Objective: To evaluate the prevalence and severity of impulse control disorders (ICD) and other impulsive-compulsive behaviors (ICB) in a cohort of patients with Parkinson’s disease (PD) after STN DBS using the Ardouin Scale of Behavior in Parkinson’s disease.

Background: ICD and other ICB (punding, hobbyism, nocturnal hyperactivity, etc.) have been increasingly recognized amongst PD populations over the last 15 years. Recent research seem to indicate that treatments, especially dopaminergic agonists (DA), have a major role in the occurrence of ICD and ICB. Whether STN DBS in PD increases or decreases the risk of ICD and ICB is still highly debated.

Methods: We conducted a cross-sectional study in a sample of consecutive patients with PD and STN DBS. Patients were interviewed using the Ardouin Scale of Behavior in Parkinson’s disease, a newly validated evaluation scale developed at the Grenoble University Hospital Centre. We evaluated the presence of ICD and ICB before surgery (retrospectively) and at the moment of interview. The presence of non-motor ON/OFF fluctuations, apathy and psychiatric disorders was also assessed.

Results: We interviewed 38 patients. Twenty were men, the mean age was 63 years, the mean duration of disease was 16,9 years and the mean time since DBS installation was 6,32 years. Before surgery, 13 patients (34%) reported a total of 23 ICD/ICB and no apathetic behavior. After surgery, 4 patients (10,5%) described 6 ICD/ICB and 2 apathetic behavior. Thus, 11/13 patients had ICD/ICB before but not after DBS, 1 patient developed apathy, 1 patient went from ICD/ICB to apathy, 1 patient with ICD/ICB was unchanged by surgery and 1 patient developed several ICD/ICB after surgery.

Conclusions: In our study, we found that most patients with ICD prior to surgery had a resolution of their symptoms post operatively. ICD develops very rarely after STN DBS. These results will need to be confirmed with a prospective study.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/impulse-control-disorders-after-stn-dbs-for-parkinsons-disease/