Objective: To identify the frequency of impulse control disorders (ICDs) and other related behaviors (i.e. punding, hobbyism, walkabout and dopamine dysregulation syndrome) in people with Parkinson’s disease (PD).

Background: ICDs are known complications in dopaminergic treatment of PD and they are independent factors for lower quality of life and depression [1]. Although frequently misdiagnosed, the other related behaviors can equally disrupt social relations, especially punding and hobbism [2].

Method: We investigated consecutive PD patients from a tertiary movement disorders and PD clinic. Patients with atypical parkinsonism and dementia were excluded. A structured interview for clinical and demographic variables was performed and data concerning the type and dosages of dopamine replacement therapy were recorded, including the levodopa equivalent dosage (LED). Participants were also assessed with the modified Hoehn and Yahr scale (H&Y), the Mini-mental State Examination (MEEM) and the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease in its shortened version (QUIP-S). Kolmogorov-Smirnov normality test was performed to test whether the measures were normally distributed or not and descriptive statistics were calculated for demographic and clinical variables. Non-normally distributed variables are shown as median (interquartile range [IQR]).

Results: Sixty-six patients were included in this study and most of them were male (n=44; 63.6%). The overall sample had a median age of 70 years (IQR 13), disease duration of 9 years (IQR 9), MEEM of 26 (IQR 6), H&Y of 2.5 (IQR 0.5) and LED of 800mg (IQR 608). Thirty (47.6%) patients were under treatment with dopamine agonists. 34 patients (53.1%) had at least one ICD (n=15; 23.4% compulsive sexual behavior, n=13; 20.3% compulsive buying, n=13; 20.3% compulsive eating, and n=10; 15.6% pathological gambling). In relation to other compulsive behaviors, twenty (31%) patients had punding, n=16; 25% hobbyism, and no patient presented walkabout. Six (9.4%) patients reported dopamine dysregulation syndrome.

Conclusion: Compulsive sexual behavior was the most frequent ICD among patients with PD in our survey, greater than in literature. Punding was the most frequent compulsive behavior.

References: [1] Amy L Phu, et al. Effect of impulse control disorders on disability and quality of life in Parkinson’s disease patients. J Clin Neurosci, 2014 Jan;21(1):63-6. [2] Weintraub D, Rektorova I. Impulse control disorders and related behaviors. Cambridge University Press, 2013:140–52.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/frequency-of-impulse-control-disorders-and-other-related-behaviors-in-people-with-parkinsons-disease/