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New onset heightened interest or drive for gambling, shopping, eating or sexual activity in patients with Parkinson's disease: the role of dopamine agonist treatment and age at motor symptoms onset
1 Movement Disorders Unit and Parkinson Centre, Department of Neurology,
Tel-Aviv Sourasky Medical Centre, Tel-Aviv, Israel and Sackler Faculty of
Medicine, Tel-Aviv University, Tel-Aviv, Israel.
* To whom correspondence should be addressed.
Alterations of impulse control that have recently been associated with Parkinson's disease (PD) are serious behavioural disturbances with significant impact on PD patients and their families. A total of 193 consecutive PD patients with no history of psychiatric illness and 190 age/gender-matched healthy controls were queried on the presence of new onset heightened interest or drive for gambling, shopping, eating or sexual activity (GSES). Clinical data were retrieved from medical charts and interviews. Logistic regressions models assessed risk factors for these specific troublesome behaviours. New or heightened interests or drives for GSES behaviours were reported by 27
patients (14% vs 0% for controls). Younger age at PD motor symptoms onset (OR =
0.99, p = 0.0172), male gender (OR = 1.10, p = 0.0576) and longer
duration of treatment with dopamine agonists (DAs)(OR = 1.18, New onset heightened interests or drives for GSES are not rare behavioural disturbances among patients with PD. Age, gender and duration of treatment with DAs have an independent and additive effect on the risk to develop such behavioural changes. Patients should be informed about potential treatment-associated behavioural changes. Key Words: Parkinson's disease;gambling;hypersexuality;shopping;bulimia;dopamine agonist drugs;impulse control disorder;hedonic homeostatic dysregulation;hypomania;dopamine dysregulation syndrome
First published on April 19, 2007, doi:10.1177/0269881106073109 |
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6 years versus
never treated, p = 0.0459) contributed additively to the risk of developing
one or more of these behavioural features.