Pathological gambling in Parkinson’s disease patients: dopaminergic medication or personality tracts fault?

Abstract

Introduction:
Impulse control disorders (ICDs) are common and clinically relevant in Parkinson disease (PD) patients, with a well established association with PD medication. However, previous studies demonstrated that ICDs are equally common in newly diagnosed, untreated PD patients and in normal population (approximately 20%). Objective: aim of our study was to detect whether the increase frequency of ICDs reported in PD patients compared to normal controls is attributable exclusively to dopaminergic medications, to personality tracts or to an interaction of both these two aspects.

Subjects and Methods:
40 Patients affected by PD according with Brain Banck Criteria were included in our study. None of them was affected by cognitive decline. Twenty patients of the studied group have had an history of pathological gambling (PG) developed after PD onset, during dopaminergic medication. The remaining 20 PD patients on the contrary had never experienced PG according to them and their caregivers reports. The two groups (PG-PD and Non PG-PD) were matched for sex, age and disease duration and severity. All subjects were tested with the Minnesota Multiphasic Inventory Personality scales (MMPI-2) that have expected high sensitivity to apparent addictive behaviors.

Results:
Our data analyzed by comparing the two groups across the numerous variables of the MMPI (Mann Whitney test) demonstrated a significant difference in PG-PD vs non PG-PD concerning depression, anxiety, social introversion and difficulty, limited compliance to rules, with an higher lying frequency (p>0.001).

Conclusions:
Accordingly with our results PG as part of ICDs seems to be secondary not only to dopaminergic medications but also to precise personality tracts. MMPI-2 may be an useful test for Pd to by utilized before adding dopaminrgic treatment, able to detect eventual personality tracts responsible for subsequent ICDs appearance.

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