Department of Neurology, Hospital General de l'Hospitalet, Consorci Sanitari Integral, Hospitalet de Llobregat (Barcelona), Spain.
J Neurol Sci. 2011 Nov 15;310(1-2):197-201. doi: 10.1016/j.jns.2011.05.044. Epub 2011 Jun 16.
Impulsive and compulsive behaviors (ICBs) have been reported to occur frequently in Parkinson's disease (PD) and include impulse control disorders (ICDs), punding and dopamine dysregulation syndrome (SSD). We report on the outcomes of 25 PD patients who developed ICBs. Information was collected on changes in parkinsonian and psychiatric medication follow-up (median=12.1 months). At time 1, only 18 patients (72%) were taking dopamine agonists (DA). At time 2, fifteen patients (83.33%) either discontinued or decreased their DA treatment. Of these patients, thirteen (86.67%) reported experiencing full or partial remission of their ICBs symptoms. When analyzing separately the 11 patients with punding, these symptoms remained unchanged in 9 patients (81.82%) independently of changes in dopaminergic drugs. In conclusion, the current study suggests that there are clear similarities, but also important differences, between punding and ICDs over time. Pathological gambling, binge or compulsive eating, pathological hypersexuality and compulsive shopping in PD were robustly associated with the use of DA but the relationship between dopaminergic medications and punding is less clear. It is important to determine if other treatment strategies may be effective for punding in PD.
冲动和强迫行为（ICBs）在帕金森病（PD）中经常发生，包括冲动控制障碍（ICDs）、刻板行为和多巴胺失调综合征（SSD）。我们报告了 25 名出现 ICB 的 PD 患者的结果。收集了关于帕金森病和精神药物治疗随访变化的信息（中位数=12.1 个月）。在时间 1，只有 18 名患者（72%）正在服用多巴胺激动剂（DA）。在时间 2，15 名患者（83.33%）停止或减少了他们的 DA 治疗。这些患者中，有 13 名（86.67%）报告说他们的 ICB 症状完全或部分缓解。当单独分析 11 名有刻板行为的患者时，这些症状在 9 名患者（81.82%）中保持不变，而与多巴胺能药物的变化无关。总之，目前的研究表明，刻板行为和 ICDs 随着时间的推移既有明显的相似之处，也有重要的不同之处。PD 中的病理性赌博、暴食或强迫性进食、病理性性欲亢进和强迫性购物与 DA 的使用密切相关，但多巴胺能药物与刻板行为之间的关系不太清楚。确定其他治疗策略是否对 PD 中的刻板行为有效非常重要。
