Association between the dose of dopaminergic medication and the behavioral disturbances in Parkinson disease

Lee, Jee-Young; Kim, Jong-Min; Kim, Jae Woo; Cho, Jinwhan; Lee, Won Yong; Kim, Han-Joon; Jeon, Beom S.

doi:10.1016/j.parkreldis.2009.12.002

« Previous Next »Parkinsonism & Related Disorders
Volume 16, Issue 3 , Pages 202-207, March 2010

Association between the dose of dopaminergic medication and the behavioral disturbances in Parkinson disease☆☆☆

Jee-Young Lee
- Department of Neurology, Inje University Ilsan Paik Hospital, Goyang, South Korea
Jong-Min Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, South Korea
Jae Woo Kim
- Department of Neurology, Dong-A University Medical Center, Busan, South Korea
Jinwhan Cho
- Department of Neurology, Seoul National University Boramae Hospital, Seoul, South Korea
Won Yong Lee
- Department of Neurology, Samsung Medical Center, Seoul, South Korea
Han-Joon Kim
- Department of Neurology, Clinical Research Institute and Movement Disorder Center, Seoul National University Hospital, Seoul, South Korea
Beom S. Jeon
- Department 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.

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.