The effect of deep brain stimulation on impulse control related disorders in Parkinson's disease – A 10-year retrospective study of 137 patients

Up to 15% of patients with Parkinson's Disease (PD) experience impulse control and related behaviours (ICRBs), though it is not fully understood why ( Maloney E.M. Djamshidian A. O'Sullivan S.S. Phenomenology and epidemiology of impulsive-compulsive behaviours in Parkinson's disease, atypical parkinsonian disorders and non-parkinsonian populations.

J. Neurol. Sci. 2017; 374: 47-52

). Dopamine agonists (DA) and high total dose of levodopa have been associated with development of ICRBs, with the reduction or withdrawal of a DA often improving these symptoms. Subthalamic nucleus deep brain stimulation (STN-DBS) can be used as a tertiary therapy for PD in order to reduce DA dosage ( Rossi P.J. Shute J.B. Opri E. Molina R. Peden C. Castellanos O. et al. Impulsivity in Parkinson's disease is associated with altered subthalamic but not globus pallidus internus activity.

J. Neurol. Neurosurg. Psychiatry. 2017; 88: 968-970

, Rossi P.J. De Jesus S. Hess C.W. Martinez-Ramirez D. Foote K.D. Gunduz A. et al. Measures of impulsivity in Parkinson's disease decrease after DBS in the setting of stable dopamine therapy.

Parkinsonism Relat. Disord. 2017; 44: 13-17

), however, the effect of STN-DBS on ICRBs is unclear ( Merola A. Romagnolo A. Rizzi L. et al. Impulse control behaviors and subthalamic deep brain stimulation in Parkinson disease. , Santin Voullemnot Vrillon et al. Impact of subthalamic DBS on ICD in PD patients: a prospective study. , Kasemsuk C. Oyama G. Hattori N. Management of impulse control disorders with deep brain stimulation: a double-edged sword.

J. Neurol. Sci. 2017; 15 (Mar): 63-68

).

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