Impulse control and related disorders in Parkinson’s disease

ABSTRACT

Neuropsychiatric disorders are common among patients with Parkinson’s disease and may appear in any stage of the disease. However, these disorders often go undiagnosed and receive insufficient treatment. Observations in recent years have revealed that dopamine replacement therapy may lead to the development or worsening of conditions, such as gambling disorder, compulsive sexual behavior, compulsive buying and binge eating, in addition to punding and dopamine dysregulation syndrome. The pathophysiology of these disorders seems to be related to abnormal dopaminergic stimulation of the basal regions of the basal ganglia, especially via nigro-mesolimbic pathways. The aim of the present study was to perform a literature review on impulsivity, impulse control disorders and related conditions among patients with Parkinson’s disease, with emphasis on their epidemiology, clinical characteristics and treatment.

RESUMO

Alterações neuropsiquiátricas são comuns na doença de Parkinson e estão presentes em todas as fases da enfermidade. No entanto, frequentemente não são reconhecidas e recebem tratamento insuficiente. Ao longo dos últimos anos, observou-se que a terapia de reposição dopaminérgica pode levar ao desenvolvimento ou piora de condições como transtorno do jogo, compulsão por sexo, compras, e comida, além da síndrome de desregulação dopaminérgica e punding. Sua fisiopatologia parece estar relacionada à estimulação dopaminérgica anormal das regiões basais dos núcleos da base, sobretudo pelas vias nigro-mesolímbicas. O presente artigo tem como objetivo fazer uma revisão da literatura a respeito de impulsividade, transtornos do controle de impulso e condições relacionadas na doença de Parkinson, com foco na epidemiologia, características clínicas e tratamento.

Parkinson’s disease - disruptive, impulse control, and conduct disorders - levodopa - dopamine agonists - impulsive behavior - bulimia

doença de Parkinson - transtornos disruptivos, de controle do impulso e da conduta - levodopa - agonistas de dopamina - comportamento impulsivo - bulimia

Publication History

Received: 10 January 2018

Accepted: 17 March 2018

Article published online:
25 August 2023

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