Article

Impulse control disorders (ICDs) in Parkinson's disease (PD) are
associated with dopamine agonist treatment. Although discontinuation of dopamine
agonist is recommended, ICD management has not been precisely stated. The aims of
the study were to describe demographic and clinical characteristics in a group of
PD patients with ICDs and to evaluate the management of dopamine agonist
treatment proposed to the same patients in order to treat the ICDs. METHODS:
Thirty-five PD patients with ICD and 607 PD patients without ICD were studied. In
the ICD group, demographic and clinical data were collected prospectively (ICD
characteristics, motor and cognitive evaluation); demographic and clinical data
were obtained retrospectively in the group without ICD. RESULTS: In the ICD
group, the sex ratio was 2.9 (versus 1.2 in the absence of ICD; p<0.05), the mean
age was 57.5 years (versus 66.9 years; p<0.01) and the mean age at PD onset was
48.3 years (versus 55.5 years; p<0.01). All ICD patients were receiving a
dopamine agonist when the ICD started (versus 50.9 % of patients receiving a
dopamine agonist in the absence of ICD; p<10(-6)). In mean, ICDs started 2.8
years before they were diagnosed. No particular dopamine agonist was associated
with ICDs more frequently than the others. Discontinuation of the dopamine
agonist was the treatment the more frequently associated with the recovery of
ICDs (93.3 %). Dose lowering and the change of dopamine agonist resulted in
complete regression of ICDs respectively in 9.1% and 33.3% of patients.
CONCLUSION: Young age, male gender and young age at PD onset are frequent in PD
patients developing ICDs, as already described in American or Asian cohorts. We
highlighted a long diagnosis delay and confirmed the strong efficacy of dopamine
agonist withdrawal.
CI - Copyright A(c) 2011 Elsevier Masson SAS. All rights reserved.

Langue : FRANCAIS