Impulsive-compulsive disorders in Parkinson's disease
Shipilova N.N., Katunin D.A., Titova N.V.

Russian National Research Medical University named after N.I. Pirogov, Moscow

The article considers the impulse-compulsive disorders and associated behavioral disorders that occur in Parkinson's disease (PD) when dopaminergic therapy is used. The overall prevalence of impulse-compulsive disorders in PD is estimated at 15%. Pathophysiological mechanisms of the development of the impulse-compulsive disorders have not been fully studied, but it is known that the dysfunction of the dopaminergic mesolimbic and mesocortical pathways of the brain is the basis. Specific personality traits, emotional and affective disorders, young age, male gender and others can increase the risk of impulse-compulsive disorders in PD. Clinical studies have confirmed the close relationship between the development of impulse control impairments and the intake of dopamine receptor agonists. Associations with other classes of antiparkinsonian drugs are weaker and more ambiguous. It is important to recognize the impulse-compulsive disorders in the clinical picture of PD, because these disorders can affect interpersonal relationships, professional and social functioning of a person, and have an increasing health risk. In addition to the clinical interview, evaluation scales and questionnaires were developed to identify the symptoms of impulse-compulsive disorders, but the most important is the high level of neurologists' awareness of the possibility of developing such symptoms in the patient. To date, a small amount of data on studies of the correction of impulse-compulsive disorders and conflicting results of clinical observations have been accumulated. The main method of levelling the symptoms is a decrease in the dose of dopamine receptor agonists and neuropsychological support. The methods for correcting these disorders using different classes of drugs require further study.

Key words: impulsive-compulsive disorders, impulse control impairments, Parkinson's disease, punding, dopamine dysregulation syndrome, dopamine receptor agonists.
For citation: Shipilova N.N., Katunin D.A., Titova N.V. Impulsive-compulsive disorders in Parkinson's disease // RMJ. 2017. № 13. P. 963–967.