Association between the dose of dopaminergic medication and the behavioral disturbances in Parkinson disease☆☆☆
Received 9 July 2009; received in revised form 30 November 2009; accepted 1 December 2009.
Abstract
Objectives
To survey the point prevalence of impulse control and repetitive behavior disorders (ICRBs) in patients with Parkinson disease (PD) and to determine the relationship between PD medication dose and the risk of ICRBs.
Methods
A multicenter cross-sectional survey was applied to consecutive patients with PD over a 3-month period. The presence of ICRBs was screened using a modified version of the Minnesota Impulsive Disorders Interview that comprised five ICRB modules: compulsive buying, gambling, sexual behavior, eating, and punding. Data regarding the patients' clinical features and concurrent anti-PD drugs were also collected during the interview. Adjusted odds ratios (ORs) of the daily doses of dopamine agonist and l-dopa for the development of an ICRB were calculated after adjustment for clinical variables.
Results
Among the 1167 patients recruited, 118 (10.1%) exhibited ICRBs. Punding was the most common ICRB (4.2%), followed by compulsive eating (3.4%), sexual behaviors (2.8%), buying (2.5%), and gambling (1.3%). Two or more ICRBs were present concomitantly in 34 of these 118 patients (28.8%). There were dose–response relationships between the dopamine agonist dose and the ORs for compulsive buying, gambling and sexual behaviors. On the other hand, the OR for punding was positively correlated with the dose of l-dopa. The OR for compulsive eating was not associated with the dose of dopamine agonist or l-dopa.
Conclusions
The dose of dopaminergic medication is significantly associated with the development of ICRB, except compulsive eating, in PD.
aDepartment of Neurology, Inje University Ilsan Paik Hospital, Goyang, South Korea
bDepartment of Neurology, Seoul National University Bundang Hospital, Seongnam, South Korea
cDepartment of Neurology, Dong-A University Medical Center, Busan, South Korea
dDepartment of Neurology, Seoul National University Boramae Hospital, Seoul, South Korea
eDepartment of Neurology, Samsung Medical Center, Seoul, South Korea
fDepartment of Neurology, Clinical Research Institute and Movement Disorder Center, Seoul National University Hospital, Seoul, South Korea
Corresponding author. BK21, Neuroscience Research Institute, Seoul National University College of Medicine, Department of Neurology, Clinical Research Institute and Movement Disorders Center, Seoul National University Hospital, Seoul 110-744, South Korea. Tel.: +82 2 2072 2876; fax: +82 2 3672 7553.
☆ Disclosure: The authors have no conflict of interest.
☆☆ The review of this paper was entirely handled by an Associate Editor, En-King Tan.
ABSTRACT