Impulse control disorders Flashcards
(28 cards)
What are impulse control disorders (ICDs) in Parkinson’s disease?
ICDs refer to a range of compulsive behaviors in Parkinson’s patients, such as pathological gambling, compulsive shopping, binge eating, and hypersexuality. They often arise due to dopaminergic treatment, which overstimulates reward pathways.
Which Parkinson’s medications are most associated with ICDs
Dopamine agonists—including pramipexole, ropinirole, and pergolide—are strongly linked to ICDs. Their effects on the brain’s reward system can amplify impulsive behaviors.
What are the non-pharmacological interventions for ICDs in Parkinson’s disease?
Cognitive behavioral therapy (CBT), psychoeducation, mindfulness techniques, and support groups have been shown to help patients manage ICDs. Multidisciplinary care teams also play a key role
What alternative treatments can replace dopamine agonists to reduce ICDs
Alternatives include levodopa/carbidopa, monoamine oxidase-B inhibitors (rasagiline, selegiline), and catechol-O-methyltransferase inhibitors (entacapone, tolcapone).
CBT for ICDs in Parkinson’s patients
A structured CBT intervention reduced ICD severity, improving impulse control and neuropsychiatric symptoms. However, caregiver burden did not significantly decrease.
Which CBT techniques for ICD in parkinson’s
Techniques included psychoeducation, self-monitoring, cognitive restructuring, behavioral problem-solving, and relapse prevention strategies.
clinical spectrum of ICDs in Parkinson’s
The study emphasized that ICDs are diverse (gambling, compulsive buying, hypersexuality) and closely linked to dopamine agonist therapy, affecting a significant portion of Parkinson’s patients.
neurobiological models of ICDs in parkinson’s
dopaminergic overstimulation
dual-process dysregulation neurotransmitter imbalance genetic vulnerability
network connectivity disruptions
predictors of CBT response in Parkinson’s patients with ICDs?
Patients with fewer ICD symptoms, lower dopaminergic medication doses, and higher social functioning showed better CBT outcomes.
How are impulse control disorders and levodopa-induced dyskinesias linked?
Both conditions result from dopaminergic overstimulation
What are emerging strategies for managing ICDs in Parkinson’s disease
Personalized risk assessment
optimized dopamine therapy
neuromodulation (DBS, transcranial stimulation) enhanced behavioral interventions
multidisciplinary care
non-dopaminergic treatments
neurocognitive correlates of medication-induced addictive behaviors in Parkinson’s
ICDs in parkinson’s are linked to reward hypersensitivity, impulsive decision-making, and altered reinforcement learning.
switching dopamine agonists to levodopa
significant reductions in ICD symptoms but dropout due to worse mood/ motor sx
suicide risk in Parkinson’s disease compared to the general population
D patients face twice the suicide risk, especially those with depression, impulse control disorders, and social isolation.
Dopamine Dysregulation Syndrome (DDS)
DDS results from compulsive dopaminergic medication use, leading to addiction-like behaviors, mood disturbances, and motor fluctuations.
reward hypersensitivity in Parkinson’s patients with ICDs
PD patients with ICDs showed heightened reward sensitivity even off medication
managing ICDs in Parkinson’s disease?
Strategies involve pharmacological adjustments, behavioral therapies (CBT, mindfulness), and multidisciplinary care models integrating neurology and psychiatry.
What percentage of Parkinson’s patients experience ICDs?
10–20% of patients on dopamine agonists develop ICDs
How does dopamine contribute to impulse control disorders
Dopamine plays a key role in reward processing and decision-making, and excess stimulation can lead to compulsive behaviors.
Which dopamine receptors are implicated in ICDs
D3 receptors, found in the limbic system
How does dopamine affect motivation and impulsivity?
Excess dopamine amplifies reward-seeking behavior, reducing impulse control.
What is punding in Parkinson’s disease?
Punding is repetitive, purposeless behavior such as sorting objects for hours.
Which brain regions are affected by ICDs?
The ventral striatum, prefrontal cortex, and limbic system.
What imaging studies show ICD-related changes in Parkinson’s patients?
fMRI and PET scans show altered activity in the mesolimbic system.
