Prevalence and factors related to Impulse-Control Disorders in Parkinson's Disease patients.

SANTIAGO PEREZ-LLORET; VERÓNICA REY; NELLY FABRE; FABIENNE ORY-MAGNE; UMBERTO SPAMPINATO; JEAN-LOUIS MONTASTRUC; OLIVIER RASCOL

Buenos Aires, Argentina

Congreso; Congreso Internacional de Movimientos Anormales; 2010

Objective: To assess the prevalence of ICD in a sample of PD patients and factors related to their occurrence.Background: Impulse-control disorders (ICD) have been recently described as an adverse drug reaction inParkinson´s Disease (PD). They have been linked to dopamine agonists, younger age, younger age at disease onsetand cognitive factors.Methods: Non-demented, non-operated PD out-patients were recruited at the Toulouse Movement Disorder Clinic.Subjects were systematically questioned about compulsive behaviors related to punding (i.e. an intenseinappropriate and unproductive fascination for common objects with repetitive meaningless movements),hypersexuality (i.e. a preoccupation with sexual feelings and thoughts, nymphomania or satyriasis), compulsiveshopping (i.e. poorly controlled preoccupations or behaviours regarding shopping), pathological gambling (PG: afailure to resist gambling impulses despite severe consequences) or binge eating (BE: eating an amount of foodthat is definitely larger than most people would eat or a lack of control over eating). Full medical history andUPDRS were performed.Results: 98 subjects were recruited (mean age was 67 10 years; 61% were males; UPDRS II and III in ON-statewere 13 7 and 24 9; 7% were on antimuscarinics, 10% on MAOb-I, 15% on amantadine, 21% on COMT-I 80% onagonists or 90% on levodopa) Twenty-seven subjects (28%) had at least one ICD (punding: 6%, hypersexuality:9%, PG: 2%, comp.shopping: 7%, BE: 15%). Subjects with an ICD were younger (61 1 vs 69 1 years, p<0.001),younger at disease onset (52 2 vs 59 1, p<0.001), were more frequently on agonists (96% vs 75%, p<0.003),had higher levodopa equivalent dose (1380 133 vs 1017 81, p<0.05) and higher IMAOb frequency (22% vs 7%,p<0.04). A logistic regression analysis disclosed that age > 69 years was the only significant factor related to ICD(Odds Ratio, IC95%: 0.3, 0.1-0.7, p<0.01). Agonists administration (pramipexole in particular) showed an almostsignificant relationship to ICD (OR: 7.2, 0.9-59.3, p=0.066).Conclusions: Prevalence of ICD in our sample was high. Age was the only significant independent factor related toICD. Agonist administration may also be related to ICD, but a larger sample size is needed to further explore thisissue.