Category: Parkinson's Disease: Non-Motor Symptoms
Objective: To investigate whether anxiety, depression, and sleep impairment relate to development of impulse control disorders (ICD) in patients with early-stage Parkinson’s disease (PD).
Background: A sub-group of PD patients experience ICDs. ICDs are characterized by a failure to resist a temptation to perform repetitive actions that can be harmful and/or substantially affect quality of life. Cross-sectional studies have demonstrated that patients with PD and ICD have significantly higher self-reported anxiety, depression, and sleep impairment compared to patients with PD without ICD. A few recent studies have investigated a prospective link between anxiety and/or depression, and development of ICD in PD, with conflicting results. No previous studies have investigated sleep problems as predictors of ICD in early PD.
Method: We investigated 188 early-stage PD patients (disease duration < 24 months) from the Parkinson’s Progressive Marker Initiative (PPMI). In patients without ICDs at baseline, defined by the Questionnaire for Impulsive-Compulsive Behaviours-Current-Short, we contrasted measures of anxiety, depression, and sleep problems at baseline in patients who later developed ICDs within ten years (n=53) or did not (n=135), using the State-Trait-Anxiety Inventory, Geriatric Depression Scale, and part 1.7 of the Movement Disorder Society- Unified Parkinson’s Disease Rating Scale, respectively.
Results: Patients with ICDs revealed significantly higher anxiety (M = 72.34 vs. 59.80; p < .001), depression (M = 2.76 vs. 1.84; p = .017), and sleep problems (M = 0.98 vs. 0.64; p = .026) at baseline compared to patients without ICD. Logistic regression analysis revealed that only anxiety significantly predicted ICD after controlling for age and sex, OR = 1.04, p = .001.
Conclusion: PD patients with ICD demonstrate significantly higher anxiety, depression, and sleep problems at baseline, though only anxiety scores predicted ICD development. Anxiety screening could alert clinicians to patients at greater risk of developing ICDs, which could inform type and dose of dopaminergic therapy.
References: Aleksovski, D., Miljkovic, D., Bravi, D., & Antonini, A. (2018). Disease progression in parkinson subtypes: The PPMI dataset. Neurological Sciences, 39(11), 1971–1976. https://doi.org/10.1007/s10072-018-3522-z
Antonini, A., Barone, P., Bonuccelli, U., Annoni, K., Asgharnejad, M., & Stanzione, P. (2017). Icarus study: Prevalence and clinical features of impulse control disorders in parkinson’s disease. Journal of Neurology, Neurosurgery & Psychiatry, 88(4), 317–324. https://doi.org/10.1136/jnnp-2016-315277
Goetz, C. G., Tilley, B. C., Shaftman, S. R., Stebbins, G. T., Fahn, S., Martinez‐Martin, P., Poewe, W., Sampaio, C., Stern, M. B., Dodel, R., Dubois, B., Holloway, R., Jankovic, J., Kulisevsky, J., Lang, A. E., Lees, A., Leurgans, S., LeWitt, P. A., Nyenhuis, D., … LaPelle, N. (2008). Movement disorder society‐sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS‐UPDRS): Scale presentation and Clinimetric testing results. Movement Disorders, 23(15), 2129–2170. https://doi.org/10.1002/mds.22340
Herrmann, N., Mittmann, N., Silver, I. L., Shulman, K. I., Busto, U. A., Shear, N. H., & Naranjo, C. A. (1996). A validation study of the Geriatric Depression Scale Short Form. International Journal of Geriatric Psychiatry, 11(5), 457–460. https://doi.org/10.1002/(sici)1099-1166(199605)11:5<457::aid-gps325>3.0.co;2-2
Imperiale, F., Agosta, F., Canu, E., Markovic, V., Inuggi, A., Jecmenica-Lukic, M., Tomic, A., Copetti, M., Basaia, S., Kostic, V. S., & Filippi, M. (2017). Brain structural and functional signatures of impulsive–compulsive behaviours in parkinson’s disease. Molecular Psychiatry, 23(2), 459–466. https://doi.org/10.1038/mp.2017.18
Marín‐Lahoz, J., Sampedro, F., Martinez‐Horta, S., Pagonabarraga, J., & Kulisevsky, J. (2019). Depression as a Risk Factor for Impulse Control Disorders in Parkinson Disease. Annals of Neurology, 86(5), 762–769. https://doi.org/10.1002/ana.25581
Ricciardi, L., Lambert, C., De Micco, R., Morgante, F., & Edwards, M. (2018). Can we predict development of impulsive–compulsive behaviours in Parkinson’s disease? Journal of Neurology, Neurosurgery & Psychiatry, 89(5), 476–481. https://doi.org/10.1136/jnnp-2017-317007
Scullin, M. K., Sollinger, A. B., Land, J., Wood-Siverio, C., Zanders, L., Lee, R., Freeman, A., Goldstein, F. C., Bliwise, D. L., & Factor, S. A. (2013). Sleep and impulsivity in Parkinson’s disease. Parkinsonism & Related Disorders, 19(11), 991–994. https://doi.org/10.1016/j.parkreldis.2013.06.018
Spielberger, C. D., Vagg, P. R., Barker, L. R., Donham, G. W., & Westberry, L. G. (1980). The factor structure of the state-trait anxiety inventory. Stress and anxiety, 7, 95-109.
Waskowiak, P., Koppelmans, V., & Ruitenberg, M. F. L. (2022). Trait Anxiety as a Risk Factor for Impulse Control Disorders in de novo Parkinson’s Disease. Journal of Parkinson’s Disease, 12(2), 689–697. https://doi.org/10.3233/JPD-212959
Weintraub, D., Hoops, S., Shea, J. A., Lyons, K. E., Pahwa, R., Driver‐Dunckley, E. D., Adler, C. H., Potenza, M. N., Miyasaki, J., Siderowf, A. D., Duda, J. E., Hurtig, H. I., Colcher, A., Horn, S. S., Stern, M. B., & Voon, V. (2009). Validation of the questionnaire for impulsive‐compulsive disorders in parkinson’s disease. Movement Disorders, 24(10), 1461–1467. https://doi.org/10.1002/mds.22571
To cite this abstract in AMA style:
T. Breddy, P. Macdonald, K. van Hedger, H. Ganjavi. Clinical Predictors of Impulse Control Disorders in Parkinson’s Disease [abstract]. Mov Disord. 2024; 39 (suppl 1). https://www.mdsabstracts.org/abstract/clinical-predictors-of-impulse-control-disorders-in-parkinsons-disease/. Accessed October 12, 2024.« Back to 2024 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-predictors-of-impulse-control-disorders-in-parkinsons-disease/