Neurobiology of Impulse Control Disorders in Parkinson's Disease

Impulse control disorders (ICDs) are a diverse group of behavioral pathologies characterized by a loss of voluntary control over impulses and drives that result in repetitive, self-destructive behavior. A number of ICDs have been reported in the setting of Parkinson's disease, particularly in patients treated with dopaminergic agents. These include hypersexuality, compulsive shopping, compulsive eating, and pathologic gambling. The phenomenon appears to be primarily a class effect of the dopamine agonists and seems to be linked to abnormalities of the dopamine neurotransmitter system. These dopaminergic abnormalities have been implicated in most of the disordered cognitive and behavioral domains that are a feature of both the addictions and the ICDs.