Addiction-Like Manifestations and Parkinson%26apos;s Disease: A Large Single Center 9-Year Experience

作者：Limotai Natlada; Oyama Genko; Go Criscely; Bernal Oscar; Ong Tiara; Moum Sarah J; Bhidayasiri Roongroj; Foote Kelly D; Bowers Dawn; Ward Herbert; Okun Michael S^*

来源：International Journal of Neuroscience, 2012, 122(3): 145-153.

DOI：10.3109/00207454.2011.633722

• agonist
• complications
• deep brain stimulation
• dopamine
• levodopa
• reward

Objective: Characterize potential risk factors and the relationship of dopamine agonist (DA) withdrawal syndrome (DAWS), dopamine dysregulation syndrome (DDS), and impulse control disorders (ICDs) in Parkinson%26apos;s disease (PD). Methods: A retrospective chart review categorized cases into three groups: DAWS, DDS, and ICDs. Results: A total of 1,040 subjects met inclusion criteria. There were 332 subjects with a history of tapering DAs and 26 (7.8%) developed DAWS. Fourteen (1.3%) and 89 (8.6%) met the criteria for both DDS and ICD. Subjects with DAWS, DDS, and ICDs had a higher baseline dose of DA, levodopa, and total dopaminergic medication (p %26lt; .05), compared to those without the three conditions. DDS was found to be related to the DAWS group (p %26lt; .001). When comparing to the PD population without DDS, younger age at onset of PD (p = .027), presence of DAWS (p %26lt; .001), ICDs (p = .003), and punding (p = .042) were all correlated with the DDS group, while male sex (p = .045), younger age at onset of PD (p %26lt; .001), presence of DAWS (p %26lt; .001), and presence of DDS (p = .001) and punding (p %26lt; .001) were related to the ICD group. Conclusions: There was a strong relationship between DAWS, DDS, and ICD in this large PD cohort. Dopaminergic therapy in a subset of PD patients was strongly associated with addiction-like behavioral issues.

• 出版日期2012-3