Prognosis of impulse control disorders in Parkinson's disease: a prospective controlled study.

Wirth, Thomas; Goetsch, Thibaut; Corvol, Jean-Christophe; Roze, Emmanuel; Mariani, Louise-Laure; Vidailhet, Marie; Grabli, David; Mallet, Luc; Pelissolo, Antoine; Rascol, Olivier; Brefel-Courbon, Christine; Ory-Magne, Fabienne; Arbus, Christophe; Bekadar, Samir; Krystkowiak, Pierre; Marques, Ana; Llorca, Michel; Krack, Paul; Castrioto, Anna; Fraix, Valérie; ... (2024). Prognosis of impulse control disorders in Parkinson's disease: a prospective controlled study. Journal of neurology, 271(5), pp. 2412-2422. Springer 10.1007/s00415-023-12170-7

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BACKGROUND

The long-term prognosis of impulsive compulsive disorders (ICD) remains poorly studied in Parkinson's disease (PD).

OBJECTIVE

Evaluating the natural history of ICD and its impact on PD symptoms including cognition and treatment adjustments.

MATERIALS AND METHODS

We assessed PD patients at baseline (BL) with (BL-ICD+) or without (BL-ICD-) ICD despite dopamine agonist (DA) exposure of > 300 mg levodopa-equivalent daily dose for > 12 months at baseline and after more than two years of follow-up. ICD were assessed using the Ardouin's Scale of Behaviors in PD (ASBPD), cognition using the Mattis scale, and PD symptoms using the UPDRS score. Treatment adjustments, DA withdrawal-associated symptoms, and ICDs social consequences were recorded.

RESULTS

149 patients were included (78 cases and 71 controls), mean duration of follow-up was 4.4 ± 1 years. At baseline, psychiatric disorders were more common among BL-ICD + (42.3 vs 12.3% among BL-ICD-, p < 0.01). At follow-up, 53.8% of BL-ICD + were not ICD-free while 21.1% of BL-ICD- had developed ICD. BL-ICD + more frequently experienced akinesia (21.8 vs 8.5%, p = 0.043) and rigidity worsening (11.5 vs 1.4%, p = 0.019) following therapeutic modifications. Decision to decrease > 50% DA doses (12.8 vs 1.4%, p = 0.019) or to withdraw DA (19.2 vs 5.6%, p = 0.025) was more frequently considered among BL-ICD+ . At follow-up, the prevalence of cognitive decline was lower among BL-ICD + (19.2 vs 37.1%, p = 0.025).

CONCLUSION

ICDs were associated with increased psychiatric burden at baseline and better cognitive prognosis. Most patients were still showing ICDs at the follow-up visit, suggesting ICD to be considered as a chronic, neuropsychiatric disorder.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Krack, Paul

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1432-1459

Publisher:

Springer

Language:

English

Submitter:

Pubmed Import

Date Deposited:

15 Jan 2024 15:43

Last Modified:

29 Apr 2024 00:13

Publisher DOI:

10.1007/s00415-023-12170-7

PubMed ID:

38214756

Uncontrolled Keywords:

Cognition Dopaminergic agonists Impulse control disorders Parkinson’s disease Prognosis

BORIS DOI:

10.48350/191603

URI:

https://boris.unibe.ch/id/eprint/191603

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