A survey of impulse control disorders in Parkinson’s disease patients in Shanghai area and literature review

摘要

Levodopa and dopamine agonists are the main treatments for Parkinson’s disease (PD) in recent years. Increased drug dosages are linked to some severe side effects, one of which is impulse control disorders (ICD). Many studies have reported the related risk factors of ICDs, such as?dopamine agonist, male sex, younger age, earlier age of onset and so on. This study aims to investigate the incidence of ICD in Chinese PD patients from Shanghai area, explore the association of ICD with dopamine replacement therapy (DRT). Two hundred seventeen PD patients were consecutively recruited from the Movement Disorder Clinic of Ruijin Hospital from March to October 2013. Minnesota Impulsive Disorders Interview was used to assess the PD patients. PD patients with possible ICD would undergo a further interview by a movement disorder specialist to confirm the diagnosis. Clinical information was also collected. Nine PD patients (4.15?%) showed ICD behaviors as follows: hypersexuality (4, 1.84?%), pathological gambling (3, 1.38?%), binge eating (1, 0.46?%), compulsive shopping (1, 0.46?%). Compared with the non-ICD PD group, ICD PD group took more dopamine agonists (LED 119.4?±?86.4?mg/d vs 60.5?±?80.5?mg/d, P?=?0.019), had higher total levodopa equivalent dosage (TLED 912.81?±?878.73?mg/d vs 503.78?±?359.14?mg/d, P?=?0.031), and had higher H&Y stage (2.33?±?0.87 vs 1.41?±?0.52, p?=?0.013). However, logistic regression analysis didn’t reveal the above factors as independent risk factors of ICD behaviors in our study. The incidence of ICDs behaviors in PD patients in our study is much lower than in western countries. ICD-PD group took higher dopamine agonists and higher total levodopa equivalent dosage, even though logistic regression analysis didn’t reveal them as independent risk factors.