Objective: Analyze associations between gender, dopamine agonists, and levodopa doses in Parkinson’s Disease (PD) patients with Impulse control disorder (ICD).

Background: ICDs, which include compulsive gambling, eating, buying, and hypersexuality, are present in 14-40% of PD patients[1]. Male gender has been cited as a risk factor for ICD. Other gender-based ICD patterns include hypersexuality in males and compulsive shopping in females[1]. Women with PD are underrepresented in clinical trials in proportion to the sex-based difference in PD prevalence [2].

Method: Patients were selected from a database of PD patients undergoing evaluation for deep brain stimulation in two academic movement disorder clinics. PD patients were marked as positive for ICD based on the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease[3]. Individual chart review was conducted to verify ICD symptoms. Clinical variables included age, gender, disease duration, medication use, and MDS-Unified Parkinson Disease Rating Scale[4]. Correlation analysis was performed using two-tailed Spearman correlation analysis (a<0.05) and Benjamini-Hochberg correction.

Results: Of 117 patients, the prevalence of ICD was 29.1% (n=34), with 44.1% (n=15) patients experiencing more than one ICD trait. 76% of all patients were male (n=89), 24% were female (n=28). Demographics are provided in Table 1. For ICD patients, hobbyism and punding were most prevalent (60.9%), followed by compulsive eating (34.8%), shopping (33.3%), medication use (26%), hypersexuality (29.2%), and gambling (16.7%). There was no significant correlation between gender, ICD diagnosis, or specific ICD trait (p>0.05, Figure 1). Use of dopamine agonist (DA) and total levodopa equivalent daily dose were not significantly associated with ICD[5]. Female gender was associated with DA use within our population (rho=0.285, p=0.002).

Conclusion: Our cohort showed no gender-based difference in ICD patterns. Potential reasons may include small sample size versus increased self-reporting by women of specific PD symptoms at tertiary centers. Our study emphasizes the need for clinicians to maintain the same level of vigilance in identifying ICD traits across genders.

Table 1

Figure 1

References: 1) Marques, A., Durif, F. & Fernagut, PO. Impulse control disorders in Parkinson’s disease. J Neural Transm 125, 1299–1312 (2018). https://doi.org/10.1007/s00702-018-1870-8
2) R. Patel, K. Kompoliti. Sex and gender differences in Parkinson’s disease. Neurol. Clin., 41 (2) (2023), pp. 371-379, Epub 2023 Feb 19. PMID: 37030964 10.1016/j.ncl.2022.12.001
3) Weintraub, D., Mamikonyan, E., Papay, K., Shea, JA., Xie, SX., Siderowf, A. Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease-Rating Scale. Mov Disord. 2012;27(2):242-247. doi:10.1002/mds.24023
4) Goetz, CG., Tilley, BC., Shaftman, SR., et al. Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov Disord. 2008;23(15):2129-2170. doi:10.1002/mds.22340
5) Jost, ST., Kaldenbach, MA., Antonini, A., et al. Levodopa Dose Equivalency in Parkinson’s Disease: Updated Systematic Review and Proposals. Mov Disord. 2023;38(7):1236-1252. doi:10.1002/mds.29410

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MDS Abstracts - https://www.mdsabstracts.org/abstract/gender-based-differences-in-impulse-control-disorders-within-parkinsons-disease/