Abstract Details

Title Impulse Control Disorders in Parkinson’s disease – a cross-sectional and longitudinal study of severity

Topic Movement Disorders

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-029

Objective To describe the prevalence, natural history and risk factors for symptoms of impulse control behaviours (ICB) amongst people with Parkinson’s disease (PD), REM sleep behaviour disorder (RBD) and controls.

Background ICB are a common and serious complication of Parkinson's.

Design/Methods

Parkinson’s patients within 3.5 years of diagnosis were recruited to the Oxford Discovery cohort for longitudinal phenotyping. Patients with RBD and controls were also recruited. Participants screening positive for ICB were invited to a semi-structured interview for formal diagnosis, repeated one year later. The intensity and impact of the ICB was clinician-rated using the Parkinson’s Impulse Control Scale. Multiple imputation and regression models were used to estimate ICB prevalence and associations.

Results Data from 921 Parkinson’s cases at baseline, 768 cases at 18 months and 531 cases at 36 months were included, with 21-25% screening positive for ICB at each visit using the questionnaire for impulsivity for Parkinson’s disease. Interviews of participants screening positive revealed that 10% (9/88) met formal criteria for impulse control disorders (ICD) while 33% (29/88) had subsyndromal ICD (ICB symptoms without reaching the formal diagnostic criteria for ICD). The overall prevalence of PD-ICB was estimated at 19.1% (95% CI: 10.1% to 28.2%). On follow-up, 24% (5/21) of subsyndromal ICD cases seen 12 months later had developed full symptoms of an ICD. PD-ICD was associated with dopamine agonist use, motor complications, and apathy. ICD prevalence in the RBD group (1%) was similar to controls (0.7%).

Conclusions ICB symptoms are common in early PD patients, and can persist or worsen over time. RBD was not in itself associated with a greater risk of ICD. The severity of the symptoms experienced are associated with factors affecting psychological well-being, such as mood and support networks. Long-term management of these symptoms is challenging highlighting the need for holistic care including non-pharmacological therapies.

Authors/Disclosures
Fahd Baig, MBBS PRESENTER	No disclosure on file
Mark J. Kelly, MBBS (Royal College of Surgeons in Ireland)	The institution of Dr. Kelly has received research support from The Health Research Board / Wellcome Trust.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Michele Hu, MD	The institution of Dr. Hu has received personal compensation in the range of $0-$499 for serving as a Consultant for Lundbeck. The institution of Dr. Hu has received personal compensation in the range of $0-$499 for serving as a Consultant for ESCAPE Bio. The institution of Dr. Hu has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Evidera. The institution of Dr. Hu has received research support from Parkinson's UK. The institution of Dr. Hu has received research support from Oxford BRC.

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