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Impulse control disorder in Parkinson's disease: a meta-analysis of cognitive, affective and motivational correlates

Martini, Alice; Dal Lago, Denise; Edelstyn, Nicola M.J.; Grange, James A.; Tamburin, Stefano

Impulse control disorder in Parkinson's disease: a meta-analysis of cognitive, affective and motivational correlates Thumbnail


Authors

Alice Martini

Denise Dal Lago

Stefano Tamburin



Abstract

Background In Parkinson’s disease (PD), impulse control disorders (ICDs) develop as side-effect of dopaminergic replacement therapy (DRT). One hypothesis is that DRT overdoses less-severely affected dopamine-modulated circuits on which cognition, affect and motivation depend. However, cognitive, affective and motivational correlates of ICD in medicated PD patients are debated. Here, we systematically reviewed and meta-analyzed the evidence for an association between ICD in PD and cognitive, affective and motivational abnormalities. Methods A systematic review and meta-analysis was performed on PubMed, Science Direct, ISI Web of Science, Cochrane, EBSCO for studies published between 1-1-2000 and 8-3-2017 comparing cognitive, affective and motivational measures in PD patients with ICD (ICD+) vs. those without ICD (ICD-). Exclusion criteria were conditions other than PD, substance and/or alcohol abuse, dementia, drug naïve patients, cognition assessed by self-report tools. Standardized mean difference (SMD) was used, and random-effect model applied. Results 10,200 studies were screened (title, abstract), 79 full-texts were assessed, and 25 were included (ICD+: 625 patients; ICD-: 938). Compared to ICD-, ICD+ showed worse performance reward-related decision-making (0.42 [0.02, 0.82], p=0.04) and set-shifting tasks (SMD=-0.49 [95% CI -0.78, -0.21], p=0.0008). ICD in PD was also related to higher self-reported rate of depression (0.35 [0.16, 0.54], p=0.0004), anxiety (0.43 [0.18, 0.68], p=0.0007), anhedonia (0.26 [0.01, 0.50], p=0.04), and impulsivity (0.79 [0.50, 1.09], p<0.00001). Heterogeneity was low to moderate, except for depression (I2=61%) and anxiety (I2=58%). Conclusions ICD in PD is associated with worse set-shifting and reward-related decision-making, and increased depression, anxiety, anhedonia and impulsivity. This is an important area for further studies as ICDs have negative impact on the quality of life of patients and their caregivers.

Acceptance Date Jul 23, 2018
Publication Date Aug 28, 2018
Publicly Available Date Mar 28, 2024
Journal Frontiers in Neurology
Publisher Frontiers Media
DOI https://doi.org/10.3389/fneur.2018.00654
Keywords Parkinson’s disease, impulse control disorder, Cognition, Affective factors, Motivation, impulsivity, Meta-analysis, Depression
Publisher URL http://doi.org/10.3389/fneur.2018.00654

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