Shipilova N N, Titova N V, Kokaeva Z G, Fedosova A S, Klimov E A, Katunina E A
Pirogov Russian National Research Medical University of the Ministry of Health of the Russia, Moscow, Russia.
Lomonosov Moscow State University, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2018;118(10):4-9. doi: 10.17116/jnevro20181181014.
To evaluate the frequency and spectrum of impulsive-compulsive disorders (ICDs) in patients with Parkinson's disease (PD) without dopaminergic medication and among patients receiving dopaminergic replacement therapy, depending on personality type, genetic factors, and to determine the influence of ICDs on the development of other non-motor manifestations of the disease.
Three hundred and eighty-six consecutive patients with idiopathic PD, including untreated patients with PD (de novo) and patients receiving dopaminergic replacement therapy during one year, were examined. ICDs were evaluated with QUIP and diagnostic criteria. Personality type and temperament features were assessed by the Eysenck personality inventory. Genotyping for the single nucleotide polymorphism rs141116007 in the DBH gene involved in the pathogenesis of PD and ICDs was performed.
ICDs were identified in 20.2% patients with PD and in 4% patients of the de novo group. The most common (10.36%) behavioral disorder was a binge eating. The frequency of ICDs among patients with PD before the onset of dopamine replacement therapy increased by 1.03 times after one year treatment. Smoking and young age were risk factors for ICDs (p<0.05). The results of the study allowed the determination of social and neuropsychological risk factors for ICDs in patients with PD. The account of these features, as well as early detection of ICDs using screening questionnaires may help to personalize treatment of patients with PD and to prevent the risk of developing comorbid non-motor manifestations of the disease.
评估未使用多巴胺能药物的帕金森病（PD）患者以及接受多巴胺能替代治疗的患者中冲动控制障碍（ICD）的频率和谱型，这取决于人格类型、遗传因素，并确定ICD对该疾病其他非运动表现发展的影响。
对386例连续性特发性PD患者进行检查，包括未经治疗的PD患者（初发）和在一年内接受多巴胺能替代治疗的患者。使用QUIP和诊断标准评估ICD。通过艾森克人格问卷评估人格类型和气质特征。对参与PD和ICD发病机制的DBH基因中的单核苷酸多态性rs141116007进行基因分型。
在20.2%的PD患者和4%的初发组患者中发现了ICD。最常见的（10.36%）行为障碍是暴饮暴食。多巴胺替代治疗开始前的PD患者中ICD的频率在治疗一年后增加了1.03倍。吸烟和年轻是ICD的危险因素（p<0.05）。该研究结果有助于确定PD患者中ICD的社会和神经心理危险因素。考虑这些特征，以及使用筛查问卷早期发现ICD，可能有助于使PD患者的治疗个性化，并预防该疾病并发非运动表现的发生风险。
