Abstract
Purpose of review
This paper reviews clinical and pathophysiological features of both impulse control disorders (ICDs) and REM sleep behavior disorder (RBD) in Parkinson’s disease (PD), as well as current evidences of their association. Then, we suggest recommendations to manage PD patients with RBD in order to prevent this potentially devastating psychiatric complication.
Recent findings
ICDs are psychiatric complications occurring in patients with Parkinson’s disease (PD) treated with dopaminergic replacement therapies (DRT). Besides DRT, risk factors for ICDs are poorly known. We recently showed an association between ICDs and RBD in PD.
Summary
Detecting RBD in PD may provide clinician the opportunity to identify patients at higher risk to develop ICDs. In PD patients with either a video-polysomnographic (v-PSG) diagnosis of RBD or a typical history of RBD when v-PSG is not available, dopamine agonists should be avoided whenever possible, or be prescribed at the lowest effective dose. Furthermore, gradual tapering of dopamine agonist would be recommended, due to the potential increased risk of dopamine withdrawal syndrome in these patients. Increased surveillance, implying patients and caregiver education to recognize early changes in behavior and in mood possibly related to a hyperdopaminergic status, should be part of the preventive strategies.
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References and Recommended Reading
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
•• Weintraub D, David AS, Evans AH, Grant JE, Stacy M. Clinical spectrum of impulse control disorders in Parkinson’s disease: Spectrum Of Impulse Control Disorders In PD. Mov Disord. 30(2):121–7 The paper provides a comprehensive clinical overview on ICDs in Parkinson’s disease.
Weintraub D. Dopamine and impulse control disorders in Parkinson’s disease. Ann Neurol. 2009;64(S2):S93–S100.
Voon V, et al. Prevalence of repetitive and reward-seeking behaviors in Parkinson disease. Neurology. 2006;67(7):1254–7.
Hassan A, et al. Dopamine agonist-triggered pathological behaviors: surveillance in the PD clinic reveals high frequencies. Parkinsonism Relat Disord. 2011;17(4):260–4.
Perez-Lloret S, et al. Prevalence and pharmacological factors associated with impulse-control disorder symptoms in patients with Parkinson disease. Clin Neuropharmacol. 2012;35(6):261–5.
Schreiber L, Odlaug BL, Grant JE. Impulse control disorders: updated review of clinical characteristics and pharmacological management. Front Psychiatry. 2011;2:1.
Clemm von Hohenberg C, Dreßing H. Stealing as an impulse control disorder associated with pramipexole—a case report from forensic psychiatric practice. Psychiatr Prax. 2017;44(3):172–4.
Gescheidt T, Bares M. Impulse control disorders in patients with Parkinson’s disease. Acta Neurol Belg. 2011;111(1):3–9.
Sobrido MJ, Dias-Silva JJ, Quintáns B. Behavioral disorders in Parkinson’s disease. Genetic, pharmacological and medico-legal aspects. Rev Neurol. 2009;48(Suppl 1):S43–8.
Singh A, Kandimala G, Dewey RB, O’Suilleabhain P. Risk factors for pathologic gambling and other compulsions among Parkinson’s disease patients taking dopamine agonists. J Clin Neurosci Off J Neurosurg Soc Australas. 2007;14(12):1178–81.
Voon V, et al. Factors associated with dopaminergic drug–related pathological gambling in Parkinson disease. Arch Neurol. 2007;64(2):212–6.
Belin D, Mar AC, Dalley JW, Robbins TW, Everitt BJ. High impulsivity predicts the switch to compulsive cocaine-taking. Science. 2008;320(5881):1352–5.
Steinberg L, Albert D, Cauffman E, Banich M, Graham S, Woolard J. Age differences in sensation seeking and impulsivity as indexed by behavior and self-report: evidence for a dual systems model. Dev Psychol. 2008;44(6):1764–78.
Weintraub D, et al. Impulse control disorders in Parkinson disease: a cross-sectional study of 3090 patients. Arch Neurol. May 2010;67(5):589–95.
Avanzi M, Baratti M, Cabrini S, Uber E, Brighetti G, Bonfà F. Prevalence of pathological gambling in patients with Parkinson’s disease. Mov Disord Off J Mov Disord Soc. 2006;21(12):2068–72.
Grosset KA, et al. Problematic gambling on dopamine agonists: not such a rarity. Mov Disord Off J Mov Disord Soc. 2006;21(12):2206–8.
• Corvol J-C, et al. Longitudinal analysis of impulse control disorders in Parkinson disease. Neurology. 2018;91(3):e189–201 The paper investigates longitudinal dose-effect relationship between dopamine replacement therapy and impulse control disorders in 411 PD patients followed for up to 5 years, providing evidences for a strong association between ICDs and both dose and duration of dopamine agonists.
Giladi N, Weitzman N, Schreiber S, Shabtai H, Peretz C. New onset heightened interest or drive for gambling, shopping, eating or sexual activity in patients with Parkinson’s disease: the role of dopamine agonist treatment and age at motor symptoms onset. J Psychopharmacol Oxf Engl. 2007;21(5):501–6.
Bastiaens J, Dorfman BJ, Christos PJ, Nirenberg MJ. Prospective cohort study of impulse control disorders in Parkinson’s disease. Mov Disord Off J Mov Disord Soc. 2013;28(3):327–33.
Evans AH, et al. Punding in Parkinson’s disease: its relation to the dopamine dysregulation syndrome. Mov Disord Off J Mov Disord Soc. 2004;19(4):397–405.
Ondo WG, Lai D. Predictors of impulsivity and reward seeking behavior with dopamine agonists. Parkinsonism Relat Disord. 2008;14(1):28–32.
Weintraub D, et al. Association of dopamine agonist use with impulse control disorders in Parkinson disease. Arch Neurol. 2006;63(7):969–73.
Garcia-Ruiz PJ, et al. Impulse control disorder in patients with Parkinson’s disease under dopamine agonist therapy: a multicentre study. J Neurol Neurosurg Psychiatry. 2014;85(8):840–4.
Rizos A, et al. A European multicentre survey of impulse control behaviours in Parkinson’s disease patients treated with short- and long-acting dopamine agonists. Eur J Neurol. 2016;23(8):1255–61.
Mamikonyan E, et al. Long-term follow-up of impulse control disorders in Parkinson’s disease. Mov Disord Off J Mov Disord Soc. 2008;23(1):75–80.
Weintraub D, et al. Amantadine use associated with impulse control disorders in Parkinson disease in cross-sectional study. Ann Neurol. 2010;68(6):963–8.
Thomas A, Bonanni L, Gambi F, Di Iorio A, Onofrj M. Pathological gambling in Parkinson disease is reduced by amantadine. Ann Neurol. 2010;68(3):400–4.
Weintraub D, Papay K, Siderowf A, Initiative PPM, et al. Screening for impulse control symptoms in patients with de novo Parkinson disease a case-control study. Neurology. 2013;80(2):176–80.
Driver-Dunckley ED, et al. Gambling and increased sexual desire with dopaminergic medications in restless legs syndrome. Clin Neuropharmacol. 2007;30(5):249–55.
Cornelius JR, Tippmann-Peikert M, Slocumb NL, Frerichs CF, Silber MH. Impulse control disorders with the use of dopaminergic agents in restless legs syndrome: a case-control study. Sleep. 2010;33(1):81–7.
Bancos I, Nannenga MR, Bostwick JM, Silber MH, Erickson D, Nippoldt TB. Impulse control disorders in patients with dopamine agonist-treated prolactinomas and nonfunctioning pituitary adenomas: a case-control study. Clin Endocrinol. 2014;80(6):863–8.
• Grall-Bronnec M, et al. Dopamine agonists and impulse control disorders: a complex association. Drug Saf. 2018;41(1):19–75 The paper offers a comprehensive review on the prevalence and factors associated with the development of ICD in patients treated with dopamine agonist agents, affected by different conditions such as PD, RLS and prolactinome.
Santangelo G, Vitale C, Trojano L, Verde F, Grossi D, Barone P. Cognitive dysfunctions and pathological gambling in patients with Parkinson’s disease. Mov Disord Off J Mov Disord Soc. 2009;24(6):899–905.
Djamshidian A, O’Sullivan SS, Lees A, Averbeck BB. Stroop test performance in impulsive and non impulsive patients with Parkinson’s disease. Parkinsonism Relat Disord. 2011;17(3):212–4.
Siri C, et al. Cognitive status of patients with Parkinson’s disease and pathological gambling. J Neurol. 2010;257(2):247–52.
Voon V, Mehta AR, Hallett M. Impulse control disorders in Parkinsonʼs disease: recent advances. Curr Opin Neurol. 2011;24(4):324–30.
Bentivoglio AR, Baldonero E, Ricciardi L, De Nigris F, Daniele A. Neuropsychological features of patients with Parkinson’s disease and impulse control disorders. Neurol Sci Off J Ital Neurol Soc Ital Soc Clin Neurophysiol. 2013;34(7):1207–13.
Cilia R, van Eimeren T. Impulse control disorders in Parkinson’s disease: seeking a roadmap toward a better understanding. Brain Struct Funct. 2011;216(4):289–99.
Koob GF, Volkow ND. Neurocircuitry of addiction. Neuropsychopharmacol Off Publ Am Coll Neuropsychopharmacol. 2010;35(1):217–38.
Dagher A, Robbins TW. Personality, addiction, dopamine: insights from Parkinson’s disease. Neuron. 2009;61(4):502–10.
Steeves TDL, et al. Increased striatal dopamine release in Parkinsonian patients with pathological gambling: a [11C] raclopride PET study. Brain. 2009;132(5):1376–85.
O’Sullivan SS, et al. Cue-induced striatal dopamine release in Parkinson’s disease-associated impulsive-compulsive behaviours. Brain J Neurol. 2011;134, Pt 4:969–78.
Frosini D, et al. Parkinson’s disease and pathological gambling: results from a functional MRI study. Mov Disord Off J Mov Disord Soc. 2010;25(14):2449–53.
Gurevich EV, Joyce JN. Distribution of dopamine D3 receptor expressing neurons in the human forebrain: comparison with D2 receptor expressing neurons. Neuropsychopharmacol Off Publ Am Coll Neuropsychopharmacol. 1999;20(1):60–80.
Voon V, et al. Chronic dopaminergic stimulation in Parkinson’s disease: from dyskinesias to impulse control disorders. Lancet Neurol. 2009;8(12):1140–9.
Cormier F, Muellner J, Corvol J-C. Genetics of impulse control disorders in Parkinson’s disease. J Neural Transm Vienna Austria 1996. 2013;120(4):665–71.
Kraemmer J, et al. Clinical-genetic model predicts incident impulse control disorders in Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2016;87(10):1106–11.
Samuel M, et al. Management of impulse control disorders in Parkinson’s disease: controversies and future approaches. Mov Disord Off J Mov Disord Soc. Feb. 2015;30(2):150–9.
Schenck CH. Rapid eye movement sleep behavior disorder: current knowledge and future directions. Sleep Med. 2013;14(8):699–702.
Fantini ML, Ferini-Strambi L, Montplaisir J. Idiopathic REM sleep behavior disorder: toward a better nosologic definition. Neurology. 2005;64(5):780–6.
Iranzo A, et al. Neurodegenerative disorder risk in idiopathic REM sleep behavior disorder: study in 174 patients. PLoS One. 2014;9(2):e89741.
Postuma RB, Gagnon JF, Vendette M, Fantini ML, Massicotte-Marquez J, Montplaisir J. Quantifying the risk of neurodegenerative disease in idiopathic REM sleep behavior disorder. Neurology. 2009;72(15):1296–300.
Arnulf I. REM sleep behavior disorder: motor manifestations and pathophysiology. Mov Disord. 2012;27(6):677–89.
Howell MJ, Schenck CH. Rapid eye movement sleep behavior disorder and neurodegenerative disease. JAMA Neurol. 2015;72(6):707–12.
• Fereshtehnejad S-M, Romenets SR, Anang JBM, Latreille V, Gagnon J-F, Postuma RB. New clinical subtypes of Parkinson disease and their longitudinal progression: a prospective cohort comparison with other phenotypes. JAMA Neurol. 2015;72(8):863 This paper provides evidences that the presence of some non-motor features in PD, such as mild cognitive impairment, orthostatic hypotension, and RBD, even at baseline visits, allows to identify a diffuse/malignant subgroup of patients for whom the most rapid progression rate could be expected.
Kumru H, Santamaria J, Tolosa E, Iranzo A. Relation between subtype of Parkinson’s disease and REM sleep behavior disorder. Sleep Med. 2007;8(7–8):779–83.
Sixel-Döring F, Trautmann E, Mollenhauer B, Trenkwalder C. Associated factors for REM sleep behavior disorder in Parkinson disease. Neurology. 2011;77(11):1048–54.
Postuma RB, Gagnon JF, Vendette M, Montplaisir JY. Markers of neurodegeneration in idiopathic rapid eye movement sleep behaviour disorder and Parkinson’s disease. Brain. 2009;132(12):3298–307.
Postuma RB, Gagnon JF, Vendette M, Charland K, Montplaisir J. REM sleep behaviour disorder in Parkinson’s disease is associated with specific motor features. J Neurol Neurosurg Psychiatry. Oct. 2008;79(10):1117–21.
Vendette M, et al. REM sleep behavior disorder predicts cognitive impairment in Parkinson disease without dementia. Neurology. 2007;69(19):1843–9.
Marques A, et al. REM sleep behaviour disorder and visuoperceptive dysfunction: a disorder of the ventral visual stream? J Neurol. 2010;257(3):383–91.
Anang JB, et al. Predictors of dementia in Parkinson disease a prospective cohort study. Neurology. 2014;83(14):1253–60.
• Fantini ML, Durif F, Marques A. Neuropsychological aspects: impulse-control disorders and other neuropsychiatric features in RBD. In: Behavior Disorder CH, Schenck BH, Videnovic A, editors. Rapid-Eye-Movement Sleep. Cham: Springer International Publishing; 2019. p. 509–25. This chapter reviews the current evidences of an increased prevalence of neuropsychiatric symptoms in RBD, both idiopathic and associated to PD.
Luppi P-H, et al. The neuronal network responsible for paradoxical sleep and its dysfunctions causing narcolepsy and rapid eye movement (REM) behavior disorder. Sleep Med Rev. Jun. 2011;15(3):153–63.
Luppi P-H, Clément O, Valencia Garcia S, Brischoux F, Fort P. New aspects in the pathophysiology of rapid eye movement sleep behavior disorder: the potential role of glutamate, gamma-aminobutyric acid, and glycine. Sleep Med. 2013;14(8):714–8.
Brooks PL, Peever JH. Impaired GABA and glycine transmission triggers cardinal features of rapid eye movement sleep behavior disorder in mice. J Neurosci. 2011;31(19):7111–21.
Boeve BF, et al. Pathophysiology of REM sleep behaviour disorder and relevance to neurodegenerative disease. Brain. 2007;130(11):2770–88.
Boeve BF, et al. Insights into REM sleep behavior disorder pathophysiology in brainstem-predominant Lewy body disease. Sleep Med. Jan. 2007;8(1):60–4.
Dugger BN, et al. Neuropathological analysis of brainstem cholinergic and catecholaminergic nuclei in relation to rapid eye movement (REM) sleep behaviour disorder: PPN/LDT nucleus in Lewy body disease. Neuropathol Appl Neurobiol. 2012;38(2):142–52.
Iranzo A, Aparicio J. A lesson from anatomy: Focal brain lesions causing REM sleep behavior disorder. Sleep Med. 2009;10(1):9–12.
Iranzo A, et al. Rapid eye movement sleep behavior disorder and potassium channel antibody-associated limbic encephalitis. Ann Neurol. 2006;59(1):178–81.
Cornelius JR, et al. Sleep manifestations of voltage-gated potassium channel complex autoimmunity. Arch Neurol. 2011;68(6):733–8.
Maquet P, et al. Functional neuroanatomy of human rapid-eye-movement sleep and dreaming. Nature. 1996;383(6596):163–6.
Rye DB. Contributions of the pedunculopontine region to normal and altered REM sleep. Sleep. 1997;20(9):757–88.
Perogamvros L, Schwartz S. The roles of the reward system in sleep and dreaming. Neurosci Biobehav Rev. 2012;36(8):1934–51.
Frauscher B, et al. Validation of the Innsbruck REM sleep behavior disorder inventory. Mov Disord Off J Mov Disord Soc. 2012;27(13):1673–8.
Fantini ML, et al. Increased risk of impulse control symptoms in Parkinson’s disease with REM sleep behaviour disorder. J Neurol Neurosurg Psychiatry. 2015;86(2):174–9.
Bellosta Diago E, Lopez Del Val LJ, Santos Lasaosa S, López Garcia E, Viloria Alebesque A. Association between REM sleep behaviour disorder and impulse control disorder in patients with Parkinson’s disease. Neurol Barc Spain. 2016.
Kim YE, et al. REM sleep behavior disorder: association with motor complications and impulse control disorders in Parkinson’s disease. Parkinsonism Relat Disord. 2014;20(10):1081–4.
Bayard S, et al. Impulse control disorder and rapid eye movement sleep behavior disorder in Parkinson’s disease. Parkinsonism Relat Disord. 2014;20(12):1411–4.
Rolinski M, et al. REM sleep behaviour disorder is associated with worse quality of life and other non-motor features in early Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2014;85(5):560–6.
Ramírez Gómez CC, et al. A multicenter comparative study of impulse control disorder in Latin American patients with Parkinson disease. Clin Neuropharmacol. 2017;40(2):51–5.
• Fantini ML, et al. Sleep and REM sleep behaviour disorder in Parkinson’s disease with impulse control disorder. J Neurol Neurosurg Psychiatry. 2017. This paper provides evidences of an association between Impulse Control Disorders and polysomnographic-confirmed RBD in Parkinson’s disease.
Sixel-Döring F, Zimmermann J, Wegener A, Mollenhauer B, Trenkwalder C. The Evolution of REM Sleep Behavior Disorder in Early Parkinson Disease. Sleep. Sep. 2016;39(9):1737–42.
Solla P, et al. Behavioral, neuropsychiatric and cognitive disorders in Parkinson’s disease patients with and without motor complications. Prog Neuro-Psychopharmacol Biol Psychiatry. 2011;35(4):1009–13.
Postuma RB, et al. Environmental risk factors for REM sleep behavior disorder: a multicenter case-control study. Neurology. 2012;79(5):428–34.
Baig F, et al. Personality and addictive behaviours in early Parkinson’s disease and REM sleep behaviour disorder. Parkinsonism Relat Disord. 2017;37:72–8.
Jacobs ML, et al. Risk factor profile in Parkinson’s disease subtype with REM sleep behavior disorder. J Park Dis. 2016;6(1):231–7.
Stiasny-Kolster K, Mayer G, Schäfer S, Möller JC, Heinzel-Gutenbrunner M, Oertel WH. The REM sleep behavior disorder screening questionnaire—a new diagnostic instrument. Mov Disord. 2007;22(16):2386–93.
Nomura T, Inoue Y, Kagimura T, Uemura Y, Nakashima K. Utility of the REM sleep behavior disorder screening questionnaire (RBDSQ) in Parkinson’s disease patients. Sleep Med. 2011;12(7):711–3.
Postuma RB, et al. A single-question screen for rapid eye movement sleep behavior disorder: a multicenter validation study. Mov Disord Off J Mov Disord Soc. 2012;27(7):913–6.
Shen S-S, et al. Validation study of REM sleep behavior disorder questionnaire-Hong Kong (RBDQ-HK) in east China. Sleep Med. 2014;15(8):952–8.
Fox SH, Lang AE. Don’t delay, start today’: delaying levodopa does not delay motor complications. Brain. 2014;137(10):2628–30.
Stocchi F, Torti M, Fossati C. Advances in dopamine receptor agonists for the treatment of Parkinson’s disease. Expert Opin Pharmacother. 2016;17(14):1889–902.
Valldeoriola F, et al. The effects of transdermal rotigotine on non-motor symptoms of Parkinson’s disease: a multicentre, observational, retrospective, post-marketing study. Int J Neurosci. 2018;128(4):369–75.
•• Béreau M, Fleury V, Bouthour W, Castrioto A, Lhommée E, Krack P. Hyperdopaminergic behavioral spectrum in Parkinson’s disease: a review. Rev Neurol (Paris). 2018. This paper outlines the pathophysiological mechanisms of the hyperdopaminergic behaviors observed in Parkinson’s disease, and provides management strategies.
Chaudhuri KR, et al. A pilot prospective, multicenter observational study of dopamine agonist withdrawal syndrome in Parkinson’s disease. Mov Disord Clin Pract. 2015;2(2):170–4.
Nirenberg MJ. Dopamine agonist withdrawal syndrome: implications for patient care. Drugs Aging. 2013;30(8):587–92.
Rabinak CA, Nirenberg MJ. Dopamine agonist withdrawal syndrome in Parkinson disease. Arch Neurol. 2010;67(1):58–63.
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Franck Durif reports other from Allergan, other from Aguettant, personal fees from Abbvie, grants from Abbott, other from medtronic, outside the submitted work. Maria Livia Fantini and Ana Marques each declare no potential conflicts of interest.
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Fantini, M.L., Durif, F. & Marques, A. Impulse Control Disorders in REM Sleep Behavior Disorder. Curr Treat Options Neurol 21, 23 (2019). https://doi.org/10.1007/s11940-019-0564-3
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DOI: https://doi.org/10.1007/s11940-019-0564-3