Leeman Robert F, Potenza Marc N
Departments of Psychiatry, Neurobiology & Child Study Center, Yale University School of Medicine, CMHC, Room S104, 34 Park Street, New Haven, CT 06519, USA.
Neuropsychiatry (London). 2011 Apr;1(2):133-147. doi: 10.2217/npy.11.11.
Impulse control disorders (ICDs), specifically those related to excessive gambling, eating, sex and shopping, have been observed in a subset of people with Parkinson's disease (PD). Although some initial case reports claimed that dopamine replacement therapies, particularly dopamine agonists, cause ICDs, more recent, larger and better controlled studies indicate a more complicated picture. While dopamine replacement therapy use is related to ICDs, other vulnerabilities, some related to PD and/or its treatment directly and others seemingly unrelated to PD, have also been associated with ICDs in PD. This suggests a complex etiology with multiple contributing factors. As ICDs occur in a sizable minority of PD patients and can be associated with significant distress and impairment, further investigation is needed to identify factors that can predict who may be more likely to develop ICDs. Clinical implications are discussed and topics for future research are offered.
冲动控制障碍（ICD），特别是那些与过度赌博、饮食、性行为和购物相关的障碍，已在一部分帕金森病（PD）患者中被观察到。尽管一些早期病例报告称多巴胺替代疗法，尤其是多巴胺激动剂会导致ICD，但最近规模更大、控制更好的研究表明情况更为复杂。虽然多巴胺替代疗法的使用与ICD有关，但其他易患因素，有些与PD及其治疗直接相关，有些似乎与PD无关，也与PD患者的ICD有关。这表明其病因复杂，有多种促成因素。由于ICD在相当一部分PD患者中出现，且可能与严重的痛苦和功能损害相关，因此需要进一步研究以确定可预测哪些人更易发生ICD的因素。本文讨论了临床意义并提出了未来研究的主题。
