The prevalence and clinical characteristics of punding in Parkinson's disease

Authors

  • Ashley H. Spencer,

    1. Department of Neuropsychiatry, University of Birmingham and BSMHFT, Birmingham, United Kingdom
    2. College of Medical and Dental Sciences, University of Birmingham, United Kingdom
    Search for more papers by this author
  • Hugh Rickards MD,

    1. Department of Neuropsychiatry, University of Birmingham and BSMHFT, Birmingham, United Kingdom
    Search for more papers by this author
  • Alfonso Fasano MD,

    1. I.R.C.C.S Neuromed, Pozzilli, Isernia, Italy
    Search for more papers by this author
  • Andrea E. Cavanna MD, PhD

    Corresponding author
    1. Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, London, United Kingdom
    • Department of Neuropsychiatry, Birmingham and Solihull Mental Health NHS Foundation Trust, Barberry Building, Birmingham B152FG, United Kingdom

    Search for more papers by this author

  • Relevant conflict of interest: Nothing to report.

Abstract

Background: Punding (the display of stereotyped, repetitive behaviors) is a relatively recently discovered feature of Parkinson's disease (PD). Little is known about the prevalence and clinical characteristics of punding in PD. Methods: In this review, four large scientific databases were comprehensively searched for literature in relation to punding prevalence and clinical correlates in the context of PD. Results: Prevalence was found to vary greatly (between 0.34 to 14%), although there were large disparities in study populations, assessment methods, and criteria. We observed an association between punding, dopaminergic medications, and impulse control disorder. Other characteristics, which may be more common among punders, include a higher severity of dyskinesia, younger age of disease onset, longer disease duration, and male gender. Discussion: More research in large clinical datasets is required in many areas before conclusions are drawn. The pathophysiology behind the punding phenomenon is also poorly understood at present, rendering it difficult to develop targeted therapy. The current mainstay of treatment is the reduction in the dose of dopaminergic medications, the evidence for other suggested therapies being purely empirical. © 2011 Movement Disorder Society

Ancillary