Martini, A, Dal Lago, D, Edelstyn, N, Grange, JA and Tamburin, S (2018) Impulse control disorder in Parkinson's disease: a meta-analysis of cognitive, affective and motivational correlates. Frontiers in Neurology, 9. ISSN 1664-2295

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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.

Item Type: Article
Additional Information: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via Frontiers Media at - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: Parkinson’s disease, impulse control disorder, Cognition, Affective factors, Motivation, impulsivity, Meta-analysis, Depression
Subjects: R Medicine > RC Internal medicine > RC346 Neurology. Diseases of the nervous system, including speech disorders
Divisions: Faculty of Natural Sciences > School of Psychology
Depositing User: Symplectic
Date Deposited: 27 Jul 2018 11:14
Last Modified: 12 Nov 2018 09:35

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