Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland.
Department of Imaging Diagnostics and Interventional Radiology, Kornel Gibiński Independent Public Central Clinical Hospital, Medical University of Silesia, 40-055 Katowice, Poland.
Medicina (Kaunas). 2023 Aug 16;59(8):1468. doi: 10.3390/medicina59081468.
Parkinson's disease (PD) is one of the most common neurodegenerative diseases in the world. It is characterized by the presence of not only typical motor symptoms but also several less known and aware non-motor symptoms (NMS). The group of disorders included in the NMS is Impulse Control Disorders (ICDs). ICDs are a group of disorders in which patients are unable to resist temptations and feel a strong, pressing desire for specific activities such as gambling, hypersexuality, binge eating, and compulsive buying. The occurrence of ICDs is believed to be associated primarily with dopaminergic treatment, with the use of dopamine agonists (DA), and to a lesser extent with high doses of L-dopa. The aim of our study was to develop a profile of Polish ICDs patients and assess the frequency of occurrence of ICDs, as well as determine the risk factors associated with these disorders against the background of the PD population from other countries. Our prospective study included 135 patients with idiopathic PD who were hospitalized between 2020 and 2022 at the Neurological Department of University Central Hospital in Katowice. In the assessment of ICDs, we used the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP). Other scales with which we assessed patients with PD were as follows: MDS-UPDRS part III and modified Hoehn-Yahr staging. Clinical data on age, gender, disease duration and onset, motor complications, and medications were collected from electronic records. ICDs were detected in 27.41% of PD patients (binge eating in 12.59%, hypersexuality in 11.11%, compulsive buying in 10.37%, and pathological gambling occurred in only 5.19% of patients. In total, 8.89% had two or more ICDs). The major finding was that ICDs were more common in patients taking DA than in those who did not use medication from this group (83.78% vs. 54.07%, respectively; = 0.0015). Patients with ICDs had longer disease duration, the presence of motor complications, and sleep disorders. An important finding was also a very low detection of ICDs in a routine medical examination; only 13.51% of all patients with ICDs had a positive medical history of this disorder. ICDs are relatively common in the population of Polish PD patients. The risk factors for developing ICDs include longer duration of the disease, presence of motor complications, sleep disorders, and use of DA and L-dopa. Due to the low detectability of ICDs in routine medical history, it is essential for physicians to pay more attention to the possibility of the occurrence of these symptoms, especially in patients with several risk factors. Further prospective studies on a larger group of PD patients are needed to establish a full profile of Polish PD patients with ICDs.
帕金森病（PD）是世界上最常见的神经退行性疾病之一。它的特点不仅是存在典型的运动症状，还有一些不太为人所知和注意的非运动症状（NMS）。NMS 包括冲动控制障碍（ICDs）。ICDs 是一组患者无法抵制诱惑，对特定活动（如赌博、性欲亢进、暴食和强迫性购物）产生强烈、紧迫欲望的疾病。ICDs 的发生被认为主要与多巴胺能治疗有关，与使用多巴胺激动剂（DA）有关，与大剂量左旋多巴的关系较小。我们研究的目的是制定波兰 ICDs 患者的特征，并评估 ICDs 的发生频率，以及确定与 PD 人群中其他国家的这些疾病相关的风险因素。我们的前瞻性研究包括 2020 年至 2022 年期间在卡托维兹大学中心医院神经科住院的 135 名特发性 PD 患者。在 ICDs 的评估中，我们使用了帕金森病冲动-强迫障碍问卷（QUIP）。我们还使用了其他量表来评估 PD 患者，包括 MDS-UPDRS 第三部分和改良 Hoehn-Yahr 分期。从电子病历中收集了年龄、性别、疾病持续时间和发病时间、运动并发症和药物等临床数据。PD 患者中发现 ICDs 占 27.41%（暴食症占 12.59%，性欲亢进占 11.11%，强迫性购物占 10.37%，只有 5.19%的患者出现病理性赌博）。共有 8.89%的患者存在两种或两种以上的 ICDs）。主要发现是，服用 DA 的患者 ICDs 更为常见，而未使用该组药物的患者则较少（分别为 83.78%和 54.07%； = 0.0015）。患有 ICDs 的患者疾病持续时间更长，存在运动并发症和睡眠障碍。一个重要的发现是，在常规体检中 ICDs 的检出率非常低；只有 13.51%的 ICDs 患者有该疾病的阳性病史。ICDs 在波兰 PD 患者人群中较为常见。发生 ICDs 的风险因素包括疾病持续时间较长、存在运动并发症、睡眠障碍以及使用 DA 和左旋多巴。由于在常规病史中 ICDs 的检出率较低，医生必须更加注意这些症状发生的可能性，尤其是在存在多种危险因素的患者中。需要对更大的 PD 患者群体进行进一步的前瞻性研究，以建立波兰 ICDs 患者的完整特征。
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