Relevant conflicts of interest/financial disclosures: Nothing to report.
Impulsivity and compulsivity in drug-naïve patients with Parkinson's disease†
Version of Record online: 10 FEB 2011
Copyright © 2011 Movement Disorder Society
Volume 26, Issue 3, pages 464–468, 15 February 2011
How to Cite
Antonini, A., Siri, C., Santangelo, G., Cilia, R., Poletti, M., Canesi, M., Caporali, A., Mancini, F., Pezzoli, G., Ceravolo, R., Bonuccelli, U. and Barone, P. (2011), Impulsivity and compulsivity in drug-naïve patients with Parkinson's disease. Mov. Disord., 26: 464–468. doi: 10.1002/mds.23501
Full financial disclosures and author roles may be found in the online version of this article.
- Issue online: 31 MAR 2011
- Version of Record online: 10 FEB 2011
- Manuscript Accepted: 30 SEP 2010
- Manuscript Revised: 2 AUG 2010
- Manuscript Received: 29 MAR 2010
- Parkinson's disease;
- drug naïve;
- impulse control disorders;
Abnormal repetitive behaviors have been reported in Parkinson's disease (PD) during dopamine replacement therapy (DRT) and associated with individual predisposing features, including impulsivity. However, impulsivity and compulsive symptoms have never been explored in PD patients before initiation of DRT. We previously reported a 20% of impulse control disorders (ICD) in an Italian cohort.
103 consecutive newly diagnosed drug-naïve PD patients (means: age = 60.5 ± 9.2 years; duration = 15.4 ± 15.3 months) were screened for compulsive sexual behavior, compulsive buying, intermittent explosive disorder (Minnesota Impulsive Disorders Interview, MIDI), and pathological gambling (South Oaks Gambling Screen, SOGS). Barratt Impulsiveness Scale (BIS-11) and Maudsley Obsessional-Compulsive Questionnaire (MOCQ/R) assessed impulsivity, obsessive-compulsive symptoms, respectively. Depression (GDS-15) and general cognitive status were additionally assessed. We also compared ICDs frequency with our healthy controls.
17.5% of PD patients screened positive for at least one ICD at MIDI (17/103) and SOGS (1/103), though none had a disorder based on DSM-IV criteria. These frequencies were similar to healthy controls. There was a trend toward higher scores in BIS-11 attentive-impulsivity subscale (15.2 ± 4.8 vs. 18.7 ± 4.9; P = 0.007) and in MOCQ/R-Doubting subscale (0.67 ± 1.1 vs. 1.5 ± 1.2; P = 0.007) in PD with ICD. We also observed a positive correlation between GDS-15 and BIS-11.
Similar to our healthy control population, we found a significant proportion of early PD patients positive for ICDs before starting treatment. We also found a relationship between impulsivity and depression. A detailed behavioral assessment before starting dopaminergic therapy is recommended. © 2011 Movement Disorder Society