Objective: To Analyse Impulse Control Disorders (ICDs) and Related Behaviors (RB) in 36 Brazilian patients with Parkinson´s disease (PD) and compare the cognition of the patients with and without ICDs in our Movement Disorders Outpatient Clinic (MDOC) at Universidade Federal de Sao Paulo (UNIFESP).

Background: ICDs are a serious complication of PD and its treatment, occurring over the course of the illness. ICDs and RB have a significant impact on quality of life, and are associated with significant psychiatric comorbidity.

Method: An observational study was done on a series of 36 consecutive patients with PD witth < 59 years of age from the MDOC at UNIFESP. Patients underwent the following assessment: Mini-Mental State Examination(MMSE), Frontal Assessment Battery(FAB), Clock Drawing Test(CDT), Hopkins Verbal Learning Test-Revised (HVLT-R), Trail Making Test A(TMT-A) and B(TMT-B), Forward Digit Span(FDS) and Backward Digit Span(BDS), Stroop Test(ST), Beck Depressive Inventory(BDI), Neuropsychiatric Inventory(NPI), PD Impulsive-Compulsive Questionnaire-Current Short(QUIP-CS) Portuguese version, Barratt Impulsiveness Scale(BIS-11), UPDRS-3 and HY.

Results: The study group showed a mean age ± SD of 50,9 ± 6,2 years(y), 30,5% of the group were women and 69,4% were men (11 and 25), 66,6% (24) patients were taking dopaminergic agonist (pramipexol), the mean duration of PD ± SD was 8,7 ± 4,6 years, the mean LEDD± was 861,1±462,7mg, the mean UPDRS-3± SD was 28,6 ± 13,3. The frequency of ICD and/or RB in this group was 66,6%(24) of which 50%(12) had binge eating, 45,8%(11) compulsive buying, 16,6%(4) compulsive sexual behavior, 12,5%(3) compulsive gambling and 54,1%(13) RB(punding, hobbyism ,and dopamine dysregulation syndrome). Patients were distributed between 2 groups (with ICD and/or RBs and without ICD and/or RBs) which presented similar age ± SD(50,2 ±5,7y; 52,2±7,3y p=0,377), LEDD±SD (865,9±398,2mg; 851,6±591mg,2 p=0,456), pramipexol dosage ± SD (1,17±1,22mg; 0,85±1,11mg p=0,447), PD duration (8,9±5,0y; 8,5±3,8y p=0,934), and similar results in cognitive and psychiatric assessment.

Conclusion: ICDs and RBs are frequent complications of PD and its treatment with a great impact in patients life.  Our study demonstrated a high frequency of ICD and RBs (66,6%)  compared to literature (up to 20%), but our sample consisted mostly of young men (69,4%) using dopaminergic agonist and this must have influenced our results.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/impulse-control-disorders-in-a-brazilian-population-with-parkinsons-disease-an-observational-study/