Impulsive and Compulsive Behaviors in Parkinson’s Disease
Background: Impulsive and compulsive behaviors (ICBs) are a heterogeneous group of conditions that may be caused by long-term dopaminergic replacement therapy (DRT) of Parkinson's disease (PD). The spectrum of ICBs includes dopamine dysregulation syndrome (DDS), punding and impulsive control di...
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doaj-eb912c5fc5bd471cb8bf3954f46449dd2020-11-24T21:06:59ZengFrontiers Media S.A.Frontiers in Aging Neuroscience1663-43652014-11-01610.3389/fnagi.2014.0031896994Impulsive and Compulsive Behaviors in Parkinson’s DiseaseGuoxin eZhang0Zhentao eZhang1Ling eLiu2Jiaolong eYang3Jinsha eHuang4Nian eXiong5Tao eWang6Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyRenmin Hospital of Wuhan UniversityUnion Hospital, Tongji Medical College, Huazhong University of Science and TechnologyUnion Hospital, Tongji Medical College, Huazhong University of Science and TechnologyUnion Hospital, Tongji Medical College, Huazhong University of Science and TechnologyUnion Hospital, Tongji Medical College, Huazhong University of Science and TechnologyUnion Hospital, Tongji Medical College, Huazhong University of Science and TechnologyBackground: Impulsive and compulsive behaviors (ICBs) are a heterogeneous group of conditions that may be caused by long-term dopaminergic replacement therapy (DRT) of Parkinson's disease (PD). The spectrum of ICBs includes dopamine dysregulation syndrome (DDS), punding and impulsive control disorders (ICDs).Contents: We made a detailed review regarding the epidemiology, pathology, clinical characteristics, risk factors, diagnosis as well as treatment of ICBs.Results: The prevalence of ICBs in PD patients is approximately 3-4% for DDS, 0.34-4.2% for punding and 6-14% for ICDs, with higher prevalence in Western populations than in Asian. Those who take high dose of Levodopa are more prone to have DDS, whereas ICDs are markedly associated with dopamine agonists (DAs). Different subtypes of ICBs share many risk factors such as male gender, higher Levodopa equivalent daily dose (LEDD), younger age at PD onset, history of alcoholism, impulsive or novelty-seeking personality. The Questionnaire for Impulsive-Compulsive Disorder in Parkinson’s Disease-Rating Scale (QUIP-RS) seems to be a rather efficacious instrument to obtain relevant information from patients and caregivers. Treatment of ICBs is still a great challenge for clinicians. Readjustment of DRT remains the primary method. Atypical antipsychotics, antidepressants, amantadine, and psychosocial interventions are also prescribed in controlling episodes of psychosis caused by compulsive DRT, but attention should be drawn to balance ICBs symptoms and motor disorders. Moreover, deep brain stimulation of the subthalamic nucleus (STN-DBS) might be a potential method in controlling ICBs.Conclusions: The exact pathophysiological mechanisms of ICBs in PD remains poorly understood. Further researches are needed not only to study the pathogenesis, prevalence, features and risk factors of ICBs, but to find efficacious therapy for patients with these devastating consequences.http://journal.frontiersin.org/Journal/10.3389/fnagi.2014.00318/fullParkinson Diseasereviewimpulsive controlled diseasedopamine dysregulation syndromedopaminergic replacement therapy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Guoxin eZhang Zhentao eZhang Ling eLiu Jiaolong eYang Jinsha eHuang Nian eXiong Tao eWang |
spellingShingle |
Guoxin eZhang Zhentao eZhang Ling eLiu Jiaolong eYang Jinsha eHuang Nian eXiong Tao eWang Impulsive and Compulsive Behaviors in Parkinson’s Disease Frontiers in Aging Neuroscience Parkinson Disease review impulsive controlled disease dopamine dysregulation syndrome dopaminergic replacement therapy |
author_facet |
Guoxin eZhang Zhentao eZhang Ling eLiu Jiaolong eYang Jinsha eHuang Nian eXiong Tao eWang |
author_sort |
Guoxin eZhang |
title |
Impulsive and Compulsive Behaviors in Parkinson’s Disease |
title_short |
Impulsive and Compulsive Behaviors in Parkinson’s Disease |
title_full |
Impulsive and Compulsive Behaviors in Parkinson’s Disease |
title_fullStr |
Impulsive and Compulsive Behaviors in Parkinson’s Disease |
title_full_unstemmed |
Impulsive and Compulsive Behaviors in Parkinson’s Disease |
title_sort |
impulsive and compulsive behaviors in parkinson’s disease |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Aging Neuroscience |
issn |
1663-4365 |
publishDate |
2014-11-01 |
description |
Background: Impulsive and compulsive behaviors (ICBs) are a heterogeneous group of conditions that may be caused by long-term dopaminergic replacement therapy (DRT) of Parkinson's disease (PD). The spectrum of ICBs includes dopamine dysregulation syndrome (DDS), punding and impulsive control disorders (ICDs).Contents: We made a detailed review regarding the epidemiology, pathology, clinical characteristics, risk factors, diagnosis as well as treatment of ICBs.Results: The prevalence of ICBs in PD patients is approximately 3-4% for DDS, 0.34-4.2% for punding and 6-14% for ICDs, with higher prevalence in Western populations than in Asian. Those who take high dose of Levodopa are more prone to have DDS, whereas ICDs are markedly associated with dopamine agonists (DAs). Different subtypes of ICBs share many risk factors such as male gender, higher Levodopa equivalent daily dose (LEDD), younger age at PD onset, history of alcoholism, impulsive or novelty-seeking personality. The Questionnaire for Impulsive-Compulsive Disorder in Parkinson’s Disease-Rating Scale (QUIP-RS) seems to be a rather efficacious instrument to obtain relevant information from patients and caregivers. Treatment of ICBs is still a great challenge for clinicians. Readjustment of DRT remains the primary method. Atypical antipsychotics, antidepressants, amantadine, and psychosocial interventions are also prescribed in controlling episodes of psychosis caused by compulsive DRT, but attention should be drawn to balance ICBs symptoms and motor disorders. Moreover, deep brain stimulation of the subthalamic nucleus (STN-DBS) might be a potential method in controlling ICBs.Conclusions: The exact pathophysiological mechanisms of ICBs in PD remains poorly understood. Further researches are needed not only to study the pathogenesis, prevalence, features and risk factors of ICBs, but to find efficacious therapy for patients with these devastating consequences. |
topic |
Parkinson Disease review impulsive controlled disease dopamine dysregulation syndrome dopaminergic replacement therapy |
url |
http://journal.frontiersin.org/Journal/10.3389/fnagi.2014.00318/full |
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