Objective: To compare the incidence and severity of ICDs among PwP treated with different DA, specifically examining their respective impacts on ICD onset and remission.

Background: Impulse control disorder (ICD) is a neuropsychiatric symptom with 12% of prevalence in people with Parkinson’s Disease (PwP) [1]. Studies strongly suggest that certain dopamine agonists (DA), such as pramipexole, increase the risk of ICD, while others, such as bromocriptine and rotigotine, might have a safer profile. [2] However, evidence remains controversial, and further comparative studies are needed to establish clear differences among these DA, understanding this connection over time can provide insights into managing NMS effectively [3]. Currently, there is a paucity of long term studies concerning ICD. [4]

Method: A longitudinal analytical study was conducted, 41 PwP and ICD participants were classified by ICD diagnosis [table1] and divided into two groups based on evolution: remission (n=25) and non-remission (n=16). Over two follow-up visits, spaced two years apart, data collected included: gender, age, PD progression, antiparkinsonian therapy, DA use, and clinical scale scores (MDS-UPDRS, PDQ-8i, QUIP-RS). Non-parametric variables were analyzed with the Wilcoxon test, and categorical variables with the chi-square (χ²) test. A multiple linear regression model was performed to identify a relationship between DA consumption and ICD remission.

Results: The remission group was significantly older at the second follow-up (62.3 ± 10.5 vs. 59.9 ± 14.4; p < 0.001). Higher levodopa use was observed in the remission group (60.97% vs. 39.02%; p = 0.037), while dopamine agonist use was lower (19.51% vs. 17.07%; p = 0.002) at the second follow-up [table2]. The regression model showed that predictors explained 53.7% of variability, with age significantly influencing outcomes, reversing over time (R=0.733, R²=0.537, β=, p=0.015). Rotigotine was associated with a lower probability of the event, suggesting a protective role (p=0.024) [table3].

Conclusion: The remission group demonstrated reduced total QUIP-RS scores and lower prevalence of specific compulsions, such as hypersexuality and compulsive shopping. Rotigotine was associated with a decreased likelihood of ICD, suggesting a safer alternative and highlighting the need for further research into its impact on ICD progression in PD.

Table 1. ICD Diagnosis

Table 2. Comparisons between ICD groups

Table 3. Results of Linear Regression

References: 1. Marques A, Vidal T, Pereira B, Benchetrit E, Socha J, Pineau F, et al. French validation of the questionnaire for Impulsive-Compulsive Disorders T in Parkinson’s Disease–Rating Scale (QUIP-RS). ElSevier. 2019. doi: https://doi.org/10.1016/j.parkreldis.2019.02.026
2. Wu HF, Yu ELM, Sheng B, Wong KK, Yeung MA, Wong WT, et al. Impulse control and related behavioral disorders (ICRD) in Idiopathic Parkinson’s Disease treated with different dopamine agonists in Hong Kong: Is any dopamine agonist better? Clin Parkinsonism Relat Disord. 2024;10:100235. doi: 10.1016/j.prdoa.2024.100235.
3. Rodríguez Violante M, González Latapi P, Cervantes Arriaga A, Camacho Ordóñez A, Weintraub D. Impulse control and related disorders in Mexican Parkinson’s disease patients. ElSevier. 2014. doi: http://dx.doi.org/10.1016/j.parkreldis.2014.05.014
4. Hu L, Lin C, Lin F, Wang L, Li Z, Cai Z, Liu X, Ye Q, Wu Y and Cai G (2023) Different impulse control disorder evolution patterns and white matter microstructural damage in the progression of Parkinson’s disease. Front. Aging Neurosci. 15:1260630. doi: 10.3389/fnagi.2023.1260630

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MDS Abstracts - https://www.mdsabstracts.org/abstract/course-of-impulse-control-disorder-in-people-living-with-parkinsons-disease-a-longitudinal-study-on-dopamine-agonist-treatment/