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Screening for impulse control disorders in Parkinson’s disease and dopamine agonist use: a study of pharmacokinetic and psychological risk factors

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Abstract

Introduction

Dopamine agonist (DA) use is considered the main risk factor for impulse control disorder (ICD) development in Parkinson’s disease (PD). Besides DAs, personality traits and cognitive features may represent risk factors for ICDs. The primary aim of this study was to investigate differences in DA plasma concentrations in PD patients with and without a positive screening for ICDs according to validated tools. The secondary aim was to compare the psychological profile between ICD positive and negative screened patients.

Methods

PD patients receiving chronic DA therapy were screened for ICDs according to the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease (QUIP). Blood samples for measurement of DA (pramipexole, ropinirole, rotigotine) trough plasma concentrations were drawn in the morning, at mean 16–19 h from the last DA dose. Patients’ psychological profile was investigated by Millon Clinical Multiaxal Inventory III and Barratt Impulsiveness Scale (BIS-11).

Results

One hundred and five PD patients were enrolled. Forty-one patients (39%) were QUIP positive, mainly for binge eating and hobbyism. Median plasma concentrations of pramipexole (n = 71, 66%), ropinirole (n = 21, 19%), and rotigotine (n = 16, 15%) were similar between QUIP positive and negative patients. QUIP positive patients showed higher motor impulsiveness (p = 0.04) and tended to higher total impulsiveness (p = 0.05).

Conclusion

This is the first prospective study to evaluate the relationship between DA plasma concentrations and ICDs risk in PD patients. DA plasma levels were overlapping between QUIP positive and negative patients. BIS-11, particularly the motor impulsiveness subscale, might be a useful screening tool in PD patients eligible for DA therapy.

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Data Availability

The datasets analysed during the current study are available in the Zenodo repository, at https://zenodo.org/record/7299691#.Y2kbHUXMKUk.

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Acknowledgements

This work was presented in part at “X Congresso Nazionale FeDerSerD. Per una medicina del Territorio da rifondare. Il ruolo dei servizi delle dipendenze nella nuova sanità pubblica.” On line congress, November 3–5, 2021. We thank the patients who participated in the study for their active cooperation. The skillful nursing assistance of Monica Balboni is gratefully acknowledged. Cecilia Baroncini edited the English text.

Funding

This work was supported by “Fondazione del Monte di Bologna e Ravenna,” grant no. 760bis/2019.

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Author notes

  1. Manuela Contin and Giovanna Lopane contributed equally to the work.

Authors and Affiliations

  1. IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Bologna, Italy

    Manuela Contin, Giovanna Lopane, Luca Marini, Susan Mohamed, Luisa Sambati, Maria Guarino, Pietro Cortelli & Giovanna Calandra-Buonaura

  2. Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy

    Manuela Contin, Pietro Cortelli & Giovanna Calandra-Buonaura

  3. Neurology Unit, Ospedale “S. Maria Della Scaletta,” Imola, Bologna, Italy

    Patrizia De Massis

  4. DSMDP-Programma Integrato Dipendenze Patologiche Ed Assistenza Alle Popolazioni Vulnerabili, AUSLBO, Bologna, Italy

    Simonetta Sermi & Chiara Persichella

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  1. Manuela Contin
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Corresponding author

Correspondence to Manuela Contin.

Ethics declarations

Standard protocol approvals, registrations, and patient consents

The study was approved by the Ethics Committee of Area Vasta Emilia Centro (CE20072) and performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments. Written informed consent was obtained from all participants.

Conflict of interest

G. C.-B. has received honoraria for speaking from Abbvie Italia, Bial Italia, and Zambon Italia. For the remaining authors, none were declared.

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Contin, M., Lopane, G., Marini, L. et al. Screening for impulse control disorders in Parkinson’s disease and dopamine agonist use: a study of pharmacokinetic and psychological risk factors. Neurol Sci 44, 565–572 (2023). https://doi.org/10.1007/s10072-022-06485-y

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