Objective: To ascertain the prevalence of problematic technology use (Technology-related ICDs, Tech-ICDs) in patients with PD.

Background: ICDs are a known complication of PD drugs causing serious harm, but problematic use of technology is not a recognized ICD. We have noticed multiple patients in our clinic with Tech-ICDs that were not detected using standard screens. To address this, we are systematically collecting detailed information on technology use in PD and matched controls. We hypothesize that Tech-ICDs are common in PD.

Methods: Consecutive PD cases and controls from our movement disorders center are being evaluated. Controls are cases’ caregivers or family members. Subjects are evaluated once by clinical status, MoCA, QUIP and a structured screen for Tech-ICDs, the PUTS-PD (Problematic Use of Technology Scale-PD) elaborated by a semi-structured interview (SSI). Technology use was defined as problematic when it was excessive or disruptive enough to cause impairment or harm to an individual based on SSI.

Results: To date, 16 PD cases (mean PD duration 10 years, mean levodopa-equivalent daily dose 946 mg, 44% on dopamine agonist) and 8 controls have completed the PUTS-PD. Mean MoCA was 27/30 in PD and 28/30 in controls. QUIP was positive in 67% of PD and 33 % of controls. Most subjects owned multiple devices (smartphone: 81% PD, 88% controls; tablet: 44% PD, 63% controls; laptop/desktop: 94% PD, 100% controls). 7 of 16 PD cases (44%) but only 1 control (13%) reported problematic use of technology now or in the past (among PD, 57% past, 29% now, 14% both; among control, both) on PUTS-PD. 9 PD completed the SSI; 44% were found to have Tech-ICD. All of PD with Tech-ICD also had classic ICD behaviors. Only 2 controls completed SSI and neither was found to have Tech-ICD or classic ICD behaviors. 55% of PD with Tech-ICD endorsed “escaping” or feeling in a “zone” with technology use. 100% with these feelings but only 25% without these feelings had a history of depression or anxiety.

Conclusions: Our preliminary result suggests that problematic technology use is common in PD and appears to occur more often in those with other ICDs. Additional screening methods are needed to identify these potentially harmful behaviors.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/technology-use-and-impulse-control-disorders-icds-in-patients-with-parkinsons-disease-pd/