Objective: To develop a model to predict changes in impulse control symptom severity (ICSS) following deep brain stimulation (DBS) in patients with Parkinson’s disease (PD).

Background: Impulse control disorders (ICDs) are a group of behaviors characterized by a failure to resist an impulse to perform an action despite negative effects, including gambling, hypersexuality, binge-eating, and compulsive shopping. ICDs are an increasingly recognized complication in PD affecting up to 14% of PD patients.1  A consensus regarding the association between ICDs and DBS for the treatment of PD has not been reached. While a majority of patients improve following surgery, de novo ICDs have been reported, suggesting a need to elucidate the relationship between ICDs and DBS.

Method: 21 patients with idiopathic PD (Mage = 60.44, 67% male, Medu. = 15.13) were enrolled in an ongoing prospective study examining the role of DBS in the development or resolution of ICSS. Patients underwent a neurological examination and a neuropsychological evaluation, including the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease Rating Scale (QUIP-RS1), a measurement of impulse control symptom severity (ICSS), prior to and one year post-DBS.  Correlation and multiple regression analyses were conducted to examine the relationship between post-DBS ICSS and pre-DBS sociodemographic, medical and treatment factors.

Results: There were no significant relationships between levodopa equivalent dosage, dopamine agonist dosage, or UPDRS ON/OFF scores and post-DBS ICSS. Pre- and post ICSS was not significantly correlated (r= 0.16, p = 0.28). However, a multiple regression model including three demographic variables previously found to be related to ICDs in the literature (age, education, and gender), along with pre-DBS ICSS produced a strong predictive model of post-DBS ICSS [R2 = 0.89, F(4, 15) = 11.038, p < 0.001].

Conclusion: Variance in post-DBS ICSS is better explained by pre-DBS sociodemographic variables than medical and treatment factors.  These findings suggest that DBS providers can use patient specific factors prior to surgery to tailor psychoeducational feedback sessions regarding potential impulse control symptoms following DBS.

References: 1. Weintraub D, Mamikonyan E, Papay K, Shea JA, Xie SX, Siderowf A. (2012). Questionnaire for impulsive‐compulsive disorders in Parkinson’s Disease–Rating Scale. Movement Disorders, 27(2), 242-247. 2. Kasemsuk, C., Oyama, G., & Hattori, N. (2017). Management of impulse control disorders with deep brain stimulation: A double-edged sword. Journal of the neurological sciences, 374, 63-68.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-influence-of-sociodemographic-factors-on-post-dbs-impulse-control-symptom-severity-in-parkinsons-disease/