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.
This Week's Must Reads
Guidelines for Cognitive Screening, Management of MS, Mult Scler; ePub 2018 Oct 10; Kalb, Beier, et al
Age a Critical Determent in MS Relapse Recovery, Mult Scler; ePub 2018 Oct 10; Conway, et al
Is Contrast MR Imaging Necessary for All Patients?, Am J Neuroradiol; ePub 2018 Oct 4; Mattay, et al
Link Between Physiological and Perceived Fall Risk, Arch Phys Med Rehab; 2018 Oct; Gunn, et al
Muscle Strength Key in Determining Gait Speed in MS, Mult Scler Relat Disord; ePub 2018 Oct 9; Yang, et al
Must Reads in Parkinson's Disease
Orthostatic Hypotension in PD Increases Care Costs, Parkinsonism Relat Disord; ePub 2017 Nov 27; Merola, et al
FDA Approves Vercise Deep Brain Stimulation System, Boston Scientific news release; 2017 Dec 11
Psychosis May Indicate Impaired Cognition in PD, Parkinsonism Relat Disord; ePub 2017 Nov 20; Hinkle, et al
Sex Disparities in Health, Care Utilization in PD, Parkinsonism Relat Disord; ePub 2017 Dec 14; Fullard, et al
Sleep Fragmentation Linked with PD in Older Adults, Mov Disord; ePub 2017 Oct 30; Sohail, Yu, et al