基于激励或奖励的性质以及重复性而相互关联，并与成瘾行为重叠。这些行为包括病理性赌博、性欲亢进、强迫性购物和强迫性进食，并且与刻板动作和强迫性用药有关。在服用多巴胺激动剂的患者中，这些行为总体上相对常见，可能产生潜在的毁灭性社会心理后果，并且通常是隐匿的。
近期研究调查了患病率及相关因素。本文综述了帕金森病中这些行为的相关文献，包括定义、流行病学、病理生理学和管理。探讨了这些行为与药物、帕金森病及个体易感性之间的关系。
这些行为可影响多达14%服用多巴胺激动剂的帕金森病患者。临床医生在开始使用多巴胺激动剂之前应警告患者，并在随访期间询问这些行为。
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