Untreated Parkinson's disease patients no more likely to have impulse control disorders

(Press-News.org) PHILADELPHIA - While approximately one in five Parkinson's disease patients experience impulse control disorder symptoms, the disease itself does not increase the risk of gambling, shopping, or other impulsivity symptoms, according to research from the Perelman School of Medicine at the University of Pennsylvania. A new study is the first to show in a large sample that people with untreated Parkinson's were no more likely to have an increased impulsivity than people without the disease. Published in the January 8, 2013, print issue of Neurology®, the medical journal of the American Academy of Neurology, this study is the strongest research to date reinforcing the reported association between disease medications and impulse control disorders in Parkinson's.

"When looking at newly diagnosed Parkinson's patients who had yet to be treated with drugs targeting the dopamine system, we saw no difference in impulsivity than what we found in healthy people without the disease," said lead study author Daniel Weintraub, MD, associate professor of Psychiatry and Neurology in the Perelman School of Medicine at the University of Pennsylvania. "Now knowing that the disease itself is not driving impulsive behaviors, we can follow newly diagnosed patients over time to see if we can predict how exposure to dopamine-related drugs and other factors play a role in impulse control disorders."

Using baseline data from 168 newly-diagnosed, untreated Parkinson's disease patients and 143 healthy control subjects, obtained upon enrollment into the Parkinson's Progression Markers Initiative (PPMI), the team also found that there was an increasing severity of depression associated with impulse control disorders among both groups, particularly with the presence of compulsive eating symptoms.

This is the first study to use an impulse control assessment tool developed and validated for use in PD, as well to enroll PD patients and healthy controls concurrently and to have both groups undergo an identical assessment process.

"For those with Parkinson's who screened positive for impulse control disorders at baseline, it will be interesting to follow the patients to see if treatment with dopamine agonists and other therapies will further increase risk over time," said Weintraub, also with the Parkinson's Disease and Mental Illness Research, Education and Clinical Center of the Philadelphia Veterans Affairs Medical Center.

This is the first data to be published from the Parkinson's Progression Markers Initiative, known as PPMI, a public-private partnership funded by The Michael J. Fox Foundation for Parkinson's Research and funding partners, including Abbott, Biogen Idec, F. Hoffman-La Roche Ltd., GE Healthcare, Genentech, and Pfizer Inc.

### In addition to Dr. Weintraub, the study was conducted by Kimberly Papay and Andrew Siderowf, MD, MSCE, of Penn's Parkinson's Disease and Movement Disorders Center. After the study was completed and submitted for publication, Dr. Siderowf left Penn for a position with Avid Radiopharmaceuticals, where he is now Medical Director.

Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $4.3 billion enterprise.

The Perelman School of Medicine is currently ranked #2 in U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $479.3 million awarded in the 2011 fiscal year.

The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania -- recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report; Penn Presbyterian Medical Center; and Pennsylvania Hospital – the nation's first hospital, founded in 1751.

Penn Medicine also includes additional patient care facilities and services throughout the Philadelphia region. Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2011, Penn Medicine provided $854 million to benefit our community.