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Predicting Impulse Control Disorders in Parkinson Disease through Incentive Biomarkers

医学 内科学 危险系数 置信区间 前瞻性队列研究 帕金森病 队列 队列研究 冲动性 疾病 精神科
作者
Juan Marín‐Lahoz,Saül Martínez‐Horta,Javier Pagonabarraga,Andrea Horta‐Barba,Ignacio Aracil‐Bolaños,Helena Bejr‐Kasem,Frederic Sampedro,Antònia Campolongo,Jaime Kulisevsky
出处
期刊:Annals of Neurology [Wiley]
卷期号:92 (6): 974-984 被引量:8
标识
DOI:10.1002/ana.26486
摘要

This study was undertaken to evaluate whether the feedback-related negativity (FRN)-a neurophysiological marker of incentive processing-can be used to predict the development of impulse control disorders (ICDs) in Parkinson disease (PD).The longitudinal cohort consisted of consecutive nondemented PD patients with no ICD history. We recorded FRN signals while they performed a gambling task. We calculated the mean amplitude difference between losses and gains (FRNdiff) to be used as a predictor of future ICD development. We performed prospective biannual follow-up assessments for 30 months to detect incident ICDs. Finally, we evaluated how basal FRNdiff was associated with posterior development of ICDs using survival models.Between October 7, 2015 and December 16, 2016, we screened 120 patients. Among them, 94 patients performed the gambling and 92 completed the follow-up. Eighteen patients developed ICDs during follow-up, whereas 74 remained free of ICDs. Baseline FRNdiff was greater in patients who developed ICDs than in those who did not (-2.33μV vs -0.84μV, p = 0.001). No other significant baseline differences were found. The FRNdiff was significantly associated with ICD development in the survival models both when not adjusted (hazard ratio [HR] = 0.73, 95% confidence interval [CI] = 0.58-0.91, p = 0.006) and when controlling for dopamine replacement therapy, sex, and age (HR = 0.74, 95% CI = 0.55-0.97, p = 0.035). None of the impulsivity measures evaluated was related to ICD development.Reward-processing differences measured by FRN signals precede ICD development in PD. This neurophysiological marker permits identification of patients with high risk of ICD development. ANN NEUROL 2022;92:974-984.
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