Impulse control disorders and related disorders (hobbyism-punding and dopamine dysregulation syndrome) occur in 15% to 20% of Parkinson's disease (PD) patients. We assessed the validity and reliability of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS), a rating scale designed to measure severity of symptoms and support a diagnosis of impulse control disorders and related disorders in PD. A convenience sample of PD patients at a movement disorders clinic self-completed the QUIP-RS and were administered a semistructured diagnostic interview by a blinded trained rater to assess discriminant validity for impulse control disorders (n = 104) and related disorders (n = 77). Subsets of patients were assessed to determine interrater reliability (n = 104), retest reliability (n = 63), and responsiveness to change (n = 29). Adequate cutoff points (both sensitivity and specificity values >80% plus acceptable likelihood ratios) were established for each impulse control disorder and hobbyism-punding. Interrater and retest reliability (intraclass correlation coefficient r) were >0.60 for all disorders. Participants in an impulse control disorder treatment study who experienced full (t = 3.65, P = .004) or partial (t = 2.98, P = .01) response demonstrated significant improvement on the rating scale over time, while nonresponders did not (t = 0.12, P = .91). The QUIP-RS appears to be valid and reliable as a rating scale for impulse control disorders and related disorders in PD. Preliminary results suggest that it can be used to support a diagnosis of these disorders, as well as to monitor changes in symptom severity over time.
") as previously reported (García-Ruiz et al. 2014). This test has been validated for each ICD with a potentially addictive reinforcement (ICDARs) namely pathological gambling, compulsive shopping, binge eating, and hypersexuality , as well as for punding (Weintraub et al. 2012). QUIP has showed a sensitivity of 100 % for patient-completed and informant-completed instruments (Papay et al. 2011). "
[Show abstract][Hide abstract] ABSTRACT: Impulse control disorders (ICDs) comprise a wide spectrum of abnormal behaviors frequently found in patients with Parkinson’s disease (PD) receiving antiparkinsonian treatment. Some ICDs share several essential features with substance use disorders. In this work, we have studied the addiction-related gene ankyrin repeat and kinase domain containing I (ANKK1) in a sample of PD patients involved in a multicenter study on ICD. We carried out the TaqIA ANKK1 single-nucleotide polymorphism (SNP) genotyping in PD patients. Clinical assessment of ICD was performed using the Questionnaire for impulsive–compulsive disorders in PD. We found no association between TaqIA SNP and ICD in PD patients (p = 0.565). However, when PD patients were grouped according the diagnosis of any ICD with a potentially addictive reinforcement (ICDARs), A1− TaqIA genotype showed significant association (p = 0.036). No association was found for the presence of punding in PD patients (p = 0.289). A logistic regression analysis confirmed the independent effect of the A1− genotype upon ICDARs (OR 8.76, 95 % CI 1.3–57.8, Wald = 5.805, p = 0.024). The TaqIA genotype A1− is associated to ICDAR in our sample and it may differentiate two types of disorders which are part of the ICD definition in PD patients.
Neurotoxicity Research 12/2014; 27(3). DOI:10.1007/s12640-014-9504-x · 3.54 Impact Factor
"In contrast to its predecessor, QUIP-RS requires individuals to rate the severity of each symptom based on its frequency using a five-point Likert scale. The QUIP-RS detects subsyndromal behaviors and establishes clear cut-off points with a good balance between sensitivity and specificity (Weintraub et al., 2012). "
[Show abstract][Hide abstract] ABSTRACT: Background: Impulsive and compulsive behaviors (ICBs) are a heterogeneous group of conditions that may be caused by long-term dopaminergic replacement therapy (DRT) of Parkinson’s disease (PD). The spectrum of ICBs includes dopamine dysregulation syndrome (DDS), punding, and impulse control disorders (ICDs).
Contents: We made a detailed review regarding the epidemiology, pathology, clinical characteristics, risk factors, diagnosis as well as treatment of ICBs.
Results: The prevalence of ICBs in PD patients is approximately 3–4% for DDS, 0.34–4.2% for punding, and 6–14% for ICDs, with higher prevalence in Western populations than in Asian. Those who take high dose of levodopa are more prone to have DDS, whereas, ICDs are markedly associated with dopamine agonists. Different subtypes of ICBs share many risk factors such as male gender, higher levodopa equivalent daily dose, younger age at PD onset, history of alcoholism, impulsive, or novelty-seeking personality. The Questionnaire for Impulsive–Compulsive Disorder in Parkinson’s Disease-Rating Scale seems to be a rather efficacious instrument to obtain relevant information from patients and caregivers. Treatment of ICBs is still a great challenge for clinicians. Readjustment of DRT remains the primary method. Atypical antipsychotics, antidepressants, amantadine, and psychosocial interventions are also prescribed in controlling episodes of psychosis caused by compulsive DRT, but attention should be drawn to balance ICBs symptoms and motor disorders. Moreover, deep brain stimulation of the subthalamic nucleus might be a potential method in controlling ICBs.
Conclusion: The exact pathophysiological mechanisms of ICBs in PD remains poorly understood. Further researches are needed not only to study the pathogenesis, prevalence, features, and risk factors of ICBs, but to find efficacious therapy for patients with these devastating consequences.
"A cohort of 1,096 patient with diagnosis of idiopathic PD according to UK-BBC32 were regularly followed and treated from January 2011 to March 2012 in our Movement Disorder Clinic; they were asked to participate in the study. Inclusion criteria were: idiopathic PD; aged between 18 and 80 years; ascertained dopaminergic response; patients willing and able to give written informed consent; patients willing and able to comply to the study procedures; stable dose of dopaminomimetic drugs for at last 28 days; diagnosis of PD-PG for group A, and diagnosis of PD-ICD for group B (diagnosis according to DSM, 4th edition [DSM-IV] text revision, Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease-Rating Scale, a rating scale designed to measure severity of symptoms and support a diagnosis of impulse control disorders and related disorders in PD).33 Group C was PD control (PD-CTR) without PG or ICD. "
[Show abstract][Hide abstract] ABSTRACT: Introduction
Dopamine replacement therapy for Parkinson’s disease (PD) was recently linked to the development of impulse control disorders such as pathological gambling (PG), hypersexuality, compulsive shopping, and binge or compulsive eating. Antiglutamatergic agents including amantadine (Ama) reduce these behaviors in PD and non-PD patients. The aim of our study is to evaluate the changes in executive functions, emotions, and reward/loss processing during Ama treatment in PD patients.
Thirty-three patients affected by idiopathic PD were selected from a cohort of 1,096 PD patients and categorized in three different groups: ten affected by PG (PD-PG); nine PD patients with other impulse control disorder (PD-ICD); and 14 PD patient without any psychiatric disorder (PD-CTR-controls). For the neuropsychological evaluation, the following behavioral tasks where administered: the Stroop, the emotional Stroop, and the monetary reward/loss risk-taking tasks.
During Ama treatment, PD-PGs showed a decrease in risky choices and an increase in non-risky choices (t(9)=−2.40, P<0.05 and t(9)=2,67, P<0.05 uncorrected, respectively). Between-group comparison showed a significant decrease in risky choices for PD-PG with respect to PD-CTR (t(22)=−4.16, P<0.01), and a decreased accuracy for positive words in comparison between PD-PG and PD-ICD (t(17)=−7,49, P<0.01) and PD-PG and PD-CTR (t(22)=−4.29, P<0.01). No within- and between-group differences were observed for Stroop task.
Our data showed that Ama add-on therapy reduces hypersensitivity to reward and sustains activation toward uncertainty in PD-PG patients. These finding might explain the behavioral mechanism underlying the effect of antiglutamatergic drugs.
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