Objective: To evaluate the relationship between the presence of dyskinesia objectively detected using a wearable device and the presence of active and past impulsive compulsive behaviour (ICB) in Parkinson’s disease (PD).

Background: ICB and dyskinesia are common and disabling complications occurring during the course of PD. Their pathophysiology is not clear yet, however an association has been recently suggested.

Method: We enrolled consecutive PD patients who presented at least motor fluctuations. Presence of dyskinesia was ascertained objectively through a wearable devise, the Parkinson’s KinetiGraph™ (PKG®). This is an accelerometry-based system for automated assessment of dyskinesia and motor fluctuations. Clinical rating of motor symptoms and complications was also made by Unified PD Rating Scale (UPDRS) parts I-IV and Dyskinesia Rating Scale (DRS). Past and active ICB were diagnosed with a semi-structured interview. The Questionnaire for Impulsive-Compulsive Disorders in PD-Rating Scale (QUIP-RS) was employed to rate ICB severity. Clinical rating scales for depression, anxiety, apathy and impulsivity were also employed.

Results: Among 55 enrolled PD subjects (36 males, mean age 60.7±6.7; mean disease duration 10.5±4.9), 25 (45%) had dyskinesia as per PKG ‘Percent Time in Dyskinesia’ score. Nineteen patients had ICB (34%). Patients with dyskinesia had higher dopamine-agonists equivalent daily dose (LEDD) (p=0.005), UPDRS-IV (p=0.02), DRS (p=0.002). Despite higher dopamine-agonists LEDD in dyskinetic patients, there was no difference in active/past ICB between subjects with and without dyskinesia (p=0.8 and 0.6). Moreover, the two groups did not differ by severity of depression, anxiety, apathy and impulsivity. When categorizing our cohort in 3 groups (none, mild/moderate and severe dyskinesia), we found no difference in any demographic, clinical, psychiatric and behavioural variable, except for LEDD dopamine-agonists (p=0.004), UPDRS-IV (p=0.06), DRS (p=0.004). Binary regression analysis did not show any association between the presence of dyskinesia and ICB, depression, anxiety, apathy and impulsivity.

Conclusion: ICB and dyskinesia are common but unrelated disorders in PD. Our data, using a home-based wearable device, challenge the association between ICB and dyskinesia in an advanced PD population.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/shedding-light-on-the-relationship-between-dyskinesia-assessed-by-a-wearable-device-and-impulsive-compulsive-behaviour-in-parkinsons-disease/