Examining the link between impulse control disorder and antidepressant use in Parkinson's disease.
Examining the link between impulse control disorder and antidepressant use in Parkinson's disease.
复制标题
检查帕金森病的冲动控制障碍与抗抑郁药物的使用之间的联系。
DOI：
10.1016/j.parkreldis.2023.105918
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发表时间：
2023
影响因子：
4.1
通讯作者：
Pontone,GregoryM
中科院分区：
文献类型：
--
作者：
Morrow,ChristopherB;Hinkle,JaredT;Seemiller,Joseph;Mills,KellyA;Pontone,GregoryM
帕金森病（PD）和双相情感障碍的轻躁狂发作中的冲动控制障碍（ICD）表现出重叠的症状，表明共同的神经生物学。为了探索这一点，测试了以下假设：（1）从OFF到ON药物状态的情感症状的较大变化将与ICD相关，（2）抗抑郁药暴露将与较大的OFF到ON情感症状变化相关，以及（3）抗抑郁药暴露将与ICD相关。（平均年龄65岁，61%男性）在“关闭”和“开启”多巴胺状态下进行评价。情感症状采用汉密尔顿焦虑和抑郁评定量表。使用双样本Wilcoxon秩和检验和Pearson χ2检验比较临床结局的差异。我们进行了多变量Logistic回归，以评估抗抑郁药暴露的关联ICD.ResultsParticipants有较高的焦虑和抑郁评分在“上”和“关”状态和较大的变化，抑郁症状从关闭到ON状态相比，那些没有ICD。与未服用抗抑郁药的受试者相比，服用抗抑郁药的受试者在“开”和“关”状态下的焦虑评分更高，在“关”状态下的抑郁评分更高，焦虑症状从“关”状态到“开”状态的变化更大。抗抑郁药的使用与更高的ICD几率相关（OR 2.3，CI [1.0-4.5]，p值0.04）。抗心律失常治疗可能与ICD有关。未来的前瞻性研究需要澄清抗抑郁药治疗和ICD出现之间的时间关联。
IntroductionImpulse control disorders (ICD) in Parkinson's disease (PD) and hypomanic episodes of bipolar disorder show overlapping symptoms, suggesting a shared neurobiology. To explore this, the following hypotheses are tested: (1) larger changes in affective symptoms from OFF to ON medication states will be associated with ICD, (2) antidepressant exposure will be associated with larger OFF to ON affective symptom changes, and (3) antidepressant exposure will be associated with ICD.Methods200 participants (mean age 65, 61 % male) were evaluated in “off” and “on” dopamine states. Affective symptoms were captured using the Hamilton Anxiety and Depression Rating Scales. Differences in clinical outcomes were compared using two-sample Wilcoxon rank-sum tests and Pearson χ2 tests. We performed multivariable logistic regression to assess the association of antidepressant exposure on ICD.ResultsParticipants with an ICD had higher anxiety and depressive scores in “on” and “off” states and larger changes in depressive symptoms from OFF to ON states compared to those without an ICD. Participants on antidepressants had higher anxiety scores in “on” and “off” states, higher depressive scores in the “off” state, and larger changes in anxiety symptoms from OFF to ON states than those not on an antidepressant. Antidepressant use was associated with a higher odds of an ICD (OR 2.3, CI [1.0–4.5], p-value 0.04).ConclusionsAffective symptom severity in “on” and “off” dopamine states is associated with ICD. Antidepressant therapy may be associated with ICD. Future prospective studies clarifying temporal associations between antidepressant initiation and ICD emergence are needed.