帕金森病伴痴呆的冲动控制及相关行为。

Impulse control and related behaviors in Parkinson's disease with dementia.

机构信息

National Center of Epidemiology and CIBERNED, Carlos, III Institute of Health, Madrid, Spain.

Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience at King's College London, London, UK.

出版信息

Eur J Neurol. 2020 Jun;27(6):944-950. doi: 10.1111/ene.14169. Epub 2020 Mar 5.

DOI:10.1111/ene.14169

PMID:32048392

Abstract

BACKGROUND AND PURPOSE

The objective was to determine the frequency, demographic and clinical correlates [such as age, sex, Parkinson's disease (PD) severity and dopaminergic treatment] of impulse control disorder (ICD) symptoms and related behaviors in patients with PD with (PD-D) and without (PD-ND) dementia.

METHODS

We analyzed historical data from a national, multi-center, cross-sectional database and assessed ICDs and related behaviors with the Scale for Evaluation of Neuropsychiatric Disorders in Parkinson's Disease administered as a semi-structured interview to patients with PD-D (n = 85) and PD-ND (n = 444) and their informants.

RESULTS

Dopamine agonist therapy use was common and similar in the two groups (78.8% in PD-D vs. 82.9% in PD-ND), but ICDs (23.5% vs. 13.3%, P = 0.02), hobbyism-punding (32.9% vs. 10.6%, P < 0.001) and dopaminergic medication abuse (8.2% vs. 3.2%, P = 0.03) were more common in the PD-D group.

CONCLUSIONS

The finding that ICDs and related behaviors are more common in patients with PD frequently treated with dopamine agonists who also have comorbid dementia suggests that the neural substrates associated with PD dementia may also predispose to development of compulsive behaviors.

摘要

背景与目的

本研究旨在确定伴有（PD-D）和不伴有（PD-ND）痴呆的帕金森病（PD）患者中冲动控制障碍（ICD）症状和相关行为的频率、人口统计学和临床相关性[如年龄、性别、PD 严重程度和多巴胺能治疗]。

方法

我们分析了来自全国性、多中心、横断面数据库的历史数据，并使用帕金森病神经精神障碍评估量表（以半结构化访谈的形式）对 PD-D（n=85）和 PD-ND（n=444）患者及其家属进行 ICD 和相关行为评估。

结果

多巴胺激动剂治疗在两组中均很常见且相似（PD-D 组为 78.8%，PD-ND 组为 82.9%），但 ICD（23.5% vs. 13.3%，P=0.02）、癖好-强迫性运动（32.9% vs. 10.6%，P<0.001）和多巴胺能药物滥用（8.2% vs. 3.2%，P=0.03）在 PD-D 组中更为常见。