Impulse Control Disorder and medication management in Patients with Early-Onset Parkinson’s Disease
Jessie Jacobson1, Khaled Ghoniem1, Aidan Mullan2, Pierpaolo Turcano1, Emanuele Camerucci3, Cole Stang1, James Bower1, Rodolfo Savica1
1Department of Neurology, 2Department of Health Sciences Research, Mayo Clinic, 3Department of Neurology, Kansas University Medical Center
Objective:
To assess the usage frequency of dopamine agonists (DA), the prevalence of impulse control disorder (ICD) in patients with Early-onset Parkinson’s Disease (EOPD), and to explore the potential factors associated with the development of ICD.  
Background:
Impulse control disorders are characterized by excessive and repetitive behaviors generally affecting patients exposed to DA. In previous studies, it has been reported that 1) there is an increased prevalence of ICD in patients with Parkinson’s disease and 2) ICD occurrence is associated with male sex and earlier disease onset. Patients with EOPD have an earlier disease onset and often face unique clinical and societal challenges. Given these factors and the scant current literature on ICD in EOPD, it is important to improve our understanding of ICD in this vulnerable population.  
Design/Methods:
We used the Mayo Data Explorer system to investigate a population-based cohort of EOPD patients between 1990 and 2022 at Mayo Clinic. We included patients with Parkinson’s disease at or before the age of 50 (according to the current Movement Disorder Society recommendations) diagnosed with ICD. All medical records were reviewed to confirm diagnosis.  
Results:
A total of 838 (518 males and 320 females) patients with EOPD were included with a mean age at symptom onset of 40.6 ± 6.7 years. DA was used in 47.4% of all patients. 24.2% of the patients using DA had ICD, and among these patients, 26% females and 23.1% males had ICD. There was no statistically significant difference in the frequency of ICD between males and females (p = 0.59). 
Conclusions:
Our study demonstrates that DA was frequently used in patients with EOPD and that about 25% of these patients are affected by ICD. Our study also showed that there was no significant difference in the prevalence of ICD development between female and male patients. 
10.1212/WNL.0000000000203838