Mateusz Zurowski1, Jonathan Darcy O'Brien. 1. aDepartment of Psychiatry, Toronto Western Hospital, University Health Network bDepartment of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
Abstract
PURPOSE OF REVIEW: Impulse control behaviours (ICBs) are a frequent comorbidity for patients with Parkinson's disease. They consist of impulse control disorders, dopamine dysregulation syndrome, and punding. The field continues to evolve in the understanding of impulsivity and assessment of risk factors in the development of these behaviours and their appropriate management in patients with Parkinson's disease. RECENT FINDINGS: Impulsivity is a multifaceted concept that is surprisingly common in untreated patients with Parkinson's disease. The incidence of ICBs increases with demographic, clinical, and biochemical risk factors. Treatments rely on reduction of dopamine agonists with exception of cognitive behavioural therapy and possibly repetitive transcranial magnetic stimulation. SUMMARY: Reduction of dopamine agonist dose is the mainstay of treatment of ICBs. Other forms of dopaminergic treatment such as deep brain stimulation or jejunal infusion are alternative treatments but may be complicated by dopamine agonist withdrawal syndrome. Other therapies show promise but data are insufficient to suggest their regular use.
PURPOSE OF REVIEW: Impulse control behaviours (ICBs) are a frequent comorbidity for patients with Parkinson's disease. They consist of impulse control disorders, dopaminedysregulation syndrome, and punding. The field continues to evolve in the understanding of impulsivity and assessment of risk factors in the development of these behaviours and their appropriate management in patients with Parkinson's disease. RECENT FINDINGS:Impulsivity is a multifaceted concept that is surprisingly common in untreated patients with Parkinson's disease. The incidence of ICBs increases with demographic, clinical, and biochemical risk factors. Treatments rely on reduction of dopamine agonists with exception of cognitive behavioural therapy and possibly repetitive transcranial magnetic stimulation. SUMMARY: Reduction of dopamine agonist dose is the mainstay of treatment of ICBs. Other forms of dopaminergic treatment such as deep brain stimulation or jejunal infusion are alternative treatments but may be complicated by dopamine agonist withdrawal syndrome. Other therapies show promise but data are insufficient to suggest their regular use.
Authors: Kala Venkiteswaran; Danielle N Alexander; Matthew D Puhl; Anand Rao; Amanda L Piquet; Jennifer E Nyland; Megha P Subramanian; Puja Iyer; Matthew M Boisvert; Erin Handly; Thyagarajan Subramanian; Patricia Sue Grigson Journal: Brain Res Bull Date: 2015-11-10 Impact factor: 4.077
Authors: Samuel Carbunaru; Robert S Eisinger; Adolfo Ramirez-Zamora; Dana Bassan; Amin Cervantes-Arriaga; Mayela Rodriguez-Violante; Daniel Martinez-Ramirez Journal: Brain Behav Date: 2018-02-10 Impact factor: 2.708