Objective: To assess frequency of impulse control disorder (ICD) in a cohort of patients with early stage of Parkinson’s disease (PD), to analyze clinical and demographic data, accompanying psychiatric and cognitive disorders during two years of follow-up.

Background: It has been estimated that up to 20% of PD patients develop ICD during course of their illness, conventionally thought at a late stage of the disease. Patients with pathological gambling, shopping and eating have been described, but also patients with complex forms of repetitive behaviors such as punding, hobbyism and dopamine-dysregulation syndrome (DDS). Rising number of studies show that these disorders can complicate early phase of disease.

Methods: We included 112 patients with unilateral PD (Hoehn and Yahr stage 1 and 1.5). Demographic and clinical data were obtained, disease severity was assessed with UPDRS scale, and presence of psychiatric disorders was assessed with scales Hamilton and Beck scale for depression, Hamilton anxiety scale and Apathy scale. Comprehensive cognitive tests battery was applied. Screening for the presence of ICD was performed with QUIP (Weintraub et al.). All patients screened as positive were analyzed in detail by two independent specialists and diagnosed according to previously published criteria. Patients were assessed twice more in one year intervals.

Results: 82% of the initial cohort completed two-years follow-up. Initially, 20% of patients had some sort of ICD (2% pathological gambling, 2% hypersexuality, 1% pathological buying, 2% pathological eating, 3% punding and 10% hobbysm). These patients have been more often treated with dopamine agonists (p=0,016) and had depressive symptoms (p=0,025), but did not differ otherwise from the no-ICD patients. Duiring follow-up period none of the patients developed DDS, pathological gambling resolved in one patient, five additional patients developed pathological eating (one resolved), one female patient developed severe pathological hypersexuality as well as three male patients.None of the patients with hobbysm developed punding.

Conclusions: ICDs (exept for DDS) can be part of clinical picture in the very beginning of PD with important implications for the further therapy choices.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/impulse-control-disorder-in-early-parkinsons-disease-follow-up-study/