冲动控制障碍：临床、药理学和遗传学危险因素综述。

Impulse control disorder: Review on clinical, pharmacologic, and genetic risk factors.

机构信息

Inserm, CNRS, Department of Neurology, CIC Neurosciences, Pitié-Salpêtrière Hospital, Paris Brain Institute - ICM, Sorbonne Université, Assistance publique-Hôpitaux de Paris, Paris, France; Université Libre de Bruxelles, Bruxelles, Belgium.

Inserm, CNRS, Department of Neurology, CIC Neurosciences, Pitié-Salpêtrière Hospital, Paris Brain Institute - ICM, Sorbonne Université, Assistance publique-Hôpitaux de Paris, Paris, France.

出版信息

Rev Neurol (Paris). 2024 Dec;180(10):1071-1077. doi: 10.1016/j.neurol.2024.07.001. Epub 2024 Sep 2.

DOI:10.1016/j.neurol.2024.07.001

PMID:39227281

Abstract

INTRODUCTION

Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms, among which impulse control disorders behaviors (ICD) emerge as significant non-motor manifestations. ICD in PD patients, including pathological gambling, hypersexuality, compulsive buying, among others, lead to considerable impairment and reduced quality of life. This review aims to explore the multifaceted risk factors associated with ICD in PD patients, including clinical, pharmacological, and genetic aspects, to enhance early identification, prevention, and management strategies.

METHODS

A comprehensive review of literature was conducted to identify studies investigating risk factors for ICD in PD. Data from clinical, pharmacological, and genetic studies were analyzed to elucidate the complex interplay of factors contributing to ICD development.

RESULTS

Clinical risk factors such as young age, male gender, and specific personality traits were consistently associated with a higher incidence of ICD. Environmental factors such as cultural nuances and geographic location influence ICD prevalence. Disease characteristics include early PD onset, longer disease duration, motor fluctuations, anxiety, depression, sleep disorders, and apathy. Pharmaceutical risk factors involve dopaminergic drugs, with dopamine agonists showing a dose-dependent association with ICD. Genetic risk factors highlight the involvement of dopaminergic and serotoninergic systems, with various neurotransmitter pathways implicated.

CONCLUSIONS

ICDs are common and severe in PD. Understanding the multifaceted risk factors for ICD in PD is crucial for identifying patients at high risk to develop these adverse effects and developing targeted interventions to prevent their occurrence. Given their frequency and potential consequences for the patient and their family, the current strategy is to systematically screen for ICDs throughout patient follow-up, particularly when prescribing dopamine agonists.

摘要

简介

帕金森病（PD）是一种神经退行性疾病，其特征为运动和非运动症状，其中冲动控制障碍行为（ICD）作为重要的非运动表现出现。PD 患者的 ICD 包括病理性赌博、性欲亢进、强迫性购买等，导致相当大的损害和生活质量降低。本综述旨在探讨与 PD 患者 ICD 相关的多方面风险因素，包括临床、药理学和遗传学方面，以加强对 ICD 的早期识别、预防和管理策略。

方法

对探索 PD 患者 ICD 风险因素的文献进行全面综述。分析临床、药理学和遗传学研究的数据，以阐明导致 ICD 发展的复杂因素相互作用。

结果

临床风险因素，如年龄较小、男性和特定的人格特质，与 ICD 的发生率较高密切相关。环境因素，如文化差异和地理位置，影响 ICD 的流行率。疾病特征包括 PD 发病早、病程长、运动波动、焦虑、抑郁、睡眠障碍和冷漠。药物治疗风险因素涉及多巴胺能药物，多巴胺激动剂与 ICD 呈剂量依赖性相关。遗传风险因素突出了多巴胺能和血清素能系统的参与，涉及各种神经递质通路。