教育講演
Parkinson病患者の行動障害
キーワード:
impulse control disorder,
dopamine dysregulation syndrome,
punding,
pathological gambling,
hypersexuality
2017 年 34 巻 3 号 p. 151-154
詳細
2017 年 34 巻 3 号 p. 151-154
Patients with Parkinson's disease (PD) may have impulsive–compulsive behaviors, such as impulse control disorder (ICD), dopamine dysregulation syndrome（DDS), and punding. ICD is a disorder characterized by impulsivity, i.e., a failure to resist temptation, urges, or impulses that may harm oneself or others. The ICDs frequently observed in patients with PD include pathological gambling, hypersexuality, binge eating, and compulsive shopping. Punding is a complex, prolonged, purposeless, and stereotyped behavior. The risk factors for developing such behaviors include a younger age of onset of PD and impulsive or novelty seeking characteristics. ICD may also be caused by dopamine agonists, with a higher risk associated with the dopamine D3 receptor subtype. Since behavioral disorders destroy the quality of life of patients with PD and their caregivers, early detection and appropriate management of symptoms are required. Changing or ceasing the use of dopamine agonists is recommended for improving ICD. In order to manage DDS, an improvement of “off” period is required, as well as limiting extra dosing of levodopa.
