Department of Neurology, Brotzu General Hospital, Cagliari, Italy.
Department of Neurology, Santa Maria University Hospital, Terni, Italy.
Parkinsonism Relat Disord. 2018 Jan;46 Suppl 1:S24-S29. doi: 10.1016/j.parkreldis.2017.07.030. Epub 2017 Aug 1.
Impulse control disorders (ICDs) are psychiatric disorders characterized by the failure to resist an impulse or by the temptation to perform an act that is harmful to oneself or to others.
ICDs, including pathological gambling, hypersexuality, compulsive eating and shopping, can occur as a complication of Parkinson's disease (PD) together with other behavioral disorders, including dopamine dysregulation syndrome. This review is based on a literature search updated to May 2017, focusing on the epidemiology, clinical features, and therapeutic options of ICDs associated with PD.
Studies on the prevalence of ICDs confirm that they represent common phenomena associated with PD, with some centers reporting up to 40% of the PD population affected; the relative prevalence of the main ICDs shows significant variability, with a majority of the studies reporting that hypersexuality is the commonest one. Risk factors associated with the development of ICDs in PD were systematically evaluated, confirming the correlation between these disorders and male gender, younger age at PD onset and family history for addiction.
We will discuss the recent advances on the functional neuroanatomy, the role of dopamine-serotonin interactions and the cognitive profile associated with ICDs. Management of PD-related ICDs is still based on poor evidence, and this topic should be the object for future research.
冲动控制障碍(ICD)是一种精神障碍,其特征是无法抵抗冲动,或受到诱惑而做出对自己或他人有害的行为。
包括病理性赌博、性欲亢进、强迫性饮食和购物在内的 ICD 可作为帕金森病(PD)的并发症之一出现,同时还伴有其他行为障碍,包括多巴胺调节障碍综合征。本综述基于截至 2017 年 5 月的文献检索,重点关注与 PD 相关的 ICD 的流行病学、临床特征和治疗选择。
关于 ICD 患病率的研究证实,它们是 PD 常见的相关现象,一些中心报告称高达 40%的 PD 患者受到影响;主要 ICD 的相对患病率存在显著差异,大多数研究报告称性欲亢进是最常见的一种。PD 患者发生 ICD 的风险因素已被系统评估,证实这些障碍与男性性别、PD 发病年龄较小和成瘾家族史相关。
我们将讨论与 ICD 相关的功能神经解剖学、多巴胺-血清素相互作用的作用以及认知特征的最新进展。PD 相关 ICD 的治疗仍基于有限的证据,这个话题应该是未来研究的对象。