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Impulse control disorders and related behaviors in Parkinson's disease: risk factors, clinical and genetic aspects and management

Abstract : Purpose of review: To review recent findings and research directions on impulse control disorders and related behaviors (ICDRBs) in Parkinson's disease (PD). Recent findings: Longitudinal studies found that prevalence increases during PD progression, incident ICDRBs being around 10% per year in patients treated with dopaminergic therapies. Screening tools and severity scales already developed have been validated and are available in several countries and languages. Main clinical risk factors include young age, male gender, type, doses and duration of the dopaminergic therapy, PD motor severity and dyskinesia, depression, anxiety, apathy, sleep disorders and impulsivity traits. Genetic factors are suspected by a high estimated heritability, but individual genes and variants remain to be replicated. Management of ICDRBs is centered on dopamine agonists decrease, with the risk to develop withdrawal symptoms. Cognitive behavioral therapy and subthalamic nucleus deep brain stimulation also improve ICDRBs. In the perspective of precision medicine, new individual prediction models of these disorders have been proposed, but they need further independent replication. Summary: Regular monitoring of ICDRB during the course of PD is needed, particularly in subject at high risk of developing these complications. Precision medicine will require appropriate use of machine learning to be reached in the clinical setting.
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https://hal.archives-ouvertes.fr/hal-03298526
Contributor : Johann Faouzi Connect in order to contact the contributor
Submitted on : Friday, July 23, 2021 - 4:39:19 PM
Last modification on : Monday, August 9, 2021 - 10:26:39 AM

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Johann Faouzi, Jean-Christophe Corvol, Louise-Laure Mariani. Impulse control disorders and related behaviors in Parkinson's disease: risk factors, clinical and genetic aspects and management. Current Opinion in Neurology, Lippincott, Williams & Wilkins, 2021, Publish Ahead of Print, ⟨10.1097/WCO.0000000000000955⟩. ⟨hal-03298526⟩

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