Risk factors for impulse control disorders and related behaviors in Parkinson’s disease: secondary analyses of the ICARUS study

Figures & data

Table 1. Definition of year 1 incidence and cumulative 2-year incidence.

Year 1 incidence
Baseline	Year 1
–	+
Cumulative 2-year incidence
Baseline	Year 1	Year 2
–	–	+
–	+	–
–	+	+

Abbreviations. ICD, impulse control disorder; –, ICD-negative; +, ICD-positive.

Table 2. Definition of shift in ICD status at year 1 versus baseline and year 2 versus year 1 or baseline.

ICD status at year 1
Baseline	Year 1	Comparison: Year 1 vs. baseline
–	+	New case
+	–	Remitter
–	–	Negative unchanged
+	+	Positive unchanged
ICD status at year 2
Baseline	Year 1	Year 2	Comparison: year 2 vs. year 1	Comparison: year 2 vs. baseline
–	–	+	New case	New case
–	+	–	Remitter	Negative unchanged
–	+	+	Positive unchanged	New case
–	–	–	Negative unchanged	Negative unchanged
+	+	–	Remitter	Remitter
+	–	+	New case	Positive unchanged
+	–	–	Negative unchanged	Remitter
+	+	+	Positive unchanged	Positive unchanged

Abbreviations. ICD, impulse control disorder; –, ICD-negative; +, ICD-positive.

Table 3. Baseline characteristics of patients negative for ICD at baseline according to subsequent ICD status at either post-baseline visit (FAS).

	ICD after baseline	No ICD after baseline
Patients	N = 147 (22%)	N = 521 (78%)
Males	71.4%	58.0%
Age (years)	64.3 (9.1)	67.1 (9.2)
BMI (kg/m^2)	26.4 (3.8)	25.7 (3.5)
Female
Age (years)	65.6 (9.7)	66.8 (9.6)
BMI (kg/m^2)	25.5 (4.1)	25.4 (4.0)
Male
Age (years)	63.8 (8.9)	67.3 (9.0)
BMI (kg/m^2)	26.8 (3.6)	26.0 (3.1)
Age at PD onset (years)	57.6 (10.5)	61.8 (10.2)
Age at PD symptom onset (years)	56.8 (11.0)^a	60.8 (10.5)^b
Duration of PD (years)	6.7 (5.7)	5.3 (4.4)
Side of PD onset
Right	51.7%	56.6%
Left	48.3%	42.6%
Not specified	0%	0.8%
PD symptom severity
Hoehn & Yahr	2.0 (0.6)	1.9 (0.6)
PD-NMSS	29.9 (25.3)	31.5 (31.1)
PDSS-2	13.9 (9.9)	11.3 (8.4)^c
PDQ-8	22.4 (15.4)	19.9 (15.6)
BDI-II	10.0 (7.5)^d	8.8 (7.4)^e
MMSE	28.6 (1.5)	28.6 (1.6)
PD-CRS	82.0 (19.3)	81.3 (19.2)^f
FAB	14.9 (3.1)	15.0 (2.8)
Region of Italy
North West	24.5%	22.5%
North East	18.4%	14.0%
Center	22.4%	29.4%
South	23.1%	17.1%
Islands	11.6%	17.1%
Discontinuation, n
Use of excluded drugs	1	0
Lost to follow-up	6	0
Other	3	1
Smoker	14.3%	8.1%
Alcohol consumption
No alcohol	42.9%	46.3%
Occasional consumption	43.5%	40.5%
Regular consumption	13.6%	13.2%
Education
No/incomplete	2.7%	2.9%
University degree	16.3%	13.2%
Marital status
Married	82.3%	82.9%
Unmarried	3.4%	3.5%
Widow	6.8%	10.2%
Other	7.5%	3.5%
Employment
Retired	65.3%	67.9%
Housewife	6.1%	10.6%
Unemployed	1.4%	1.3%
Other^g	27.2%	20.2%

Abbreviations. ICD, impulsive control disorder; FAS, full analysis set; BMI, body mass index; PD, Parkinson’s disease; MMSE, Mini-Mental State Examination; PD-NMSS, Parkinson’s Disease Non-Motor Symptom Scale; PDSS-2, Parkinson’s Disease Sleep Scale-2; PD-CRS, Parkinson’s Disease-Cognition Rating Scale; PDQ-8, Parkinson’s Disease Questionnaire-8 item short form; BDI-II, Beck Depression Inventory-II; FAB, Frontal Assessment Battery.

Data are mean (SD) unless otherwise specified.

^a n = 143; ^bn = 515; ^cn = 520; ^dn = 145; ^en = 517; ^fn = 516; ^gIncludes freelancer, teacher, clerk, workman, trader, craftsman, and other; for the “no ICD after baseline” group, this category also includes manager and farmer.

Figure 1. ICD status (“new cases” and “remitters”) by modified MIDI, (A) overall ICD behaviors and (B) ICD behavior subtypes (FAS). Abbreviations. ICD, impulsive control disorder; MIDI, Minnesota Impulsive Disorders Interview; PD, Parkinson’s disease.

Figure 2. ICD status (“new cases” and “remitters”) by: (A) gender, (B) age at baseline, (C) age at PD onset, (D) PD duration at baseline, and (E) disease status according to PD treatment at baseline. Abbreviations. BL, baseline; ICD, impulsive control disorder; MIDI, Minnesota Impulsive Disorders Interview; PD, Parkinson’s disease; Y, year.

Table 4. ICD subtype status (“new cases” and “remitters”) at post-baseline visits by demographic and clinical features at baseline (FAS).

		Buying disorder		Compulsive gambling		Compulsive sexual behavior		Compulsive eating		Punding behavior
	N	New cases	Remitters	New cases	Remitters	New cases	Remitters	New cases	Remitters	New cases	Remitters
Year 1 vs. baseline
Gender
Males	639	19 (3.0%)	18 (2.8%)	14 (2.2%)	23 (3.6%)	34 (5.3%)	34 (5.3%)	39 (6.1%)	29 (4.5%)	27 (4.2%)	31 (4.9%)
Females	356	4 (1.1%)	7 (2.0%)	7 (2.0%)	11 (3.1%)	3 (0.8%)	4 (1.1%)	20 (5.6%)	21 (5.9%)	9 (2.5%)	12 (3.4%)
Age at baseline
≤70 years	688	19 (2.8%)	21 (3.1%)	19 (2.8%)	28 (4.1%)	33 (4.8%)	29 (4.2%)	44 (6.4%)	37 (5.4%)	26 (3.8%)	37 (5.4%)
>70 years	307	4 (1.3%)	4 (1.3%)	2 (0.7%)	6 (2.0%)	4 (1.3%)	9 (2.9%)	15 (4.9%)	13 (4.2%)	10 (3.3%)	6 (2.0%)
Age at PD onset
≤60 years	484	14 (2.9%)	18 (3.7%)	11 (2.3%)	27 (5.6%)	21 (4.3%)	17 (3.5%)	34 (7.0%)	28 (5.8%)	20 (4.1%)	26 (5.4%)
>60 years	511	9 (1.8%)	7 (1.4%)	10 (2.0%)	7 (1.4%)	16 (3.1%)	21 (4.1%)	25 (4.9%)	22 (4.3%)	16 (3.1%)	17 (3.3%)
PD duration
≤6 years	650	12 (1.8%)	13 (2.0%)	12 (1.8%)	13 (2.0%)	19 (2.9%)	24 (3.7%)	34 (5.2%)	27 (4.2%)	19 (2.9%)	29 (4.5%)
>6 years	345	11 (3.2%)	12 (3.5%)	9 (2.6%)	21 (6.1%)	18 (5.2%)	14 (4.1%)	25 (7.2%)	23 (6.7%)	17 (4.9%)	14 (4.1%)
Disease status (PD treatment)
Stable, optimal treatment	625	13 (2.1%)	15 (2.4%)	11 (1.8%)	15 (2.4%)	24 (3.8%)	21 (3.4%)	26 (4.2%)	27 (4.3%)	21 (3.4%)	25 (4.0%)
Stable, suboptimal treatment	223	5 (2.2%)	5 (2.2%)	6 (2.7%)	11 (4.9%)	6 (2.7%)	13 (5.8%)	23 (10.3%)	10 (4.5%)	6 (2.7%)	8 (3.6%)
Complicated	147	5 (3.4%)	5 (3.4%)	4 (2.7%)	8 (5.4%)	7 (4.8%)	4 (2.7%)	10 (6.8%)	13 (8.8%)	9 (6.1%)	10 (6.8%)
Year 2 vs. year 1
Gender
Males	588	20 (3.4%)	11 (1.9%)	21 (3.6%)	13 (2.2%)	28 (4.8%)	35 (6.0%)	40 (6.8%)	31 (5.3%)	22 (3.7%)	27 (4.6%)
Females	331	6 (1.8%)	6 (1.8%)	1 (0.3%)	7 (2.1%)	3 (0.9%)	3 (0.9%)	9 (2.7%)	24 (7.3%)	10 (3.0%)	10 (3.0%)
Age at baseline
≤70 years	641	24 (3.7%)	15 (2.3%)	20 (3.1%)	17 (2.7%)	23 (3.6%)	33 (5.1%)	40 (6.2%)	43 (6.7%)	25 (3.9%)	30 (4.7%)
>70 years	278	2 (0.7%)	2 (0.7%)	2 (0.7%)	3 (1.1%)	8 (2.9%)	5 (1.8%)	9 (3.2%)	12 (4.3%)	7 (2.5%)	7 (2.5%)
Age at PD onset
≤60 years	449	19 (4.2%)	13 (2.9%)	16 (3.6%)	8 (1.8%)	18 (4.0%)	23 (5.1%)	35 (7.8%)	31 (6.9%)	18 (4.0%)	19 (4.2%)
>60 years	470	7 (1.5%)	4 (0.9%)	6 (1.3%)	12 (2.6%)	13 (2.8%)	15 (3.2%)	14 (3.0%)	24 (5.1%)	14 (3.0%)	18 (3.8%)
PD duration
≤6 years	607	13 (2.1%)	9 (1.5%)	13 (2.1%)	12 (2.0%)	19 (3.1%)	20 (3.3%)	30 (4.9%)	28 (4.6%)	19 (3.1%)	19 (3.1%)
>6 years	312	13 (4.2%)	8 (2.6%)	9 (2.9%)	8 (2.6%)	12 (3.8%)	18 (5.8%)	19 (6.1%)	27 (8.7%)	13 (4.2%)	18 (5.8%)
Disease status (PD treatment)
Stable, optimal treatment	588	13 (2.2%)	9 (1.5%)	15 (2.6%)	13 (2.2%)	21 (3.6%)	22 (3.7%)	25 (4.3%)	27 (4.6%)	18 (3.1%)	23 (3.9%)
Stable, suboptimal treatment	200	8 (4.0%)	5 (2.5%)	6 (3.0%)	4 (2.0%)	7 (3.5%)	10 (5.0%)	12 (6.0%)	22 (11.0%)	9 (4.5%)	9 (4.5%)
Complicated	131	5 (3.8%)	3 (2.3%)	1 (0.8%)	3 (2.3%)	3 (2.3%)	6 (4.6%)	12 (9.2%)	6 (4.6%)	5 (3.8%)	5 (3.8%)
Year 2 vs. baseline
Gender
Males	593	24 (4.0%)	18 (3.0%)	19 (3.2%)	21 (3.5%)	30 (5.1%)	38 (6.4%)	50 (8.4%)	35 (5.9%)	29 (4.9%)	36 (6.1%)
Females	332	8 (2.4%)	11 (3.3%)	3 (0.9%)	12 (3.6%)	4 (1.2%)	4 (1.2%)	13 (3.9%)	28 (8.4%)	14 (4.2%)	16 (4.8%)
Age at baseline
≤70 years	647	29 (4.5%)	25 (3.9%)	20 (3.1%)	26 (4.0%)	28 (4.3%)	33 (5.1%)	49 (7.6%)	50 (7.7%)	31 (4.8%)	45 (7.0%)
>70 years	278	3 (1.1%)	4 (1.4%)	2 (0.7%)	7 (2.5%)	6 (2.2%)	9 (3.2%)	14 (5.0%)	13 (4.7%)	12 (4.3%)	7 (2.5%)
Age at PD onset
≤60 years	453	22 (4.9%)	21 (4.6%)	16 (3.5%)	25 (5.5%)	21 (4.6%)	22 (4.9%)	43 (9.5%)	40 (8.8%)	23 (5.1%)	30 (6.6%)
>60 years	472	10 (2.1%)	8 (1.7%)	6 (1.3%)	8 (1.7%)	13 (2.8%)	20 (4.2%)	20 (4.2%)	23 (4.9%)	20 (4.2%)	22 (4.7%)
PD duration
≤6 years	609	18 (3.0%)	16 (2.6%)	14 (2.3%)	13 (2.1%)	22 (3.6%)	24 (3.9%)	40 (6.6%)	32 (5.3%)	26 (4.3%)	33 (5.4%)
>6 years	316	14 (4.4%)	13 (4.1%)	8 (2.5%)	20 (6.3%)	12 (3.8%)	18 (5.7%)	23 (7.3%)	31 (9.8%)	17 (5.4%)	19 (6.0%)
Disease status (PD treatment)
Stable, optimal treatment	589	17 (2.9%)	16 (2.7%)	13 (2.2%)	16 (2.7%)	26 (4.4%)	25 (4.2%)	33 (5.6%)	35 (5.9%)	24 (4.1%)	33 (5.6%)
Stable, suboptimal treatment	203	10 (4.9%)	8 (3.9%)	7 (3.4%)	9 (4.4%)	5 (2.5%)	13 (6.4%)	18 (8.9%)	16 (7.9%)	11 (5.4%)	11 (5.4%)
Complicated	133	5 (3.8%)	5 (3.8%)	2 (1.5%)	8 (6.0%)	3 (2.3%)	4 (3.0%)	12 (9.0%)	12 (9.0%)	8 (6.0%)	8 (6.0%)

Abbreviations. ICDL, impulsive control disorder; FAS, full analysis set; PD, Parkinson’s disease.

The gray fields = difference of ≥2% between “new cases” and “remitters”.