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Impulse Control Disorders in Older Adults With PD

June 26, 2018

Historically, nonmotor features of movement disorders have be recognized, and research in this area continues to grow.

Jean-Christophe Corvol, MD, and colleagues from the Assistance Publique Hôpitaux de Paris, conducted a study assessing patients with Parkinson disease (PD) to investigate dopamine-agonist (DA) use in relation to incidence of impulse control disorders (ICDs) in a dose-effect relationship.

Researchers used data from a multicenter longitudinal cohort of patients with PD with ≤ 5 years’ disease duration at baseline who were followed up annually for up to 5 years. Face-to-face, semistructured interviews with movement disorder specialists were conducted to evaluate ICDs in participants. Researchers also studied the association between several time-dependent definitions of DA use using generalized estimating equations and Poisson models with robust variance, taking dose and duration of treatment into account.

Among 411 patients (40.6% women, mean age 62.3 years, average follow-up 3.3 years, SD 1.7 years), 356 (86.6%) took a DA at least once since disease onset. In 306 patients without ICDs at baseline, the 5-year cumulative incidence of ICDs was 46.1% (95% confidence interval [CI] 37.4–55.7, DA ever users 51.5% [95% CI 41.8–62.1], DA never users 12.4% [95% CI 4.8–30.0]). ICD prevalence increased from 19.7% at baseline to 32.8% after 5 years.

Lifetime average daily dose and duration of treatment were independently associated with ICDs with significant dose-effect relationships. Similar analyses for levodopa were not in favor of a strong association. ICDs progressively resolved after DA discontinuation.

In their article, authors concluded that “ICDs were strongly associated with DA use with a dose-effect relationship; both increasing duration and dose were associated with ICDs. ICDs progressively resolved after DA discontinuation.”

—Amanda Del Signore

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