Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease-Rating Scale
Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania 19104-2676, USA. Movement Disorders
(Impact Factor: 5.68).
02/2012; 27(2):242-7. DOI: 10.1002/mds.24023
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.
Available from: Daniele Corbo
- "First, although our patients subgroups were clinically well matched, our sample size was relatively small. Second, we have not used the questionnaire for impulsive-compulsive disorders in Parkinson's disease rating scale (QUIP-RS)which is a valid screening instrument to assess and score ICDs not explored by the MIDI (i.e. medication use, and hobbyism). "
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To investigate gray matter (GM) and cortical thickness (CTh) changes in patients with Parkinson's disease (PD) with and without Impulse Control Disorders (ICDs).
Fifteen patients with PD with ICDs (ICD+), 15 patients with PD without ICDs (ICD-) and 24 age and sex-matched healthy controls (HCs) were enrolled in the study. Patients were screened for ICDs by the Minnesota Impulsive Disorders Interview (MIDI) and underwent an extensive neuropsychological evaluation. Whole brain structural imaging was performed on a 3T GE MR scanner. Surface-based investigation of CTh was carried out by using Freesurfer Software. We also used voxel-based morphometry to investigate the pattern of GM atrophy.
The voxel-wise analysis of the regional differences in CTh revealed that ICD+ patients showed a statistically significant (p<0.01 FDR) thicker cortex when compared to both ICD- patients and HCs in the anterior cingulate (ACC) and orbitofrontal (OFC) cortices. Moreover, cortical thickness abnormalities were positively correlated with ICD severity (p<0.05 FDR). VBM data did not reveal any statistically significant differences in local GM.
Our results demonstrate that ICD+ patients have an increased CTh in limbic regions when compared with ICD- patients at the same disease stage and with an equal daily levodopa equivalent dose. These corticometric changes may play a role in the lack of inhibition of compulsive behaviors. The presence of such structural abnormalities may result from a synergistic effect of dopaminergic therapy in patients with a pre-existing vulnerability to develop an abnormal behavioral response to external stimuli.
Available from: Pedro J García-Ruiz
- ") 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). "
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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.
Available from: Ling Liu
- "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). "
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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.
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