[Impulse control disorders in Parkinson's disease]

Tijdschr Psychiatr. 2011;53(4):211-22.
[Article in Dutch]

Abstract

Background: Parkinson's disease is characterised not only by the classic triad of bradykinesia, rigidity and tremor, but also by the frequent occurrence of various non-motor symptoms such as the impulse control disorders (pathological gambling, hypersexuality, compulsive buying, binge eating, punding and dopamine dependency).

Aim: To increase insight into the clinical presentation, risk factors, treatment and the underlying pathophysiological mechanisms of impulse control disorders in Parkinson's disease.

Method: Relevant literature was reviewed.

Results: Impulse control disorders belong to an important group of neuropsychiatric disorders that occur at some point in 5-10% of patients with Parkinson's disease. They generally occur in conjunction with dopaminergic medication and can have a marked social, relational and/ or financial impact.

Conclusion: Early recognition of impulse control disorders in Parkinson's disease is important and a close collaboration between the neurologist and the psychiatrist is essential in order to ensure correct diagnosis and the best possible treatment. Impulse control disorders in Parkinson's disease show considerable phenomenological overlap with other repetitive behaviours within the impulsive-compulsive spectrum of disorders to which the obsessive-compulsive disorders and addiction disorders belong. The overlap can possibly be explained by a shared pathophysiological mechanism involving an imbalance between the direct and indirect pathways of the dorsal and ventral frontal-striatal circuits.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Comorbidity
  • Disruptive, Impulse Control, and Conduct Disorders / epidemiology*
  • Disruptive, Impulse Control, and Conduct Disorders / metabolism
  • Disruptive, Impulse Control, and Conduct Disorders / pathology
  • Dopamine / metabolism*
  • Humans
  • Neural Pathways / pathology*
  • Parkinson Disease / epidemiology*
  • Parkinson Disease / metabolism
  • Parkinson Disease / pathology
  • Risk Factors

Substances

  • Dopamine