Skip to main content
SpringerLink
Log in

Risk factors of impulsive-compulsive behaviors in PD patients: a meta-analysis

  • Review
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

Objective

To summarize the reliable risk factors of impulsive-compulsive behaviors (ICBs) in Parkinson’s disease (PD) patients through a meta-analysis on studies in which PD-ICBs were diagnosed by clinical interview.

Methods

PubMed, Embase, Web of Science, CNKI and Wanfang databases were searched. We selected studies ensuring that diagnosis of ICBs in PD patients depends on semi-structured interviews according to the clinical diagnostic criteria of ICBs. The Newcastle–Ottawa Scale was used to evaluate quality of the included studies. The analyzed factors included demographic information, clinical characteristics of PD and medications.

Results

A total of 856 records were screened and 66 full texts were evaluated, and 13 studies (684 PD patients with ICBs [PD-ICBs] and 3,382 PD patients without ICBs [PD-non-ICBs]) were included. Compared with PD-non-ICBs, PD-ICBs were younger in age (− 3.7 [− 5.53, − 1.87], P < 0.0001), with a greater proportion of males (1.64 [1.21, 2.22], P = 0.001), with a younger age of PD onset (− 5.42 [− 7.87, − 2.97], P < 0.0001) and a longer course of PD (1.30 [0.38, 2.22], P = 0.005). PD-ICBs were also associated with higher HAM-D (1.74 [0.47, 3.01], P = 0.007), more levodopa dosage (1.74 [1.09, 2.77], P = 0.02) and dopamine receptor agonists (DA) use (3.96 [2.74, 5.71), P < 0.00001), and higher average dose (levodopa 117.53 [53.59, 181.46], P = 0.0003; DA 80.03 [46.16, 113.90], P < 0.00001), as well as more amantadine use (2.20 [1.42, 3.40], P = 0.0004). The meta-analysis of most factors showed less heterogeneity, except age, age of onset, PD duration, Hoehn and Yahr stage, MMSE and drug dosage. However, whether rapid eye movement sleep behavior disorder, dyskinesia, genetic polymorphism and other factors are risk factors for PD-ICBs remains unclear.

Conclusion

This meta-analysis suggests that males, young, early disease onset, long disease duration, depression, dose of levodopa, dopamine receptor agonists and amantadine are risk factors of ICBs in PD patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14
Fig. 15
Fig. 16

Similar content being viewed by others

References

  1. Seppi K, Ray Chaudhuri K, Coelho M, Fox SH, Katzenschlager R, Perez Lloret S et al (2019) Update on treatments for nonmotor symptoms of Parkinson’s disease-an evidence-based medicine review. Mov Disord 34:180–198

    PubMed  PubMed Central  Google Scholar 

  2. Weintraub D, Koester J, Potenza MN, Siderowf AD, Stacy M, Voon V et al (2010) Impulse control disorders in Parkinson disease a cross-sectional study of 3090 patients. Arch Neurol 67:589–595

    PubMed  Google Scholar 

  3. Weintraub D, Claassen DO (2017) Impulse control and related disorders in Parkinson’s disease. Int Rev Neurobiol 133:679–717

    PubMed  Google Scholar 

  4. Phu AL, Xu Z, Brakoulias V, Mahant N, Fung VSC, Moore GD et al (2014) Effect of impulse control disorders on disability and quality of life in Parkinson’s disease patients. J Clin Neurosci 21:63–66

    PubMed  Google Scholar 

  5. Erga AH, Alves G, Tysnes OB, Pedersen KF (2020) Impulsive and compulsive behaviors in Parkinson’s disease: Impact on quality of and satisfaction with life, and caregiver burden. Parkinsonism Relat Disord 78:27–30

    PubMed  Google Scholar 

  6. Cossu G, Rinaldi R, Colosimo C (2018) The rise and fall of impulse control behavior disorders. Parkinsonism Relat Disord 46(Suppl 1):S24-29

    PubMed  Google Scholar 

  7. Fan W, Ding H, Ma J, Chan P (2009) Impulse Control Disorders in Parkinson’s disease in a Chinese population. Neurosci Lett 465:6–9

    CAS  PubMed  Google Scholar 

  8. Evans AH, Okai D, Weintraub D, Lim SY, O’Sullivan SS, Voon V et al (2019) Scales to assess impulsive and compulsive behaviors in Parkinson’s disease: critique and recommendations. Mov Disord 34:791–798

    PubMed  Google Scholar 

  9. Weintraub D, Hoops S, Shea JA, Lyons KE, Pahwa R, Driver-Dunckley ED et al (2009) Validation of the Questionnaire for impulsive-compulsive disorders in Parkinson’s disease. Mov Disord 24:1461–1467

    PubMed  PubMed Central  Google Scholar 

  10. Weintraub D, Mamikonyan E, Papay K, Shea JA, Xie SX, Siderowf A (2012) Questionnaire for impulsive-compulsive disorders in Parkinson’s disease-rating scale. Mov Disord 27:242–247

    PubMed  Google Scholar 

  11. Probst CC, Winter LM, Möller B, Weber H, Weintraub D, Witt K et al (2014) Validation of the Questionnaire for impulsive-compulsive disorders in Parkinson’s disease (QUIP) and the QUIP-rating scale in a German speaking sample. J Neurol 261:936–942

    PubMed  PubMed Central  Google Scholar 

  12. Marques A, Vidal T, Pereira B, Benchetrit E, Socha J, Pineau F et al (2019) French validation of the Questionnaire for impulsive-compulsive disorders in Parkinson’s disease-rating Scale (QUIP-RS). Parkinsonism Relat Disord 63:117–123

    PubMed  Google Scholar 

  13. Tanaka K, Wada-Isoe K, Nakashita S, Yamamoto M, Nakashima K (2013) Impulsive compulsive behaviors in Japanese Parkinson’s disease patients and utility of the Japanese version of the Questionnaire for impulsive-compulsive disorders in Parkinson’s disease. J Neurol Sci 331:76–80

    PubMed  Google Scholar 

  14. Choi J, Lee J, Cho JW, Ko S, Ahn T, Kim SJ et al (2020) Validation of the Korean Version of the Questionnaire for impulsive-compulsive disorders in Parkinson’s disease rating Scale. J Clin Neurol 16:245–253

    PubMed  PubMed Central  Google Scholar 

  15. Guerra DF, Lemos SA, Paz T, Filho L, Vasconcellos LF, de Britto V et al (2020) Measurement properties from the Brazilian Portuguese version of the QUIP-RS. NPJ Parkinsons Dis 6:6

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Maréchal E, Denoiseux B, Thys E, Cras P, Crosiers D (2019) Impulsive-compulsive behaviours in Belgian-Flemish Parkinson’s disease patients: a questionnaire-based study. Parkinsons Dis. https://doi.org/10.1155/2019/7832487

    Article  PubMed  PubMed Central  Google Scholar 

  17. Izzo VA, Donati MA, Ramat S, Primi C (2019) Impulse control disorders in Parkinson’s disease: a systematic review on the psychometric properties of the existing measures. PLoS ONE 14:e217700

    Google Scholar 

  18. Voon V, Fox SH (2007) Medication-related impulse control and repetitive behaviors in Parkinson disease. Arch Neurol 64:1089–1096

    PubMed  Google Scholar 

  19. Erga AH, Alves G, Larsen JP, Tysnes OBR, Pedersen KF (2017) Impulsive and compulsive behaviors in Parkinson’s disease: the Norwegian ParkWest Study. J Parkinsons Dis 7:183–191

    PubMed  PubMed Central  Google Scholar 

  20. Garcia-Ruiz PJ, Martinez CJ, Alonso-Canovas A, Herranz BA, Vela L, Sanchez AP et al (2014) Impulse control disorder in patients with Parkinson’s disease under dopamine agonist therapy: a multicentre study. J Neurol Neurosurg Psychiatry 85:840–844

    PubMed  Google Scholar 

  21. Binck S, Pauly C, Vaillant M, Hipp G, Gantenbein M, Krueger R et al (2021) Contributing factors and evolution of impulse control disorder in the Luxembourg Parkinson cohort. Front Neurol. https://doi.org/10.3389/fneur.2020.638735

    Article  PubMed  PubMed Central  Google Scholar 

  22. Sharma A, Goyal V, Behari M, Srivastva A, Shukla G, Vibha D (2015) Impulse control disorders and related behaviours (ICD-RBs) in Parkinson’s disease patients: assessment using “Questionnaire for impulsive-compulsive disorders in Parkinson’s disease” (QUIP). Ann Indian Acad Neurol 18:49–59

    PubMed  PubMed Central  Google Scholar 

  23. Poletti M, Bonuccelli U (2012) Impulse control disorders in Parkinson’s disease: the role of personality and cognitive status. J Neurol 259:2269–2277

    PubMed  Google Scholar 

  24. Wang X, Wei M, Xiao Q (2016) A survey of impulse control disorders in Parkinson’s disease patients in Shanghai area and literature review. Transl Neurodegener. https://doi.org/10.1186/s40035-016-0051-7

    Article  PubMed  PubMed Central  Google Scholar 

  25. Liu B, Luo W, Mo Y, Wei C, Tao R, Han M (2019) Meta-analysis of related factors of impulse control disorders in patients with Parkinson’s disease. Neurosci Lett 707:134313

    CAS  PubMed  Google Scholar 

  26. Singh A, Kandimala G Jr, Dewey RB, O’Suilleabhain P (2007) Risk factors for pathologic gambling and other compulsions among Parkinson’s disease patients taking dopamine agonists. J Clin Neurosci 14:1178–1181

    CAS  PubMed  Google Scholar 

  27. Baig F, Kelly MJ, Lawton MA, Ruffmann C, Rolinski M, Klein JC et al (2019) Impulse control disorders in Parkinson disease and RBD: a longitudinal study of severity. Neurology 93:e675–e687

    PubMed  PubMed Central  Google Scholar 

  28. Weintraub D, Papay K, Siderowf A, Initiative PPM (2013) Screening for impulse control symptoms in patients with de novo Parkinson disease: a case-control study. Neurology 80:176–180

    PubMed  PubMed Central  Google Scholar 

  29. Baumann CR, Held U, Valko PO, Wienecke M, Waldvogel D (2014) Body side and predominant motor features at the onset of Parkinson’s disease are linked to motor and nonmotor progression. Mov Disord 29:207–213

    PubMed  Google Scholar 

  30. Stirnimann N, N’Diaye K, Jeune FL, Houvenaghel JF, Robert G, Drapier S, Drapier D, Grandjean D, Vérin M, Péron J (2018) Hemispheric specialization of the basal ganglia during vocal emotion decoding: evidence from asymmetric Parkinson’s disease and 18FDG PET. Neuropsychologia 119:1–11

    PubMed  Google Scholar 

  31. Solla P, Cannas A, Floris G, Marrosu F, Marrosu MG (2010) Does asymmetry of motor symptoms or other factors tell us something about risk of compulsive reward-seeking activities in patients with Parkinson’s disease? Mov Disord (Conference Abstract) 25:S286–S287

    Google Scholar 

  32. Phillipps C, Longato N, Béreau M, Carrière N, LaghaBoukbiza O, Mengin AC et al (2020) Is motor side onset of Parkinson’s disease a risk factor for developing impulsive-compulsive behavior? A Cross-Sectional Study. Mov Disord 35:1080–1081

    PubMed  Google Scholar 

  33. Shipilova NN, Titova NV, Kokaeva ZG, Fedosova AS, Klimov EA, Katunina EA (2018) A clinical and genetic study of impulsive-compulsive disorders in patients with Parkinson’s disease. Zh Nevrol Psikhiatr Im S S Korsakova 118:4–9

    CAS  PubMed  Google Scholar 

  34. Marin-Lahoz J, Sampedro F, Martinez-Horta S, Pagonabarraga J, Kulisevsky J (2020) Depression as a risk factor for impulse control disorders in Parkinson disease. Ann Neurol 88:205

    PubMed  Google Scholar 

  35. Lubomski M, Davis RL, Sue CM (2020) Depression in Parkinson’s disease: perspectives from an Australian cohort. J Affect Disord 277:1038–1044

    CAS  PubMed  Google Scholar 

  36. Carbunaru S, Eisinger RS, Ramirez-Zamora A, Bassan D, Cervantes-Arriaga A, Rodriguez-Violante M, Martinez-Ramirez D (2018) Impulse control disorders in Parkinson’s: sleep disorders and nondopaminergic associations. Brain Behav 8:e00904

    PubMed  PubMed Central  Google Scholar 

  37. Voon V, Schoerling A, Wenzel S, Ekanayake V, Reiff J, Trenkwalder C et al (2011) Frequency of impulse control behaviours associated with dopaminergic therapy in restless legs syndrome. BMC Neurol 11:117

    CAS  PubMed  PubMed Central  Google Scholar 

  38. Dogansen SC, Cikrikcili U, Oruk G, Kutbay NO, Tanrikulu S, Hekimsoy Z et al (2019) Dopamine agonist-induced impulse control disorders in patients with prolactinoma: a cross-sectional multicenter study. J Clin Endocrinol Metab 104:2527–2534

    PubMed  Google Scholar 

  39. Lee JY, Choi JH, Jeon B, Cho J (2019) Predictors of refractory impulse control disorder to dopamine agonists substitution therapy in Parkinson’s disease patients. Mov Disord (Conference Abstract) 34:S648

    Google Scholar 

  40. Kobayashi S, Asano K, Matsuda N, Ugawa Y (2019) Dopaminergic influences on risk preferences of Parkinson’s disease patients. Cogn Affect Behav Neurosci 19:88–97

    PubMed  Google Scholar 

  41. Li J, Gao S, Hou Z, Niu X (2014) Analysis of related factors of impulse control disorder in 112 patients with Parkinson’s disease. Chin J Integr Med Cardio/Cerebrovasc Dis 12:196–198

    Google Scholar 

  42. Poletti M, Logi C, Lucetti C, Del Dotto P, Baldacci F, Vergallo A et al (2013) A single-center, cross-sectional prevalence study of impulse control disorders in Parkinson disease: association with dopaminergic drugs. J Clin Psychopharmacol 33:691–694

    CAS  PubMed  Google Scholar 

  43. Sáez-Francàs N, Martí AG, Ramírez N, de Fàbregues O, Álvarez-Sabín J, Casas M et al (2016) Clinical and psychopathological factors associated with impulse control disorders in Parkinson’s disease. Neurologia 31:231–238

    PubMed  Google Scholar 

  44. Biundo R, Weis L, Abbruzzese G, Buonaura GC, Cortelli P, Jori MC et al (2017) Impulse control disorders in advanced Parkinson’s disease with dyskinesia: the ALTHEA study. Mov Disord 32:1557–1565

    CAS  PubMed  Google Scholar 

  45. Simoni S, Paoletti FP, Eusebi P, Cappelletti G, Filidei M, Brahimi E et al (2020) Impulse control disorders and levodopa-induced dyskinesias in Parkinson’s Disease: pulsatile versus continuous dopaminergic stimulation. J Parkinsons Dis 10:927–934

    CAS  PubMed  Google Scholar 

  46. Lu H, Shen Q, Zhao Q, Huang H, Ning P, Wang H et al (2020) Association between REM sleep behavior disorder and impulsive–compulsive behaviors in Parkinson’s disease: a systematic review and meta-analysis of observational studies. J Neurol 267:331–340

    PubMed  Google Scholar 

  47. Dien D, David C, John S (2011) The emergence of devastating impulse control disorders during dopamine agonist therapy of the restless legs syndrome. Clin Neuropharmacol 34:66–70

    Google Scholar 

  48. Fantini ML, Macedo L, Zibetti M, Sarchioto M, Vidal T, Pereira B et al (2015) Increased risk of impulse control symptoms in Parkinson’s disease with REM sleep behaviour disorder. J Neurol Neurosurg Psychiatry 86:174–179

    CAS  PubMed  Google Scholar 

  49. Livia FM, Janel F, Bruno P, Daniel W, AnaRaquel M, Franck D (2020) Is rapid eye movement sleep behavior disorder a risk factor for impulse control disorder in Parkinson disease? Ann Neurol 88:759–770

    Google Scholar 

  50. Morgante F, De Angelis A, Siri C, Horne M, Leake A, Paviour D et al (2019) Shedding light on the relationship between dyskinesia assessed by a wearable device and impulsive compulsive behaviour in Parkinson’s disease. Mov Disord (Conference Abstract) 34:S153

    Google Scholar 

  51. Zhang Y, He AQ, Li L, Chen W, Liu ZG (2017) Clinical characteristics of impulse control and related disorders in Chinese Parkinson’s disease patients. BMC Neurol 17:98

    PubMed  PubMed Central  Google Scholar 

  52. Voon V, Sohr M, Lang AE, Potenza MN, Siderowf AD, Whetteckey J et al (2011) Impulse control disorders in Parkinson disease: a multicenter case–control study. Ann Neurol 69:986–996

    PubMed  Google Scholar 

  53. Marković V, Stanković I, Petrović I, Stojković T, Dragašević-Mišković N, Radovanović S et al (2020) Dynamics of impulsive-compulsive behaviors in early Parkinson’s disease: a prospective study. J Neurol 267:1127–1136

    PubMed  Google Scholar 

  54. Kon T, Ueno T, Haga R, Tomiyama M (2018) The factors associated with impulse control behaviors in Parkinson’s disease: a 2-year longitudinal retrospective cohort study. Brain Behav 8:e1036

    Google Scholar 

  55. Auyeung M, Tsoi TH, Tang WK, Cheung CM, Lee CN, Li R et al (2011) Impulse control disorders in Chinese Parkinson’s disease patients: the effect of ergot derived dopamine agonist. Parkinsonism Relat Disord 17:635–637

    CAS  PubMed  Google Scholar 

  56. Limotai N, Oyama G, Go C, Bernal O, Ong T, Moum SJ et al (2012) Addiction-like manifestations and Parkinson’s disease: a large single center 9-year experience. Int J Neurosci 122:145–153

    CAS  PubMed  Google Scholar 

  57. Chiang HL, Huang YS, Chen ST, Wu YR (2012) Are there ethnic differences in impulsive/compulsive behaviors in Parkinson’s disease? Eur J Neurol 19:494–500

    PubMed  Google Scholar 

  58. Pontieri FE, Assogna F, Pellicano C, Cacciari C, Pannunzi S, Morrone A et al (2015) Sociodemographic, neuropsychiatric and cognitive characteristics of pathological gambling and impulse control disorders NOS in Parkinson’s disease. Eur Neuropsychopharmacol 25:69–76

    CAS  PubMed  Google Scholar 

Download references

Funding

This work was supported by Department of Education Zhejiang Province Scientific Research Project, No. Y201942038; and Zhejiang Province Medical Science and Technology Project, No. 2018KY872 and 2020RC061.

Author information

Authors and Affiliations

  1. Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, No. 1 Shangcheng Avenue, Yiwu, 322000, Zhejiang Province, China

    Lanxiao Cao, Tian Xu, Gaohua Zhao, Dayao Lv, Jinyu Lu & Guohua Zhao

Authors
  1. Lanxiao Cao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tian Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gaohua Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Dayao Lv
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jinyu Lu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Guohua Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

GZ had the idea for the article. LC, TX, GZ, DL and JL performed the literature search and data analysis. The first draft of the manuscript was written by LC. GZ and TX critically revised the work. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Guohua Zhao.

Ethics declarations

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical approval

The manuscript does not contain clinical studies or patient data.

Informed consent

This article does not contain any previously unpublished studies that would require informed consent.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cao, L., Xu, T., Zhao, G. et al. Risk factors of impulsive-compulsive behaviors in PD patients: a meta-analysis. J Neurol 269, 1298–1315 (2022). https://doi.org/10.1007/s00415-021-10724-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00415-021-10724-1

Keywords

Search

Navigation