Impulse Control Disorders in Parkinson's Disease: Has COVID-19 Related Lockdown Been a Trigger?

Background: Parkinson's disease (PD) patients, especially those on dopamine agonists (DA), are at risk of impulse control disorders (ICD). Little attention has been paid to the influence of environmental factors.

Cases: Retrospective analysis of consecutive PD patients seen in our outpatient Movement Disorders Clinic during 2 months (September-November 2020) to explore the frequency of ICD during the preceding 2-month lockdown period, and comparison with an equivalent control group (September-November 2019). Among 114 patients assessed, 15 (13%) presented ICD during the lockdown, versus 6 (4.5%, P 0.02) in the control group. When analyzing only patients on DA, ICD occurrence increased to 31% (vs. 9.6% pre-lockdown, P 0.026). ICD during lockdown required drug regime adjustment in 80% (vs. 16.7% pre-lockdown, P 0.014).

Conclusion: During COVID-19 lockdown, the occurrence of ICD in PD patients taking DA was higher than expected, and with increased severity. Environmental stressors may play a role in ICD presentation in vulnerable patients.