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J Neurol. 2019 Oct 18. doi: 10.1007/s00415-019-09584-7. [Epub ahead of print]

Evolution of impulsive-compulsive behaviors and cognition in Parkinson's disease.

Author information

1
The Norwegian Centre for Movement Disorders, Stavanger University Hospital, P.O. Box 8100, 4068, Stavanger, Norway. alkn@sus.no.
2
The Norwegian Centre for Movement Disorders, Stavanger University Hospital, P.O. Box 8100, 4068, Stavanger, Norway.
3
Department of Neurology, Stavanger University Hospital, Stavanger, Norway.
4
Department of Chemistry, Bioscience and Environmental Engineering, University of Stavanger, Stavanger, Norway.
5
Department of Clinical Medicine, University of Bergen, Bergen, Norway.
6
Department of Neurology, Haukeland University Hospital, Bergen, Norway.

Abstract

The longitudinal course of ICBs in patients with Parkinson's disease (PwP) relative to controls has not been explored as of yet. The aim of this study is to determine the frequency, evolution and associated cognitive and clinical features of impulsive and compulsive behaviors (ICBs) over 4 years of prospective follow-up in a population-based cohort with early Parkinson's disease (PD). We recruited 124 cognitively intact participants with early PD and 156 matched controls from the Norwegian ParkWest study. ICBs were assessed using the self-report short form version of the Questionnaire for Impulsive-Compulsive Disorders in PD. Cognitive changes were examined in PwP with and without ICBs who completed the 4-year follow-up. Generalized linear mixed modelling and mixed linear regression were used to analyze clinical factors and cognitive changes associated with ICBs in PwP over time. ICBs were more common in PwP than controls at all visits, with an age-adjusted odds ratio (OR) varying between 2.5 (95% CI 1.1-5.6; p = 0.022) and 5.1 (95% CI 2.4-11.0; p < 0.001). The 4-year cumulative frequency of ICBs in PwP was 46.8% and 23.3% developed incident ICBs during the study period, but the presence of ICBs was non-persistent in nearly 30%. ICBs were independently associated with younger age (OR 0.95, 95% CI 0.91-0.99: p = 0.008) and use of dopamine agonist (OR 4.1, 95% CI 1.56-10.69). Cognitive changes over time did not differ between patients with and without ICBs. In conclusion, ICBs are common in PwP, but are often non-persistent and not associated with greater cognitive impairment over time.

KEYWORDS:

Cognition; Impulse control disorders; ParkWest; Parkinson’s disease

PMID:
31628533
DOI:
10.1007/s00415-019-09584-7

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