Impulse control disorders related cognitive and behavioral features in Parkinson’s disease

Objectives: This study aimed to investigate cognitive and behavioral distinctions in patients with Parkinson's disease (PD) with impulse control disorders (ICDs). Patients and methods: A total of 72 patients (52 males, 20 females; mean age: 60.8±9.2 years; range, 41 to 77 years) with PD (31 with ICD features [PDwIC] and 41 without ICD [PDwoICD]) and 67 healthy controls (35 males, 32 females; mean age: 60.4±10.4 years; range, 36 to 79 years) were included in this prospective cross-sectional study between April 2018 and January 2020. All participants underwent a comprehensive neuropsychometric assessment, including a battery of cognitive and psychiatric tests. Furthermore, the Iowa Gambling Task was employed to evaluate risky decision-making capacities, and the UPPS (Urgency, Premeditation [lack of], Perseverance [lack of], Sensation Seeking) Impulsive Behavior Scale was utilized to assess impulsive personality traits. The Beck Depression Inventory (BDI) was used to assess the presence and severity of depression. Results: The PDwICD, PDwoICD, and healthy control groups showed comparable characteristics in terms of age and education level. Male sex was more prevalent in the PDwICD group than in the control group (p=0.01). The PDwICD group exhibited significantly higher MDS UPDRS I scores and total LEDD compared to the PDwoICD group (p=0.027 and p=0.003, respectively). The PDwICD group also had higher BDI scores and UPPS-Sensation Seeking subscores than the PDwoICD group (p=0.001 and p=0.044, respectively). The multivariate analyses demonstrated an independent association between higher scores of BDI and presence of ICD in PD (p=0.006). Conclusion: In conclusion, comprehensive screening for affective characteristics can help clinicians identify those at higher risk for impulsive behaviors in PD. Prospective studies are needed to better understand the factors leading to ICDs and explore the roles of personality traits, cognitive and behavioral features, and dopaminergic medications.