Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Neurol Sci. 2024 Jan;45(1):171-175. doi: 10.1007/s10072-023-07006-1. Epub 2023 Aug 15.
This study aims to clinically evaluate the impulse control disorders (ICDs) encountered in treating Parkinson's disease.
This is a retrospective analysis between 2010 and 2022. We retrieved the medical records of all patients diagnosed with idiopathic Parkinson's disease. The demographic and clinical findings were recorded. ICDs constituted a specific item in the examination, and each one (compulsive shopping, compulsive eating, pathological gambling, hypersexuality, punding, dopamine dysregulation syndrome, and hobbyism) was noted separately.
In the study period, we identified 1824 patients (56.2% men, n = 1025). The mean age was 70.5 ± 11.9 years. In the cohort, 128 (7%) patients with Parkinson's disease had one or more ICDs. The ICDs were compulsive shopping, punding/hobbyism, compulsive eating, hypersexuality, pathological gambling, and dopamine dysregulation syndrome. When we compared patients with and without ICDs, patients with ICDs were younger (p ≤ 0.001), and the men/women ratio was higher in this group with ICDs. Although the mean daily pramipexole dose was higher in patients with ICDs, mean daily long-acting pramipexole dose was only 1.4 ± 0.92 mg/day.
The significant findings in this study were (i) the lower frequency of ICDs (7%); (ii) the common occurrence of compulsive shopping, punding/hobbyism, and compulsive eating; and (iii) the development of ICDs under relatively lower doses of pramipexole. We suggest that ICDs in Parkinson's disease should be associated with a personal trait with dopamine agonists, and potential electrophysiological or genetic markers of this trait warrant further analysis to avoid treatment in these patients.
本研究旨在临床评估治疗帕金森病时遇到的冲动控制障碍（ICD）。
这是一项 2010 年至 2022 年的回顾性分析。我们检索了所有诊断为特发性帕金森病患者的病历。记录了人口统计学和临床发现。ICD 是检查中的一个特定项目，每个项目（强迫性购物、强迫性进食、病理性赌博、性欲亢进、强迫性囤积、多巴胺失调综合征和癖好）都单独记录。
在研究期间，我们确定了 1824 名患者（56.2%为男性，n = 1025）。平均年龄为 70.5 ± 11.9 岁。在队列中，128 名（7%）帕金森病患者有一个或多个 ICD。ICD 为强迫性购物、强迫性囤积/癖好、强迫性进食、性欲亢进、病理性赌博和多巴胺失调综合征。当我们比较有和没有 ICD 的患者时，有 ICD 的患者更年轻（p ≤ 0.001），并且该组中男性/女性比例更高。尽管有 ICD 的患者的普拉克索日剂量较高，但每日长效普拉克索剂量仅为 1.4 ± 0.92 mg/天。
本研究的重要发现是（i）ICD 的频率较低（7%）；（ii）强迫性购物、强迫性囤积/癖好和强迫性进食常见；（iii）在相对较低剂量的普拉克索下发生 ICD。我们建议帕金森病中的 ICD 应与多巴胺激动剂相关的个体特质相关，这种特质的潜在电生理或遗传标志物值得进一步分析，以避免在这些患者中进行治疗。
