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Predictors of punding in Parkinson's disease: Results from a questionnaire survey

Authors

  • Andrew J. Lawrence BA,

    Corresponding author
    1. Department of Experimental Psychology, University of Cambridge, United Kingdom
    2. Behavioural and Clinical Neuroscience Institute, University of Cambridge, United Kingdom
    • Department of Experimental Psychology, University of Cambridge, Downing Street, Cambridge CB2 3EB, United Kingdom
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  • Andrew D. Blackwell PhD,

    1. Department of Psychiatry, University of Cambridge School of Medicine, Cambridge, United Kingdom
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  • Roger A. Barker MRCP, PhD,

    1. Behavioural and Clinical Neuroscience Institute, University of Cambridge, United Kingdom
    2. Cambridge Centre for Brain Repair, Department of Clinical Neuroscience, Addenbrooke's Hospital, Cambridge, United Kingdom
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  • Francesca Spagnolo MD,

    1. Department of Neurology, San Raffaele Hospital, Milan, Italy
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  • Luke Clark DPhil,

    1. Department of Experimental Psychology, University of Cambridge, United Kingdom
    2. Behavioural and Clinical Neuroscience Institute, University of Cambridge, United Kingdom
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  • Michael R. F. Aitken PhD,

    1. Department of Experimental Psychology, University of Cambridge, United Kingdom
    2. Behavioural and Clinical Neuroscience Institute, University of Cambridge, United Kingdom
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  • Barbara J. Sahakian PhD, DClinPsych, FMedSci

    1. Behavioural and Clinical Neuroscience Institute, University of Cambridge, United Kingdom
    2. Department of Psychiatry, University of Cambridge School of Medicine, Cambridge, United Kingdom
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Abstract

Dopamine replacement therapy (DRT) for Parkinson's disease (PD) has recently been linked to the development of a number of nonmotor behavioral control problems. Punding, one of these nonmotor problems, is a term used to describe complex, purposeless stereotyped behaviors such as the repetitive handling or sorting of objects. A self-report questionnaire was adapted to assess punding in the context of dysfunctional hobby-related activities. We report the results of a survey of PD outpatients from a PD research clinic (n = 141) and non-PD controls (n = 103); conducted to identify clinical and psychological factors predictive of punding behaviors. The PD group reported hobbies and activities, which scored significantly higher on the Punding Scale than controls. Higher impulsivity, poorer disease-related quality of life, younger age of disease onset, and concomitant daily medication dosage from dopamine receptor agonists were independently predictive of higher Punding Scale scores in the PD group. These findings are similar to those seen in dopamine dysregulation syndrome, and provide further evidence for the role of impulsivity and age at disease onset in DRT-related nonmotor behavioral problems in PD. © 2007 Movement Disorder Society

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