Turcano Pierpaolo, Jacobson Jessie, Ghoniem Khaled, Mullan Aidan, Camerucci Emanuele, Stang Cole, Piat Capucine, Bower James H, Savica Rodolfo
Department of Neurology, Mayo Clinic, Rochester, MN, United States.
Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States.
Front Neurol. 2024 May 22;15:1404904. doi: 10.3389/fneur.2024.1404904. eCollection 2024.
Impulse control disorders (ICDs) are defined as excessive and repetitive behaviors that may affect Parkinson's disease (PD) patients exposed to dopamine agonists. Current data on ICDs in patients with early-onset Parkinson's disease (EOPD) is lacking. In this study we aim to assess the frequency of use of dopamine agonists, the prevalence of ICDs, and to explore potential factors associated with their development in patients with EOPD.
We used the Mayo Clinic Data Explorer system to investigate a population-based cohort of EOPD patients between 1990 and 2022 at Mayo Clinic, Rochester, MN. We used ICD coding for parkinsonism; then, we reviewed all the clinical records and included only those patients with a clinical diagnosis of PD with symptoms onset at or before the age of 50, and who developed ICDs after using therapeutic doses of dopamine agonists.
A total of 831 (513 males and 318 females) patients with EOPD were included with a median age at symptom onset of 42 years of age (CI: 37-46). Dopamine agonists were used in 49.7% of all patients; of these, only 14.5% developed symptoms of one or more ICDs. Hypersexuality was the most commonly observed ICD (38.3%), and the only one having a statistically significant male predominance ( = 0.011).
ICDs are common in EOPD, particularly when associated with the use of dopamine agonists.
冲动控制障碍(ICDs)被定义为可能影响使用多巴胺激动剂的帕金森病(PD)患者的过度且重复的行为。目前缺乏关于早发性帕金森病(EOPD)患者冲动控制障碍的相关数据。在本研究中,我们旨在评估多巴胺激动剂的使用频率、冲动控制障碍的患病率,并探讨EOPD患者中与冲动控制障碍发生相关的潜在因素。
我们使用梅奥诊所数据浏览器系统,对1990年至2022年期间在明尼苏达州罗切斯特市梅奥诊所的一组基于人群的EOPD患者进行调查。我们使用帕金森综合征的国际疾病分类编码;然后,我们查阅了所有临床记录,仅纳入那些临床诊断为帕金森病且症状在50岁及以前出现,并且在使用治疗剂量多巴胺激动剂后出现冲动控制障碍的患者。
共纳入831例(513例男性和318例女性)EOPD患者,症状出现的中位年龄为42岁(置信区间:37 - 46岁)。所有患者中有49.7%使用了多巴胺激动剂;其中,只有14.5%出现了一种或多种冲动控制障碍的症状。性欲亢进是最常观察到的冲动控制障碍(38.3%),并且是唯一在男性中具有统计学显著优势的症状(P = 0.011)。
冲动控制障碍在EOPD中很常见,特别是在与使用多巴胺激动剂相关时。