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Impulse control and repetitive behavior disorders are more common in PD patients with levodopa-induced dyskinesias

F. Paolini Paoletti, N. Tambasco, G. Cappelletti, P. Eusebi, S. Simoni, P. Nigro, E. Brahimi, M. Filidei, P. Calabresi (Perugia, Italy)

Meeting: 2019 International Congress

Abstract Number: 2180

Keywords: Behavioral abnormalities, Dyskinesias, Levodopa(L-dopa)

Session Information

Date: Wednesday, September 25, 2019

Session Title: Phenomenology and Clinical Assessment of Movement Disorders

Session Time: 1:15pm-2:45pm

Location: Les Muses Terrace, Level 3

Objective: Our aim was to evaluate the prevalence of impulse control and repetitive behavior disorders (ICRB) in patients affected by Parkinson’s disease (PD) with and without levodopa-induced dyskinesias (LID).

Background: Dopaminergic replacement therapy is the backbone of treatment in PD. However, over time it is associated with the development of behavior and motor complications represented by ICRB and LID, respectively. An increasing risk of ICRB and LID co-occurrence has been previously suggested in PD [1].

Method: 55 PD patients affected by LID and 62 PD patients without LID were recruited from our Movement Disorders Centre. Motor impairment and disease-related disability were evaluated by using Hoehn and Yahr (H&Y) scale. For each patient Levodopa Equivalent Daily Dose (LEDD) and Dopamine Agonists Equivalent Daily Dose (DAED) were calculated. ICRB were tested by means of Impulsive-Compulsive Disorders Questionnaire-Rating Scale (QUIP-RS). Statistical analysis was performed by using Spearman coefficient for associations between continuous variable and Chi-square test for categorical variables.

Results: In our cohort the overall prevalence of ICRB was 41% (95% CI = 32% to 50%). The prevalence of ICRB was higher in patients with LID compared to those without LID (58% vs 26%, p<0.001). We did not find any correlations between QUIP-RS and disease duration, H&Y, LEDD and DAED.

Conclusion: Our study suggests that ICRB are more common in PD patients with LID, in line with previous literature [2]. Findings such these strengthen the idea that behavior and motor complications of dopaminergic replacement therapy share underlying pathophysiological mechanisms.

References: [1] Voon V et al. Impulse control disorders and levodopa-induced dyskinesia in Parkinson’s disease: an update. Lancet Neurol. 2017 Mar;16(3):238-250. [2] Biundo R et al. Impulse control disorders in advanced Parkinson’s disease with dyskinesia: The ALTHEA study. Mov Disord. 2017 Nov;32(11):1557-1565.

To cite this abstract in AMA style:

F. Paolini Paoletti, N. Tambasco, G. Cappelletti, P. Eusebi, S. Simoni, P. Nigro, E. Brahimi, M. Filidei, P. Calabresi. Impulse control and repetitive behavior disorders are more common in PD patients with levodopa-induced dyskinesias [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/impulse-control-and-repetitive-behavior-disorders-are-more-common-in-pd-patients-with-levodopa-induced-dyskinesias/. Accessed June 15, 2025.
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