Movement Disorders Center, Neurology Department, Perugia General Hospital and University of Perugia, Perugia, Italy.
Neurology Department, Perugia General Hospital and University of Perugia, Perugia, Italy.
J Parkinsons Dis. 2020;10(3):927-934. doi: 10.3233/JPD-191833.
Dopaminergic medications in Parkinson's disease (PD) are usually associated with the development of both levodopa-induced dyskinesias (LID) and impulse control and repetitive behavior disorders (ICRB).
To assess the prevalence and the severity of ICRB in a cohort of moderate and advanced PD patients and to investigate the potential interplay between ICRB, LID and dopaminergic therapies.
117 PD patients were consecutively recruited. LID were assessed by using the Rush Dyskinesia Rating Scale (RDRS). ICRB were tested by means of Questionnaire for Impulsive Compulsive Disorders in Parkinson's Disease Rating Scale (QUIP-RS).
55 patients were affected by LID. Among them, 37 were treated only by oral therapy, OT (LID/OT), while 18 were on treatment with jejunal levodopa infusion, JLI (LID/JLI). 62 patients were not affected by LID (NLID) and all of them were on therapy only with oral drugs. The overall prevalence of clinically significant ICRB was 34% (95% CI = 26% to 43%) and the mean value (±SD) of QUIP-RS total score was 5.4±8.5. Prevalence of clinically significant ICRB, as well as severity of ICRB, was higher in patients with LID compared to NLID patients (p = 0.016 and p < 0.001, respectively). When considering LID/JLI, LID/OT and NLID groups, QUIP-RS total score was significantly higher in LID/OT patients compared to LID/JLI (10.4±11.8 vs. 4.9±6.0, p = 0.019) and NLID (10.4±11.8 vs. 2.5±4.8, p < 0.001) groups.
PD patients with LID show ICRB more frequently and more severely than patients without LID. Among LID patients, those treated by JLI showed a lower severity of ICRB than those on OT, suggesting a potential protective effect of JLI on ICRB.
在帕金森病（PD）患者中，多巴胺能药物通常与左旋多巴诱导的运动障碍（LID）和冲动控制及重复行为障碍（ICRB）的发展有关。
评估中重度和晚期 PD 患者中 ICRB 的患病率和严重程度，并探讨 ICRB、LID 和多巴胺能治疗之间的潜在相互作用。
连续招募了 117 名 PD 患者。使用 Rush 运动障碍评定量表（RDRS）评估 LID。使用帕金森病冲动控制障碍问卷评定量表（QUIP-RS）测试 ICRB。
55 名患者患有 LID。其中 37 名患者仅接受口服治疗（LID/OT），18 名患者接受空肠内左旋多巴输注治疗（LID/JLI）。62 名患者未患有 LID（NLID），他们均仅接受口服药物治疗。临床上显著的 ICRB 总患病率为 34%（95%CI=26%至 43%），QUIP-RS 总分的平均值（±SD）为 5.4±8.5。与 NLID 患者相比，患有 LID 的患者中临床上显著的 ICRB 患病率以及 ICRB 的严重程度更高（p=0.016 和 p<0.001）。当考虑 LID/JLI、LID/OT 和 NLID 组时，LID/OT 患者的 QUIP-RS 总分明显高于 LID/JLI（10.4±11.8 比 4.9±6.0，p=0.019）和 NLID（10.4±11.8 比 2.5±4.8，p<0.001）组。
患有 LID 的 PD 患者比不患有 LID 的患者更频繁且更严重地出现 ICRB。在 LID 患者中，接受 JLI 治疗的患者的 ICRB 严重程度低于接受 OT 治疗的患者，这表明 JLI 对 ICRB 具有潜在的保护作用。
