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The long-term outcome of impulsive compulsive behaviours in Parkinson’s disease
  1. Pedro Melo Barbosa1,2,3,
  2. Atbin Djamshidian1,4,
  3. Sean S O'Sullivan5,
  4. Eduardo de Pablo-Fernandez1,2,3,
  5. Prasad Korlipara2,3,
  6. Huw R Morris2,3,
  7. Kailash P Bhatia2,3,
  8. Patricia Limousin2,3,
  9. Thomas Foltynie2,3,
  10. Andrew J Lees1,
  11. Thomas T Warner1,2,3
  1. 1 Reta Lila Weston Institute of Neurological Studies, UCL Queen Square Institute of Neurology, London, UK
  2. 2 Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
  3. 3 The National Hospital for Neurology and Neurosurgery, London UK
  4. 4 Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
  5. 5 Department of Neurology, Bon Secours Hospital, Cork, Ireland
  1. Correspondence to Dr Thomas T Warner, Reta Lila Weston Institute of Neurological Studies, Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, London WC1N1PJ, UK; t.warner{at}ucl.ac.uk

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Introduction

Impulsive compulsive behaviours (ICBs) such as dopamine dysregulation syndrome (DDS), pathological gambling, compulsive sexual behaviour, punding, compulsive shopping and binge eating are recognised complications of dopaminergic treatment that affect at least one in seven patients with Parkinson’s disease (PD).1 Only a few studies provide long-term data on ICBs although any firm conclusions are limited by restricted follow-up periods. We present long-term longitudinal data on 46 PD patients with ICBs with follow-up for a mean period of 8.2 years.

Methods

Patients with PD and ICBs who participated in previous research studies from 2007 to 2012 visit 1 (V1) were invited for re-assessment visit 2 (V2). Participants underwent a clinical interview and assessment with questionnaires and scales (detailed in online supplementary materials). The diagnosis of ICBs was based on screening questionnaires and confirmed with a structured interview. The study received ethics approval. Data was analysed in Statistical Package for Social Science 22 (SPSS 22). All variables were tested for normality and statistical tests chosen accordingly. A p value<0.05 was considered significant. Bonferroni correction was applied for comparison between visits and significance was considered to have been reached when p<0.025.

Supplementary data

[jnnp-2018-319891supp001.pdf]

Results

Of the 90 original participants, 46 were included. Eight declined to participate, five were lost to follow-up and 31 had died (see online supplementary figure 1). No cases of suicide or traumatic fatality were reported. Participants were followed up for 8.2 years (±2.6). Three patients had a biallelic parkin mutation. See table 1 for demographic and clinical details at each visit and online supplementary table 1 for results of the scales/questionnaires used at V2.

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Table 1

Comparison between visits

Initial treatment of ICBs consisted of …

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