Behavioral disturbances in Parkinson's disease patients receiving dopaminergic therapy

Abstract

Introduction. Parkinsons disease (PD) is a progressive neurological disorder caused by degeneration of dopaminergic neurons in the substantia nigra pars compacta. The most effective therapy for this disease includes dopaminergic drugs that may lead to the development of behavioral disturbances or impulse control disorders. The latter include compulsive buying, gambling addiction, hypersexuality, compulsive overeating, punding (nongoal oriented repetitive activity), and the dopamine dysregulation syndrome. Objective. To reveal frequency of behavioral disturbances in patients with PD and assess their effect on quality-of-life parameters and activities of daily living in patients and their relatives. Materials and methods. In order to determine the prevalence of impulse control disorders (ICD), 340 patients with PD were surveyed by completing the QUIPShort questionnaire to detect ICD. Sixty patients with PD with verified ICD (17% of the total number of patients examined) and 20 patients with PD without behavioral disturbances were included in further analysis; a number of specialized tests were used to assess ICD, impulsivity, activities of daily living, quality of life, anxiety, depression, and cognitive impairment. Results. Dopamine dysregulation syndrome (DDS) was found in 8% of patients with PD; punding, in 10%; compulsive overeating, in 6%; hypersexuality, in 5%; compulsive buying, in 4%; and gambling addiction, in 1% of patients. The average parameter of activities of daily living for PD patients with ICD was 60.05 9.76%; quality of life, 67.21 18.54%. These values were significantly lower than those in patients without behavioral disturbances. Conclusions. ICD is detected in every fifth patient with PD receiving dopaminergic therapy. DDS and punding are diagnosed most frequently. Development of ICD has a significant effect on patients activities of daily living and reduces quality of life both of the patients and their relatives.

Keywords

• parkinson’s disease
• dopaminergic therapy
• impulse control disorders
• punding
• dopamine dysregulation syndrome
• hypersexuality
• compulsive overeating
• compulsive buying disorder
• activities of daily living
• quality of life