Impulse-Control Disorders in Parkinson's Disease patients.

SANTAIGO PEREZ-LLORET; VERÓNICA REY; NELLY FABRE; OLIVIER RASCOL

Toronto, Canada

Congreso; Congreso Internacional de Movimientos Anormales; 2011

Objective: To assess the prevalence of ICD in a sample of PD and non-PD patients and to evaluate the factorsrelated to their occurrence.Background: Impulse-control disorders (ICD) can occur with any dopaminergic drug in Parkinson´s Disease(PD), specially in younger patients.Methods: Ambulatory non-demented, non-operated PD outpatients or patients who had recovered from strokewere recruited at the Toulouse University hospital. Subjects were systematically questioned about compulsivebehaviors related to punding (i.e. an intense inappropriate and unproductive fascination for common objectswith repetitive meaningless movements), hypersexuality (i.e. a preoccupation with sexual feelings andthoughts, and manifesting with nymphomania or satyriasis), compulsive shopping (i.e. poorly controlledpreoccupations or behaviours regarding shopping), pathological gambling (PG: a failure to resist gamblingimpulses despite severe consequences) or binge eating (BE: eating an amount of food that is definitely largerthan most people would eat or a lack of control over eating). Full medical history and UPDRS were performed.Results: 203 PD patients and 44 non-PD were recruited (age: 69 2 vs 67 1 y p=0.3, males: 55% vs 62%p=0.4). In PD, mean disease duration was 9 1 years, mean UPDRS II+III in ON-state was 37 2. Eight % ofpatients were on MAOB-Inhibitors, 23% on COMT-I, 80% on agonists or 90% on levodopa. ICDs were reportedby 0% of non-PD and 21.2% of PD (punding: 3.2%, hypersexuality: 8.2%, PG: 2.0%, comp.shopping: 5.3%,BE: 11.4%). PD patients with ICDs were younger (62 1 vs 68 1 years, p<0.001), more frequently on agonists(100% vs 73%, p<0.001), had higher levodopa equivalent dose (1622 294 vs 1030 50, p<0.05) and morefrequently on a MAO-B inhibitor (15% vs 6%, p<0.05). A logistic regression analysis disclosed that age > 68years (OR= 0.3, 0.1-0.6), MAO-B inhibitor administration (3.7, 1.1-12.6) or dopamine agonists were the onlysignificant factors related to ICD.Conclusions: Prevalence of ICD in our sample of PD patients was high (21%), while non post-stroke patienthad this type of ADR. While age and ropinirole administration are known to increase ICD risk, we observed thatMAO-B inhibitors could also be related to ICD occurrence.