title: Impulsivity and compulsivity in drug-naïve patients with Parkinson's disease.
abstract: BACKGROUND
  Abnormal repetitive behaviors have been reported in Parkinson's disease (PD) during dopamine replacement therapy (DRT) and associated with individual predisposing features, including impulsivity. However, impulsivity and compulsive symptoms have never been explored in PD patients before initiation of DRT. We previously reported a 20% of impulse control disorders (ICD) in an Italian cohort.
  
  
  METHODS
  103 consecutive newly diagnosed drug-naïve PD patients (means: age = 60.5 ± 9.2 years; duration = 15.4 ± 15.3 months) were screened for compulsive sexual behavior, compulsive buying, intermittent explosive disorder (Minnesota Impulsive Disorders Interview, MIDI), and pathological gambling (South Oaks Gambling Screen, SOGS). Barratt Impulsiveness Scale (BIS-11) and Maudsley Obsessional-Compulsive Questionnaire (MOCQ/R) assessed impulsivity, obsessive-compulsive symptoms, respectively. Depression (GDS-15) and general cognitive status were additionally assessed. We also compared ICDs frequency with our healthy controls.
  
  
  RESULTS
  17.5% of PD patients screened positive for at least one ICD at MIDI (17/103) and SOGS (1/103), though none had a disorder based on DSM-IV criteria. These frequencies were similar to healthy controls. There was a trend toward higher scores in BIS-11 attentive-impulsivity subscale (15.2 ± 4.8 vs. 18.7 ± 4.9; P = 0.007) and in MOCQ/R-Doubting subscale (0.67 ± 1.1 vs. 1.5 ± 1.2; P = 0.007) in PD with ICD. We also observed a positive correlation between GDS-15 and BIS-11.
  
  
  CONCLUSIONS
  Similar to our healthy control population, we found a significant proportion of early PD patients positive for ICDs before starting treatment. We also found a relationship between impulsivity and depression. A detailed behavioral assessment before starting dopaminergic therapy is recommended.
authors.affiliation: Department of Neurology, Parkinson Institute, Istituti Clinici di Perfezionamento, Milan, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Antonini
authors.forename: Chiara
authors.initials: C
authors.lastname: Siri
authors.forename: Gabriella
authors.initials: G
authors.lastname: Santangelo
authors.forename: Roberto
authors.initials: R
authors.lastname: Cilia
authors.forename: Michele
authors.initials: M
authors.lastname: Poletti
authors.forename: Margherita
authors.initials: M
authors.lastname: Canesi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Caporali
authors.forename: Francesca
authors.initials: F
authors.lastname: Mancini
authors.forename: Gianni
authors.initials: G
authors.lastname: Pezzoli
authors.forename: Roberto
authors.initials: R
authors.lastname: Ceravolo
authors.forename: Ubaldo
authors.initials: U
authors.lastname: Bonuccelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Barone
mesh_terms: D000328:Adult; D000368:Aged; D003072:Cognition Disorders / Q000209:etiology; D003192:Compulsive Behavior / Q000209:etiology*; D004185:Disability Evaluation; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications*; D012720:Severity of Illness Index