Patients with newly diagnosed Parkinson’s disease did not have more symptoms of impulse control disorders or related behavioral issues than those in a control group, results of a case-control study showed.

Cumulative rates of impulse control or related problems were 18.5% among 168 patients with Parkinson’s disease and 20.3% in a matched group of healthy controls.

Neither the overall rate nor rates of individual types of behavior differed significantly between groups, including gambling impulse buying, sexual behavior, and eating, as reported in the Jan. 8 issue of Neurology.

“Parkinson’s disease 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 Parkinson’s disease medications and impulse control disorders in Parkinson’s disease,” Daniel Weintraub, MD, of the University of Pennsylvania in Philadelphia, and co-authors wrote in conclusion.

“Given that approximately 20% of patients with newly diagnosed Parkinson’s disease 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 Parkinson’s disease medications are initiated,” they noted.

Patients with Parkinson’s disease often have impulse control disorders, with estimates of co-occurrence ranging as high as 14% of Parkinson’s cases, and medications used to treat Parkinson’s disease have a well-established association with impulse control disorders and related behaviors.

Comparison studies have suggested that patients with treated Parkinson’s disease have a higher prevalence of impulse-control disorders as compared with the general population. Whether the disease itself confers a risk of impulse control disorders remains unclear, however. To examine the issue, Weintraub and colleagues conducted a case-control study at 21 movement disorder centers.

The study included 168 patients with recently diagnosed, untreated Parkinson’s disease and a control group of 143 healthy adults. Cases and controls completed the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s’s Disease (QUIP), and the primary outcome was the overall prevalence of impulse-control disorders and related behaviors as determined by QUIP scores.

The case group had more men (71.4% versus 56.6%, P=0.007), a lower mean score on the Montreal Cognitive Assessment (27.1 versus 28.3, P

In addition to the overall lack of difference in the frequency of impulse-control disorders, the Parkinson’s group did not demonstrate a significantly higher rate of:

Compulsive gambling — 1.2% versus 0.7%
Compulsive buying — 3.0% versus 2.1%
Compulsive sexual behavior — 4.2% versus 3.5%
Compulsive eating — 7.1% versus 10.5%
Punding (excessive repetition of nongoal oriented activities ) — 4.8% versus 2.1%
Hobbyism (excessive repetition of more complex activities) — 5.4% versus 11.9% (P=0.04)
Walkabout (aimless wandering) — 0.6% versus 0.7%
Logistic regression analysis showed that “a diagnosis of Parkinson’s disease was not associated with the presence of symptoms of impulse control or related behavior, either individually or as a group,” the authors reported.

“The only significant correlate in the multivariable model was increasing severity of depressive symptoms. On subanalysis, increasing severity of depression was associated with the presence of compulsive-eating symptoms (P=0.007).”

Weintraub and colleagues noted several limitations to the study, including the fact that they could not determine symptom severity or whether patients met diagnostic criteria for an impulse disorder.

The study was supported by PPMI, a public-private entity that receives funding from the Michael J. Fox Foundation for Parkinson’s Research, Abbott, Biogen Idec, F. Hoffman-La Roche, GE Healthcare, Genentech, and Pfizer.

Weintraub disclosed relationships with the Michael J. Fox Foundation for Parkinson’s Research, Novartis, Teva Pharmaceuticals, Eli Lilly, Lundbeck, Biogen, Pfizer, Avanir Pharmaceuticals, and Merck. Co-authors disclosed relationships with the Michael J. Fox Foundation, National Parkinson Fundation, Teva, Ipsen, Schering-Ploough, Merck Serono, and General Electric. Co-authors included an employee of Avid Radiopharmaceuticals.

Primary source: Neurology
Source reference:

You Might Also Enjoy...

3 Solutions for Migraines You May Not Have Tried

Migraines can have an incredible impact on your life, forcing you into a vicious cycle of head pain. If you’re tired of the grip that migraines have on your world, there are several treatments that can help.

3 Ways to Help Lower Your Risk of Alzheimer’s

Even if you have a family history of Alzheimer’s disease, you don’t have to shrug and settle for waiting to see what happens as you get older. You can lower your risk for Alzheimer’s by making lifestyle changes in midlife — read on to learn how.