Impulse Control Disorders Are Independent of Parkinson Disease Motor Subtypes.
Impulse Control Disorders Are Independent of Parkinson Disease Motor Subtypes.
Where did the research take place?
The study site has not been established. Author addresses may differ from where the research occurred.
Houston, US · Author affiliation
Department of Neurology, Baylor College of Medicine, Houston, TX USALocation evidence
Tel Aviv, IL · Author affiliation
Department of Occupational Therapy, Gray Faculty of Medical & Health Sciences, Sagol School of Neuroscience, Center for Accessible Neuropsychology, Tel Aviv University, Tel Aviv, IsraelLocation evidence
Buenos Aires, AR · Author affiliation
Sección de Movimientos Anormales, Departamento de Neurología, Fleni, Buenos Aires, Argentina; Instituto Fleni-CONICET (INEU), Buenos Aires, ArgentinaLocation evidence
New York City, US · Author affiliation
Department of Neurology, Columbia University Irving Medical Center, New York, NY USALocation evidence
Boston, US · Author affiliation
Department of Neurology, Brigham and Women’s Hospital, Harvard University, Boston, MA, USALocation evidence
Publication status: preprint
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Original abstract
OBJECTIVE: Impulse control disorders (ICDs) are clinically important nonmotor features of Parkinson's disease (PD). Tremor-dominant PD (TD-PD) has been associated with greater cerebello-thalamo-cortical involvement, whereas postural instability/gait difficulty-dominant PD (PIGD-PD) has been linked to more prominent basal ganglia and frontostriatal dysfunction. We therefore examined whether ICD symptoms differ by motor phenotypes. METHODS: This cross-sectional study analyzed baseline data from the Parkinson's Precision Medicine Initiative (PPMI). Motor subtype classification was based on Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) criteria. ICD symptoms were assessed using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Current Short Form (QUIP-CS) and evaluated across multiple levels of analysis using the standard screening definition and normalized QUIP-CS scores analyzed categorically and continuously. Temporal-alignment, subgroup, multivariable, and Bayesian analyses were performed to assess the robustness of the primary findings. RESULTS: We analyzed 305 participants (173 TD-PD, 132 PIGD-PD). Screening-defined ICD positivity was similar between subtypes (21.4% vs 21.2%, OR = 1.01, 95% CI 0.58-1.76, p = 0.970). Continuous and categorical normalized QUIP-CS scores likewise did not differ between groups (continuous score: 0.0338 vs 0.0384, p = 0.674; categorical score: 3.5% vs 4.5%, p = 0.632). Temporally aligned, subgroup, and multivariable sensitivity analyses consistently supported the primary finding, and Bayesian analysis provided moderate evidence supporting the null hypothesis (BF01 = 7.21). CONCLUSIONS: ICD symptoms do not differ between TD-PD and PIGD-PD motor subtypes in early PD. These findings suggest that motor subtype-associated differences in cerebellar involvement do not substantially influence ICD symptoms in early PD.