Iowa Gambling Task Performance in Parkinson Disease Patients with Impulse Control Disorders.
OBJECTIVE
A subgroup of patients with Parkinson disease (PD) develops impulse control disorders (ICD) associated with their dopamine replacement therapy. Patients and their families may be reluctant to report ICD symptoms or unaware these symptoms are related to PD medication, which can make detecting an ICD difficult for clinicians. Ideally, a behavioral measure that is sensitive to ICD could be employed to ensure that patients with these behaviors are identified and treated. The Iowa Gambling Task (IGT), a standardized decision-making task, has proven sensitive in other populations with impulse control problems. We hypothesized that the IGT would differentiate between PD patients with and without ICD.


METHODS
We compared IGT performance and disease variables in 24 PD patients with ICD and 24 PD patients without ICD. Patient groups were matched in terms of age, sex, and duration of PD.


RESULTS
There were no significant differences in IGT scores between PD groups. IGT performance declined with increasing age, but the majority of patients performed within normal limits based on published age- and education-corrected normative data.


CONCLUSIONS
The IGT did not distinguish between PD patients with and without ICD. Increasing age negatively impacted performance in both groups. Other studies have found that IGT performance may decline in normal aging. Our results suggest that the IGT lacks the sensitivity and specificity needed to differentiate between age-related deficits and disruption in frontal-subcortical circuits underlying ICD associated with PD medications. Therefore, the IGT is not an appropriate behavioral measure for ICD in PD patients.
['Biars|Julia W|JW|', 'Johnson|Nicole L|NL|', 'Nespeca|Michelle|M|', 'Busch|Robyn M|RM|', 'Kubu|Cynthia S|CS|', 'Floden|Darlene P|DP|']
D016022:Case-Control Studies D003657:Decision Making D007174:Disruptive, Impulse Control, and Conduct Disorders D005260:Female D005715:Gambling D006801:Humans D008297:Male D008875:Middle Aged D009483:Neuropsychological Tests D010300:Parkinson Disease D011237:Predictive Value of Tests
Elderly/geriatrics/aging Executive functions Parkinson’s disease