[Repetitive impulse-associated behavioral disorders in Parkinson's disease]

Nervenarzt. 2012 Dec;83(12):1582-9. doi: 10.1007/s00115-012-3631-5.
[Article in German]


Parkinson's disease (PD) is associated with a number of behavioral disorders which may cause considerable social, professional or financial problems. Impulse control disorders (ICDs), such as pathological gambling, binge eating, compulsive shopping and hypersexuality occur in approximately 13-14% of PD patients. Further behavioral disorders are the dopamine dysregulation syndrome (DDS), a substance dependence characterized by craving for dopaminergic substances and punding (prolonged repetitive activities which are not goal-oriented).Treatment-related risk factors are dopamine agonists for ICDs and a high total dopaminergic dose for DDS and punding. Shared risk factors are young age at onset, impulsive personality traits, depression and possibly dyskinesia. At the neuronal level these behavioral disorders seem to be associated with changes in the reward system and dysfunction of the orbitofrontal cortex. The evidence level for management strategies is at present insufficient. For ICDs current clinical practice consists of discontinuation or reduction of dopamine agonists.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Chronic Disease
  • Dopamine Agonists / adverse effects*
  • Dopamine Agonists / therapeutic use*
  • Humans
  • Impulsive Behavior / diagnosis
  • Impulsive Behavior / etiology*
  • Impulsive Behavior / prevention & control*
  • Parkinson Disease / complications*
  • Parkinson Disease / drug therapy*
  • Secondary Prevention
  • Treatment Outcome


  • Dopamine Agonists