Department of Neurology, Guro Hospital, Korea University College of Medicine, # 97 Guro-dong gil, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea.
J Neurol. 2013 Feb;260(2):429-37. doi: 10.1007/s00415-012-6645-9. Epub 2012 Aug 15.
Impulse control and repetitive behavior disorders (ICRBs) are a group of diseases including impulse control disorder (ICD), repetitive behavior disorder (RB), and dopamine dysregulation syndrome (DDS). This study determined the prevalence and associated characteristics of ICRBs in Parkinson's disease (PD) patients. Included were 297 patients, interviewed with the questionnaire for impulsive-compulsive disorders in PD for screening of various ICRBs. Questionnaire results and clinical characteristics were analyzed. The ICRB prevalence among PD patients was 15.5 % (46 of 297), with 35 patients with ICD, 20 with RB, and 7 with DDS. Patients with ICRB were predominantly male, younger, taking higher doses of dopaminergic drugs, and had longer disease duration, worse Unified Parkinson's Disease Rating Scale (UPDRS) motor score, and worse PD quality of life questionnaire score. However, each ICRB subtype had different risk factor profiles. ICD patients were predominantly male, younger, had longer disease duration, were affected by PD from young age, were taking higher total dopaminergic drug dosages, and had more RB. RB patients had higher UPDRS part III scores, were taking higher levodopa doses, and had higher comorbid ICD. DDS patients were taking higher dopamine agonist doses, and had more frequent ICD. In multivariate logistic regression for secondary analysis, only younger age and comorbid RB or DDS showed significant association with ICD and only poor UPDRS III score and comorbid ICD were significantly associated with RB. These findings suggested that different risk factors contribute to development of each ICRB subtype. ICRB could be a combination of heterogeneous disease entities that need to be treated separately.
冲动控制和重复行为障碍（ICRB）是一组疾病，包括冲动控制障碍（ICD）、重复行为障碍（RB）和多巴胺调节障碍综合征（DDS）。本研究旨在确定帕金森病（PD）患者中 ICRB 的患病率及相关特征。共纳入 297 例患者，采用 PD 冲动-强迫障碍问卷进行访谈，以筛查各种 ICRB。分析问卷结果和临床特征。PD 患者的 ICRB 患病率为 15.5%（297 例中有 46 例），其中 35 例为 ICD，20 例为 RB，7 例为 DDS。ICRB 患者主要为男性，年龄较小，服用较高剂量的多巴胺能药物，且疾病病程较长，UPDRS 运动评分较差，PD 生活质量问卷评分较差。然而，每种 ICRB 亚型都有不同的危险因素特征。ICD 患者主要为男性，年龄较小，疾病病程较长，年轻起病，总多巴胺能药物剂量较高，且 RB 更为常见。RB 患者 UPDRS 第三部分评分较高，服用左旋多巴剂量较高，且合并 ICD 的比例较高。DDS 患者服用较高剂量的多巴胺激动剂，且 ICD 更为频繁。在对 ICD 和 RB 进行二次分析的多变量逻辑回归中，仅年龄较小和合并 RB 或 DDS 与 ICD 显著相关，而仅 UPDRS 第三部分评分较差和合并 ICD 与 RB 显著相关。这些结果表明，不同的危险因素导致了每种 ICRB 亚型的发生。ICRB 可能是一组异质性疾病实体的组合，需要分别进行治疗。
