Document Detail


Prospective cohort study of impulse control disorders in Parkinson's disease.
MedLine Citation:
PMID:  23283708     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Impulse control disorders (ICDs) are potentially serious side effects of dopamine agonist therapy in Parkinson's disease (PD), but prospective data are lacking about their incidence, time course, and risk factors. This work was a 4-year, prospective cohort study of outpatients with PD and no previous ICDs (N = 164). All subjects treated with a dopamine agonist during the study were followed longitudinally for new-onset ICDs. Baseline characteristics were compared in groups with (ICD+) and without (ICD-) subsequent ICDs. Forty-six subjects were treated with a dopamine agonist, including 25 who were newly treated and 21 who received ongoing dopamine agonist therapy. Of these 46 subjects, 18 (39.1%) developed new-onset ICDs. The timing of ICD onset varied from 3.0 to 114.0 months (median, 23.0) after initiation of dopamine agonist therapy. Baseline demographic characteristics were similar in ICD+ and ICD- groups. At baseline, ICD+ subjects had a greater prevalence of motor complications (61.1% versus 25.0%; P = 0.01) than ICD- subjects, despite comparable total dopaminergic medication usage in both groups (median, 150.0 versus 150.0 levodopa equivalents; P = 0.61). Compared with ICD- subjects, ICD+ subjects had a greater baseline prevalence of caffeine use (100% versus 66.7%; P = 0.007) and higher lifetime prevalence of cigarette smoking (44.4% versus 14.3%; P = 0.04). Peak dopamine agonist doses were higher in ICD+ than ICD- subjects (median 300.0 versus 165.0 L-dopa equivalents; P = 0.03), but cumulative dopamine agonist exposure was similar in both groups. In summary, the timing of new-onset ICDs in PD is highly variable. Risk factors include cigarette smoking, caffeine use, motor complications, and higher peak dopamine agonist dosage.
Authors:
Jesse Bastiaens; Benjamin J Dorfman; Paul J Christos; Melissa J Nirenberg
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2013-01-02
Journal Detail:
Title:  Movement disorders : official journal of the Movement Disorder Society     Volume:  28     ISSN:  1531-8257     ISO Abbreviation:  Mov. Disord.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-03-25     Completed Date:  2013-09-20     Revised Date:  2014-02-13    
Medline Journal Info:
Nlm Unique ID:  8610688     Medline TA:  Mov Disord     Country:  United States    
Other Details:
Languages:  eng     Pagination:  327-33     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Movement Disorders Society.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cohort Studies
Disease-Free Survival
Dopamine Agonists / adverse effects*
Female
Humans
Impulse Control Disorders / chemically induced*,  epidemiology*
Longitudinal Studies
Male
Mental Status Schedule
Middle Aged
Parkinson Disease / drug therapy*,  epidemiology
Risk Factors
Grant Support
ID/Acronym/Agency:
2UL1 TR000457-06/TR/NCATS NIH HHS; UL1 RR024996/RR/NCRR NIH HHS; UL1 TR000457/TR/NCATS NIH HHS
Chemical
Reg. No./Substance:
0/Dopamine Agonists
Comments/Corrections

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