Objective: To characterize the obsessive-compulsive symptoms (OCS) and Impulse Control Disorders (ICD) in patients with Parkinson’s Disease (PD), as well as explore the correlation between OCS and impulsivity dimensions and the influence of dopaminergic replacement therapy in ICD.

Background: Compulsiveness and impulsivity represent non-motor symptoms of PD and are related to lack of self-control. The dysfunction of frontoestriatal pathways, as seen in PD, has been implicated in the pathogenesis of Obsessive-Compulsive Disorder (OCD) and ICD. Despite being reported as troublesome by patients and caregivers, these features have been less studied compared to motor symptoms of PD.

Method: We conducted a descriptive cross-sectional and exploratory study in a sample of patients with PD, without cognitive dysfunction or prior psychiatric disorder. Clinical and demographic data were collected, and all participants completed a protocol with questionnaires: Obsessive-Compulsive Inventory – Revised (OCI-R), Barratt Impulsiveness Scale version 11 (BIS-11) and Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease – Rating Scale (QUIP-RS). Statistical analysis was performed using SPSS software.

Results: We evaluated 31 PD patients with mean age of 67.39±9.16 years and mean disease duration of 9.39±6.48 years. Regarding the OC symptoms (OCI-R), 29% of patients had a score suggestive of the presence of OCD. Motor impulsivity (motor BIS-11) was the dimension that most correlated with OCS (ρ=0.522; p<0.01). About 42% presented at least one symptom of ICD, with the most frequent being “compulsive shopping”. There was a statistically significant association between higher doses of dopaminergic therapy and three subtypes of ICD (“pathological gambling”, “hypersexuality” and “compulsive shopping”).

Conclusion: The manifestations of OC spectrum are present in PD patients, and the results support a possible underdiagnosis of these symptoms. Motor impulsivity was the dimension of impulsivity that most correlated with OCS, suggesting a different pattern from that which occurs in OCD. These results point towards a marked overlap between OCS, impulsivity and ICD dimensions, highlighting important clinical and therapeutic implications.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/obsessive-compulsive-symptoms-in-parkinsons-disease-beyond-the-impulse-control-disorders/