Ignite Creation Date:
2024-05-06 @ 8:11 PM
Last Modification Date:
2024-10-26 @ 3:22 PM
Study NCT ID:
NCT06289855
Status:
NOT_YET_RECRUITING
Last Update Posted:
2024-03-08
First Post:
2024-02-26
Brief Title:
Impulse Control Disorder Among Parkinsons Disease Patients
Sponsor:
Assiut University
Organization:
Assiut University
Study Overview
Official Title:
Impulse Control Disorder Among Parkinsons Disease Patients Clinical and Neurophysiological Study
Status:
NOT_YET_RECRUITING
Status Verified Date:
2024-03
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
The goal of this observational study is to learn about impulse control disorders in Parkinsons disease patients
The main question it aims to answer
Detect Relative frequency of impulse control disorder among Parkinsons disease patients
Detect Relation between impulse control disorders and other non motor and motor symptoms in Parkinsons disease patients using clinical neurophysiological and radiological assessment
The main question it aims to answer
Detect Relative frequency of impulse control disorder among Parkinsons disease patients
Detect Relation between impulse control disorders and other non motor and motor symptoms in Parkinsons disease patients using clinical neurophysiological and radiological assessment
Detailed Description:
Parkinson disease PD is a multisystem disease with motor and non-motor NM deficits Dementia and mild forms of cognitive impairment as well as neuropsychiatric symptoms ie impulse control disorders are frequent and disabling non-motor symptoms of Parkinsons disease PD According to the fifth edition of the American Psychiatric Associations Diagnostic and Statistical Manual DSM-5 impulse control disorders are defined as disruptive impulse-control while conduct disorders include conditions involving problems in the self-control of emotions and behaviors
Many studies have highlighted potential risk factors for these behaviors including the fact that that ICDs are associated with younger age male sex and younger age at disease onset Also these behaviors have been consistently linked to the use of dopaminergic medications used to treat Parkinsons disease motor symptoms dopamine agonists levodopa and other agents and less consistently to neuro-modulation techniques such as deep brain stimulation DBS
Up to 14-17 of patients with Parkinsons disease display a set of impulsive-compulsive spectrum disorders during the course of illness Once uncontrolled behaviors develop either patients fail understand or recognize the severity of their actions or hide them in shame with devastating social and financial results for themselves and their families
Previous neuropsychological studies have also demonstrated that impulse control disorders in Parkinsons disease are associated with an altered cognitive profile characterized by impaired cognitive flexibility and planning capability as well as by more inappropriate behavior and poor feedback processes Also Cognitive impairment and dementia in particular are associated with adverse outcomes including gait impairment and falls greater disability and caregiver burden higher economic costs and increased mortality
Motor deficits have been repeatedly associated with changes in the activity of the motor cortex in patients with Parkinsons disease A key regulator of cortical motor output is the balance between excitation and inhibition which can be assessed in humans with transcranial magnetic stimulation TMS techniques
A common measure to explore inhibitory mechanisms is the short-interval intracortical inhibition SICI induced by paired-pulse TMS stimuli Several studies have described reduced SICI ie less inhibition in the motor cortex of patients with Parkinsons disease
The development of neuroimaging techniques including Voxel-based morphometry VBM which is an automated quantitative magnetic resonance imaging MRI technique extensively used to assess the grey matter GM morphology changes in the brain and has been widely used in Parkinsons disease The majority of the studies focused on grey matter GM changes in Parkinsons disease associated with motor and non-motor symptoms
Reduced cortical thickness of fronto-striatal regions has been reported as the key feature to differentiate Parkinsons disease with impulse control disorders from Parkinsons disease without impulse control disorders patients but a concomitant increased amygdala volume and a positive relationship between impulse control disorders severity and middle frontal and parietal cortical volumes have been also shown In addition two studies showed an increased cortical thickness in meso-limbic regions and another one reported a relatively preserved grey matter in Parkinsons disease with impulse control disorders patients compared with Parkinsons disease without impulse control disorders cases Also studies showed that changes in grey matter volume are associated with lack of inhibition related to impulse control disorders behaviors in Parkinsons disease
Therefore impulse control disorder is becoming an increasingly recognized psychiatric complication in Parkinsons disease and whether or not its associated with cortical dysfunction and further cognitive and gait and balance affection need further clinical neurophysiological and radiological analysis to further understand the underlying mechanism
Many studies have highlighted potential risk factors for these behaviors including the fact that that ICDs are associated with younger age male sex and younger age at disease onset Also these behaviors have been consistently linked to the use of dopaminergic medications used to treat Parkinsons disease motor symptoms dopamine agonists levodopa and other agents and less consistently to neuro-modulation techniques such as deep brain stimulation DBS
Up to 14-17 of patients with Parkinsons disease display a set of impulsive-compulsive spectrum disorders during the course of illness Once uncontrolled behaviors develop either patients fail understand or recognize the severity of their actions or hide them in shame with devastating social and financial results for themselves and their families
Previous neuropsychological studies have also demonstrated that impulse control disorders in Parkinsons disease are associated with an altered cognitive profile characterized by impaired cognitive flexibility and planning capability as well as by more inappropriate behavior and poor feedback processes Also Cognitive impairment and dementia in particular are associated with adverse outcomes including gait impairment and falls greater disability and caregiver burden higher economic costs and increased mortality
Motor deficits have been repeatedly associated with changes in the activity of the motor cortex in patients with Parkinsons disease A key regulator of cortical motor output is the balance between excitation and inhibition which can be assessed in humans with transcranial magnetic stimulation TMS techniques
A common measure to explore inhibitory mechanisms is the short-interval intracortical inhibition SICI induced by paired-pulse TMS stimuli Several studies have described reduced SICI ie less inhibition in the motor cortex of patients with Parkinsons disease
The development of neuroimaging techniques including Voxel-based morphometry VBM which is an automated quantitative magnetic resonance imaging MRI technique extensively used to assess the grey matter GM morphology changes in the brain and has been widely used in Parkinsons disease The majority of the studies focused on grey matter GM changes in Parkinsons disease associated with motor and non-motor symptoms
Reduced cortical thickness of fronto-striatal regions has been reported as the key feature to differentiate Parkinsons disease with impulse control disorders from Parkinsons disease without impulse control disorders patients but a concomitant increased amygdala volume and a positive relationship between impulse control disorders severity and middle frontal and parietal cortical volumes have been also shown In addition two studies showed an increased cortical thickness in meso-limbic regions and another one reported a relatively preserved grey matter in Parkinsons disease with impulse control disorders patients compared with Parkinsons disease without impulse control disorders cases Also studies showed that changes in grey matter volume are associated with lack of inhibition related to impulse control disorders behaviors in Parkinsons disease
Therefore impulse control disorder is becoming an increasingly recognized psychiatric complication in Parkinsons disease and whether or not its associated with cortical dysfunction and further cognitive and gait and balance affection need further clinical neurophysiological and radiological analysis to further understand the underlying mechanism
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None