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Abstract
Objective: To determine the frequency and correlates of impulse control and related behavior symptoms in patients with de novo, untreated Parkinson disease (PD) and healthy controls (HCs).
Methods: The Parkinson's Progression Markers Initiative is an international, multisite, case-control clinical study conducted at 21 academic movement disorders centers. Participants were recently diagnosed, untreated PD patients (n = 168) and HCs (n = 143). The outcome measures were presence of current impulse control and related behavior symptoms based on recommended cutoff points for the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP)-Short Form.
Results: There were 311 participants with complete QUIP data. Frequencies of impulse control and related behavior symptoms for patients with PD vs HCs were as follows: gambling (1.2% vs 0.7%), buying (3.0% vs 2.1%), sexual behavior (4.2% vs 3.5%), eating (7.1% vs 10.5%), punding (4.8% vs 2.1%), hobbyism (5.4% vs 11.9%), walkabout (0.6% vs 0.7%), and any impulse control or related behavior (18.5% vs 20.3%). In multivariable models, a diagnosis of PD was not associated with symptoms of any impulse control or related behavior (p ≥ 0.10 in all cases).
Conclusions: PD itself does not seem to confer an increased risk for development of impulse control or related behavior symptoms, which further reinforces the reported association between PD medications and impulse control disorders in PD. Given that approximately 20% of patients with newly diagnosed PD report some impulse control or related behavior symptoms, long-term follow-up is needed to determine whether such patients are at increased risk for impulse control disorder development once PD medications are initiated.
GLOSSARY
- HC=
- healthy control;
- ICD=
- impulse control disorder;
- MoCA=
- Montreal Cognitive Assessment;
- PD=
- Parkinson disease;
- PPMI=
- Parkinson's Progression Marker Initiative;
- QUIP=
- Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease;
- UPDRS=
- Unified Parkinson's Disease Rating Scale
Footnotes
Parkinson's Progression Markers Initiative coinvestigators are listed on the Neurology® Web site at www.neurology.org.
Supplemental data at www.neurology.org
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received May 23, 2012.
- Accepted August 21, 2012.
- © 2013 American Academy of Neurology
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