Psychosis may be an important marker of impaired volition across motor and cognitive domains in Parkinson disease (PD), according to a recent study. Furthermore, unpredictable motor fluctuations, psychosis, and depression may together comprise a phenotypic profile of patients at increased risk for dopamine dysregulation syndrome/impulse control disorder (DDS/ICD). Similarly, dyskinetic PD patients should be closely monitored for psychotic symptoms and treated appropriately. Researchers analyzed cross-sectional data from 654 participants collected through the NINDS Parkinson's Disease Biomarkers Program. DDS/ICD symptoms and dyskinesias were assessed using the Movement Disorders Society (revised) Unified Parkinson's Disease Rating Scale. Potential associated variables were selected from PD-validated or PD-specific scales of neuropsychiatric or motoric status. They found:
- 53 (8.1%) participants endorsed DDS and/or ICD symptoms and 150 (22.9%) were dyskinetic.
- In multivariable analysis, psychosis was independently associated with both dyskinesias and DDS/ICD.
- Unpredictable motor fluctuations and depression were also associated with DDS/ICD; female sex, low tremor score, and high akinesia-rigidity score were associated with dyskinesias.
Hinkle JT, Perepezko K, Rosenthal LS, et al. Markers of impaired motor and cognitive volition in Parkinson's disease: Correlates of dopamine dysregulation syndrome, impulse control disorder, and dyskinesias. [Published online ahead of print November 20, 2017]. Parkinsonism Relat Disord. doi:10.1016/j.parkreldis.2017.11.338.
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