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Parkinson's disease (PD) is a progressive neurodegenerative disorder primarily characterized by motor and cognitive symptoms. However, emerging evidence suggests that personality alterations may also be present, potentially affecting patients' quality of life and clinical outcomes. Prior studies have identified patterns such as lower openness and extraversion and higher neuroticism in PD patients, although findings have been inconsistent. This study aimed to investigate the structural organization of personality in PD using a network-based approach, and to examine the influence of age, sex, disease duration, and impulsive-compulsive symptoms on personality traits. A total of 237 PD patients (aged 45-86) completed the HEXACO Adjective Scale (HAS), assessing six personality traits: Honesty-Humility (H), Emotionality (E), Extraversion (X), Agreeableness (A), Conscientiousness (C), and Openness (O). Impulsive-compulsive behaviors were assessed using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS). Personality structure was analyzed Exploratory Graph Analysis (EGA), a network model that identifies item clusters based on conditional dependencies. Multivariate multiple linear regression was used to test the effects of demographic and clinical variables on trait expression. EGA identified seven item-level communities. Traits E, X, and C formed coherent and distinct clusters, while items from A and H tended to cluster based on item polarity (positive negative wording) rather than theoretical trait boundaries. O items split into two distinct communities, one composed of the items from the facet, and the other encompassing the remaining O items. At the trait level, HEXACO dimensions grouped into two higher-order clusters: a Cooperativity-Integrity community (H, A, C) and an Engagement community (E, X, O). Regression analyses showed that higher ICD symptoms predicted lower levels of H, A, and C; longer disease duration was associated with lower C, and sex showed significant differences in E. These findings reveal subtle but systematic alterations in the structural organization of personality traits in PD. Specifically, we observed a polarity-based overlap between H and A, possibly reflecting age-related convergence of the two traits-consistent with a recent study reporting similar effects in healthy aging-and a bifurcation within O centered on the Unconventionality facet, a trait often considered idiopathic in PD, even in its prodromal stages. These personality signatures may contribute to a refined clinical profiling of PD patients and support the value of incorporating personality assessment into personalized care approaches.

Background and Objectives: Impulse Control Disorders (ICDs) including pathological gambling, hypersexuality, compulsive eating, compulsive buying, and other related behaviors are well-known distinct non-motor symptoms in Parkinson’s Disease (PD). Some large-scale studies present a prevalence of at least 10%, however, there are other reports providing much higher rates. The majority of the conducted studies investigating ICDs focus mainly on pharmacological factors, however, from a psychological perspective, there is yet enough room for investigation. In order to address the above issues, we designed a two-part study. Materials and Methods: First, we aimed to identify the incidence of ICD and related behaviors in a cohort of 892 Greek PD patients. Second, we administered a comprehensive battery of psychometric tools to assess psychological factors such as personality dimensions, quality of life, defenses, coherence, and resilience as well as to screen general cognitive capacity in PD patients with ICD manifestations. Results: With regard to the first part, we identified ICD manifestations in 12.4% of the patients. Preliminary findings from the second part indicate elevated activity, rather than impulsivity, as well as interrelations between several variables, including measures of activity, coping mechanisms, and quality of life. Conclusions: We present a working hypothesis for the contribution of high activity channeled to specific behavioral patterns through specific coping mechanisms, concerning the emergence of ICDs and related behaviors in PD, and further stress the importance of compulsivity rather than impulsivity in this process.

Background: Frontal lobe circuit dysfunction, including the mesolimbic network, plays an important role in learning reward behaviors and is involved in the development of impulsive compulsive disorders (ICDs) in Parkinson’s disease (PD). ICDs in PD are characterized by disinhibited, reward-driven behaviors performed with poor impulse control, often linked to dopaminergic treatment. The purpose of the present study was to assess the presence of these behaviors in relation to frontal dysfunction and overall cognitive status in a cohort of patients with sporadic PD. Methods: The study consisted of 55 patients (n = 55), 36 males (65.5%), diagnosed with Parkinson’s disease, assessed at the First Neurological Clinic of Eginition University Hospital in Athens. The participants had a mean age of 62.6 (±13.54) years, with an average of 11.94 (±3.00) years of education and a mean disease duration of 7.17 (±5.90) years. The evaluation tools used to assess the participants were the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease (QUIP), Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB), and Geriatric Depression Scale (GDS). Results: The mean score on the QUIP was 0.64 (±1.05), with a threshold of 1. Of the total number of patients (n = 55), 18 (32.72%) showed behaviors related to ICDs. The most commonly reported impulsive compulsive behavior was an excessive preoccupation with hobbies (n = 7, 38.9%), followed by a tendency toward gambling (n = 6, 33.3%). The mean score on the MoCA scale was 24.69/30 (±4.25), while the mean score on the FAB scale was 14.70/18 (±2.45). Pearson’s correlation analysis revealed a moderate positive correlation between total MoCA score and FAB (r = 0.588, p < 0.000) and a weak to moderate negative correlation between MoCA score and QUIP (r = −0.291, p = 0.038). Additionally, there was a statistically significant negative correlation between QUIP scores and performance on the MoCA attention subtests (Forward Digit Span, Backward Digit Span, and Vigilance tasks), (r = −0.389, p = 0.009). Conclusions: Lower global cognitive function, as measured by the MoCA, was strongly associated with reduced frontal lobe function, as measured by the FAB, in Parkinson’s patients. Additionally, lower scores on the MoCA, particularly in the attention subtests, showed a weak to moderate correlation with increased impulsive compulsive behaviors, as measured by the QUIP.

Dopaminergic medications administered to remedy motor symptoms in Parkinson's disease are associated with an enhanced risk for impulse control disorders (ICD) and related compulsive behaviors (ICD-RB). Thus, the present study focuses on investigating the gender difference in the prevalence of ICD-RBs in Indian PD patients on dopamine replacement therapy (DRT), its impact on quality of life and to identify ICDs relevant in Indian scenario apart from the criteria set in QUIP-RS. This was a hospital-based observational cross-sectional study in which Parkinson's disease patients attending neurology clinic were included. Complete details of anti-parkinsonian therapy along with demographic and clinical variables were recorded on a predesigned Performa. Questionnaire for Impulsive-Compulsive Disorders in Parkinson's disease (QUIP), which is a validated quick screening tool, was used to detect ICD-RBs. The relative frequency and comparative impact of ICD on health-related quality of life (QOL) was studied using validated PDQ-39 Questionnaire. Out of 102 patients, at least one ICD or ICD-RB was present in 41.19% and ≥2 ICD-RBs were present in 15.59%. At least one ICD was present in 16.67%, any ICD-related compulsive behaviors was present in 34.31% patients. The most common was punding and compulsive medication use (12.75% each), followed by hobbyism (7.84%), compulsive eating (6.86%), pathological gambling (3.92%), and hypersexuality, walkabout, and compulsive shopping (2.94% each). ICDs not classified elsewhere such as trichotillomania were found 3 patients (2.94%). ICD-RBs showed a trend to be more frequent in women (44.82% women vs. 39.39% men). As compared with patients without ICD-RBs, those with ICD-RBs were found to have higher dose of LD and DA and higher Hoehn and Yahr stage. ICD-RBs have a negative impact on the quality of life of Parkinson's disease patients. ICDs and ICD-RBs have been included in the behavioral spectrum of nonmotor symptoms in PD. PD patients are at increased risk of developing ICD-RBs which interfere with important activities and have obligation in ordinary life, leading to legal and psychological consequences with a great impact on QOL.

The aims of the current study were to explore the relationship between compulsive buying (CB) and impulsivity, and to investigate the proposal that emotion regulation deficits and mindful attentional awareness may also play a role in maladaptive buying behaviours. In a community-recruited sample of 49 compulsive buyers with a mean age of 29.02 (SD = 11.24) and 37 healthy controls with a mean age of 25.61 (SD = 7.38) CB was significantly related to several domains of impulsivity and emotion regulation deficits. Furthermore, CB was associated with less dispositional mindful attentional focus, which was in turn associated with specific emotion regulation deficits. Multivariate analysis of variance (MANCOVA) controlling for general psychopathology supported significant group differences in all outcome measures, with the exception of difficulties engaging in goal-directed behaviour. Taken together, the findings suggest that CB is characterized by impulsivity, but that emotional vulnerabilities and poor regulatory processes may also play a role in either the development or maintenance of CB. Limitations and future directions are discussed.

Impulsive–compulsive and related behavioral disorders (ICD) are drug-induced non-motor symptoms of Parkinson’s disease (PD). Recently research has focused on evaluating whether ICD could be predicted and managed using a pharmacogenetic approach based on dopaminergic therapies, which are the main risk factors. The aim of our study was to evaluate the role of candidate genes such as DBH, DRD2, MAOA, BDNF, COMT, SLC6A4, SLC6A3, ACE, DRD1 gene polymorphisms in the pathogenesis of ICD in PD. We compared patients with PD and ICD (n = 49), patients with PD without ICD (n = 36) and a healthy control group (n = 365). ICD was diagnosed using the QUIP questionnaires and specific diagnostic criteria for subtypes of ICD. Genotyping was conducted using a number of PCR techniques and SNaPshot. Statistical analysis was performed using WinPepi and APSampler v3.6 software. PCA testing was conducted using RStudio software v1.4.1106-5. The following substitutions showed statistically significant correlations with PD and ICD: DBH (rs2097629, rs1611115), DRD2 (rs6275, rs12364283, rs1076560), ACE (rs4646994), DRD1 (rs686), BDNF (rs6265), these associations are novel in Russian PD patients. Our findings suggest that polymorphisms in DBH, BDNF, DRD2, ACE genes in Russian subjects are associated with an increased risk of ICD development.

Rationale Impulsive-compulsive disorders (ICD) in patients with Parkinson’s disease (PD) have been described as behavioral or substance addictions including hypersexuality, gambling, or compulsive medication use of the dopamine replacement therapy (DRT). Objectives A remaining challenge is to understand the neuroadaptations leading to reward bias in PD patients under DRT. Methods To this end, the appetitive effect of the D2/D3 agonist pramipexole was assessed after chronic exposure to l -dopa in an alpha-synuclein PD rat model. Results Association of progressive nigral loss and chronic l -dopa was required to observe a pramipexole-induced place preference. This behavioral outcome was inhibited by metabotropic glutamate receptor 5 (mGluR5) antagonism while transcriptional profiling highlighted regulations potentially related to the context of psychostimulant addiction. Conclusion This study provides evidences strongly suggesting that PD-like lesion and l -dopa therapy were concomitant factors involved in striatal remodeling underlying the pramipexole-induced place preference. Molecular and pharmacological data suggest a key involvement of the glutamatergic pathway in this behavioral outcome.

Background: Dopaminergic medications administered to remedy motor symptoms in Parkinson's disease are associated with an enhanced risk for impulse control disorders (ICD) and related compulsive behaviors (ICD-RB). Thus, the present study focuses on investigating the gender difference in the prevalence of ICD-RBs in Indian PD patients on dopamine replacement therapy (DRT), its impact on quality of life and to identify ICDs relevant in Indian scenario apart from the criteria set in QUIP-RS. Method: This was a hospital-based observational cross-sectional study in which Parkinson's disease patients attending neurology clinic were included. Complete details of anti-parkinsonian therapy along with demographic and clinical variables were recorded on a predesigned Performa. Questionnaire for Impulsive-Compulsive Disorders in Parkinson's disease (QUIP), which is a validated quick screening tool, was used to detect ICD-RBs. The relative frequency and comparative impact of ICD on health-related quality of life (QOL) was studied using validated PDQ-39 Questionnaire. Results: Out of 102 patients, at least one ICD or ICD-RB was present in 41.19% and ≥2 ICD-RBs were present in 15.59%. At least one ICD was present in 16.67%, any ICD-related compulsive behaviors was present in 34.31% patients. The most common was punding and compulsive medication use (12.75% each), followed by hobbyism (7.84%), compulsive eating (6.86%), pathological gambling (3.92%), and hypersexuality, walkabout, and compulsive shopping (2.94% each). ICDs not classified elsewhere such as trichotillomania were found 3 patients (2.94%). ICD-RBs showed a trend to be more frequent in women (44.82% women vs. 39.39% men). As compared with patients without ICD-RBs, those with ICD-RBs were found to have higher dose of LD and DA and higher Hoehn and Yahr stage. ICD-RBs have a negative impact on the quality of life of Parkinson's disease patients. Conclusion: ICDs and ICD-RBs have been included in the behavioral spectrum of nonmotor symptoms in PD. PD patients are at increased risk of developing ICD-RBs which interfere with important activities and have obligation in ordinary life, leading to legal and psychological consequences with a great impact on QOL.

The aim of the study was to assess the extent of fur chewing problems on chinchilla farms. The research was based on a 20-question survey addressed to breeders. A total of 47 anonymous questionnaires were answered. Results showed that the problem of fur chewing was found in as many as 85% of the farms but the proportion of affected animals was usually low (mean±SE: 3.5±0.55%). To determine the relationship between herd size and the extent of the problem, the Pearson’s correlation coefficient was calculated to be r = -0.315 (P≤0.05), possibly indicating the problem to be more severe on smaller farms. No correlation was found between fur chewing and the type of fodder (pellets from different producers), temperature, humidity, type of cage equipment or frequency of dust baths. Moreover, the level of fur-biting animals kept on a deep-litter floor was estimated at 1.7% while the level of those kept on a wire floor and in a mixed system was 2.8-times higher (P≤0.05). The fact that 37.5% of the respondents perceived the predisposition to fur chewing to be hereditary was an important observation suggesting a direction for further research. A considerable proportion of those surveyed (37.5%) also pointed to a greater excitability among fur chewers. To sum up, results of the present study revealed that keeping animals on litter reduces the incidence of fur chewing. Breeders’ observations also suggest that fur biting may be determined genetically and/or connected with impulsive-compulsive disorders; however, more detailed studies are necessary to confirm these hypotheses.

In Parkinson’s disease (PD), there is increasing evidence for disorders in the impulsive-compulsive spectrum, related to the disease itself, to the pharmacological management of this disease or to both. These disorders comprise dopamine deficiency syndrome (with immediate reward seeking behaviour), dopamine dependency syndrome (with addictive behaviour), dopamine dysregulation syndrome (with both addictive behaviour and stereotyped behaviour) and impulse control disorders (such as pathological gambling, compulsive shopping, binge eating and hypersexuality). These disorders are especially seen in PD patients with young age of onset, higher doses of antiparkinsonian drugs, pre-existent or current depression, pre-existing recreational drug or alcohol use, and high novelty seeking personality traits. Dopamine is not only implicated in voluntary movement control but also plays a significant role in the brain’s reward system and the modulation of behaviours. Therefore, most if not all drugnaïve PD patients will suffer dysphoria, leading to mild immediate reward seeking behaviour as a consequence of the striatal dopaminergic denervation. In some of these patients, during treatment, this may even lead to the intake of increasing quantities of levodopa, above those required to adequately treat motor parkinsonism, with all characteristics of a dopamine dependence syndrome. These patients may develop plastic changes in the striatal matrix leading to hyperkinesia, caused by extracellular striatal dopaminergic fluctuations due to pulsatile dopamine replacement therapy. As soon as these changes are also seen in the striatal striosomes, in the framework of a dopamine dysregulation syndrome, stereotyped behaviours (punding) may occur (supposedly due to dorsal versus ventral striatal overactivity). Finally, impulse control disorders are suggested as being pure adverse side-effects of dopamine replacement therapy. Obsessive-compulsive behaviour (caused by ventral to dorsal overactivity) so far has not been described in PD patients. Treatment of impulse control disorders is related to the underlying pathology. In the case of an intrinsic dopamine deficiency syndrome, treatment with dopamine replacement therapy, especially levodopa, will help. In the multifactorial (intrinsic and extrinsic) dopamine dependency and dysregulation syndromes, addictive behaviour might best be helped by psychosocial strategies, and punding by continuous dopaminergic receptor stimulation (or amantadine), hypothesized to reduce the plastic changes-induced hypersensitization. The extrinsic impulse control disorders might be best treated by reducing or replacing dopamine receptor agonists.