Mesude TUTUNCU, Nazan KARAGÖZ, Vasfiye Burcu ALBAY, Aysun SOYSAL

İdiopatik Parkinson Hastalığında Dürtüsellik: Eşleştirilmiş Vaka Kontrol Çalışması

GİRİŞ ve AMAÇ: Çalışmanın amacı İdiopatik parkinson hastalarında (IPH) dürtü kontrol bozukluğu (DKB) prevelansını saptamak ve dürtü kontrol bozukluğunun dürtüsellik üzerine etkisine bakmak. YÖNTEM ve GEREÇLER: 40 IPH ve 40 sağlıklı kontrol dahil edildi. tüm katılımcılar Minnesota Dürtü Kontrol Bozukluğu testi ve Barret dürtüsellik ölçeği ile değerlendirildi BULGULAR: 7 IPH ve 1 sağlıklı kontrolde dürtü kontrol bozukluğu saptandı. Dopamin agonist kullanımı DKB için risk oluşturuyordu. Hasta grupta motor dürtüslellik harici tüm dürtüsellik parametreleri daha fazlaydı. Hasta grupta kllinik olarak DKB varlığında motor dürtüsellik harici tüm dürtüsellik parametreleri artıyordu. TARTIŞMA ve SONUÇ: IPD'deki motor olmayan bulgular sorgulanmadığı takdirde göz ardı edilebilir. İPD hastalarında artan dürtüsellik dikkatlice izlenmelidir. ICD'si olmayan IPD hastalarının bile, özellikle planlama dışı ve bilişsel alanlarda, dürtüsellik eğilimlerini arttırdığı unutulmamalıdır. Ayrıca, yalnızca motor dürtüsellik ölçen testler yeterli olmayabilir.

Anahtar Kelimeler:

Parkinson Hastalığı, Dürtü Kontrol Bozuklukları, Dürtüsellik, Dopamin Agonisti, Dopamin Replasman Tedavisi

Impulsivity In Idiopathic Parkinson Disease: Paired Case Control Study

INTRODUCTION: The aim of the current study was to estimate the frequency of Impulse Control Disorder (ICD) in patients with Idiopathic Parkinson’s Disease (IPD) and to investigate impulsivity in IPD patients. METHODS: 40 IPD patients (24 female, 16 male) treated with dopamine replacement therapy (DRT) and age and sex similar 40 healthy controls (HC) (23 female, 17 male) were included in this paired case-control study. Minnesota Impulsive Disorder Interview (MIDI) and the Turkish version of the Barratt Impulsiveness Scale (BIS-11) were applied to all participants. The patient and control groups were compared in terms of impulsivity and ICD. The effect of dopamine agonist (DA) usage on the presence of impulse control disorder was evaluated in the patient group. RESULTS: 7 patients with IPD (17.5%) and 1 healthy control (2.5%) reported at least one ICD in MIDI. Multiple ICDs were reported in 2 of 7 patients (28.57%) with IPD. ICD was significantly more frequent in IPD patient group (p=0.002) and DA was found to be a significant risk for ICD. IPD patients had higher scores in total impulsivity, non-planning, and cognitive impulsivity but interestingly lower scores in motor impulsivity as compared with controls. Except for motor impulsivity, the other domains of impulsivity including nonplanning and cognitive impulsivity were found to be increased in the presence of ICD in patients group. DISCUSSION AND CONCLUSION: Non-motor findings in IPD can be overlooked if they are not questioned. Increased impulsivity should be carefully followed in patients with IPD. It should be kept in mind that even IPD patients who had no ICD have increased tendencies for impulsivity, especially in non-planning and cognitive areas. In addition, the tests which only measures motor impulsivity may not be sufficient.

Keywords:

Parkinson’s Disease, Impulse Control Disorders, Impulsiveness, Dopamine Agonist, Dopamine Replacement Therapy,

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