Impulse Control Disorders in patients with Parkinson’s Disease

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GESCHEIDT Tomáš BAREŠ Martin

Rok publikování 2011
Druh Článek v odborném periodiku
Časopis / Zdroj Acta Neurologica Belgica
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
Obor Neurologie, neurochirurgie, neurovědy
Klíčová slova Parkinson’s disease; impulse control disorders; pathological gambling; hypersexuality; punding; dopamine dysregulation syndrome; dopaminergic agonists
Popis In patients with Parkinson’s disease with higher prevalence than in current population there appear pathological behaviours characterized by compulsion, repetitiveness and impulsivity, which are connected with material profit or pleasurable experience. They are, in particular, pathological gambling, hypersexuality, compulsive shopping and compulsive eating (in the literature they are collectively referred to as impulse control disorders). Pathological preoccupation with repeated mechanical activities (so-called punding) and excessive compulsive intake of dopaminergic medication (so-called dopamine dysregulation syndrome or also syndrome of hedonistic homeostatic dysregulation) are of similar nature. The paper treats briefly the risk factors and prevalence of these pathological behaviours. In current clinical practice, these psychiatric complications frequently escape doctors’ attention, they are underdiagnosed. Although no generally valid recommendations for their therapy are currently available, they can be influenced medically. Of advantage can be modified dopaminergic medication (usually dose reduction of dopaminergic agonists); multidisciplinary approach to the problem is appropriate. The pathological behaviours given above can frequently lead to considerable material losses and markedly aggravate patients’ handicap in the social sphere; it can be expected that in the future they can become a problem also from the ethical and legal points of view.
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