title: Developments in impulse control behaviours of Parkinson's disease.
abstract: OBJECTIVE
  Impulse control behaviours (ICBs) are a frequent comorbidity for patients with Parkinson's disease. They consist of impulse control disorders, dopamine dysregulation syndrome, and punding. The field continues to evolve in the understanding of impulsivity and assessment of risk factors in the development of these behaviours and their appropriate management in patients with Parkinson's disease.
  
  
  RESULTS
  Impulsivity is a multifaceted concept that is surprisingly common in untreated patients with Parkinson's disease. The incidence of ICBs increases with demographic, clinical, and biochemical risk factors. Treatments rely on reduction of dopamine agonists with exception of cognitive behavioural therapy and possibly repetitive transcranial magnetic stimulation.
  
  
  CONCLUSIONS
  Reduction of dopamine agonist dose is the mainstay of treatment of ICBs. Other forms of dopaminergic treatment such as deep brain stimulation or jejunal infusion are alternative treatments but may be complicated by dopamine agonist withdrawal syndrome. Other therapies show promise but data are insufficient to suggest their regular use.
authors.affiliation: aDepartment of Psychiatry, Toronto Western Hospital, University Health Network bDepartment of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Mateusz
authors.initials: M
authors.lastname: Zurowski
authors.forename: Jonathan Darcy
authors.initials: JD
authors.lastname: O'Brien
mesh_terms: D046690:Deep Brain Stimulation; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000150:complications* / Q000188:drug therapy / Q000523:psychology; D018491:Dopamine Agonists / Q000627:therapeutic use; D006801:Humans; D007175:Impulsive Behavior / Q000502:physiology*; D010300:Parkinson Disease / Q000150:complications* / Q000188:drug therapy / Q000523:psychology
chemical_list: D018491:Dopamine Agonists