The high prevalence of impulse control behaviors in patients with early-onset Parkinson's disease: A cross-sectional multicenter study L. Vela a, ⁎, J.C. Martínez Castrillo b , P. García Ruiz c , C. Gasca-Salas d , Y. Macías Macías a , E. Pérez Fernández a , I. Ybot e , E. Lopez Valdés f , M.M. Kurtis g , I.J. Posada Rodriguez h , M. Mata i , C. Ruiz Huete j , M. Eimil k , C. Borrue l , J. del Val c , L. López-Manzanares m , A. Rojo Sebastian n , R. Marasescu o a Department of Neurology, Hospital Fundacion Alcorcón, Madrid, Spain b Department of Neurology, Hospital Ramón y Cajal, Madrid, Spain c Department of Neurology, Fundación Jiménez Díaz, Madrid, Spain d M CINAC- Hospital U HM Puerta del Sur, Mostoles. Universidad CEU San Pablo, Madrid, Spain e Department of Neurology, Hospital U La Paz, Madrid, Spain f Department of Neurology, Hospital Clínico San Carlos, Madrid, Spain g Department of Neurology, Hospital Ruber Internacional, Madrid, Spain h Department of Neurology, Hospital 12 de Octubre, Madrid, Spain i Department of Neurology, Hospital Puerta de Hierro, Madrid, Spain j Department of Neurology, Hospital Nuestra Señora del Rosario, Madrid, Spain k Department of Neurology, Hospital de Torrejón, Madrid, Spain l Department of Neurology, Hospital Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain m Department of Neurology, Hospital de la Princesa, Madrid, Spain n Department of Neurology, Hospital Príncipe de Asturias - Alcalá de Henares, Madrid, Spain o Department of Neurology, Hospital de Getafe, Madrid, Spain abstract article info Article history: Received 6 December 2015 Received in revised form 20 May 2016 Accepted 1 July 2016 Available online 02 July 2016 Introduction: In Parkinson's disease patients, impulse control disorders (ICDs) have been associated with younger age and early disease onset, yet the prevalence of ICDs in early-onset Parkinson's disease (EOPD) patients has yet to be studied. Thus, we set out to compare the prevalence of impulse control behaviors (ICBs) in a cohort of EOPD patients with that in age and gender matched healthy controls (HCs), as well as to analyze the association of these symptoms with the use of dopaminergic drugs and other clinical or demographic factors. Methods: A cross-sectional, multicenter study was carried out on patients recruited from outpatient Movement Disorder Clinics, assessing ICBs using the short form of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP). In addition, depression and quality of life (QoL) were measured, along with other demographic and clinical variables. Results: Of the 87 EOPD patients, 49 (58.3%) displayed an ICB, as did 28 of the 87 HCs (32.9%; p = 0.001). Most of the EOPD patients that displayed an ICB (91.8%) were medicated with a dopamine agonist (DA) and accordingly, DA treatment was associated with a 7-fold increased risk of developing an ICB. Patients with ICBs had a higher depression score and a worse QoL. Conclusions: ICBs are much more prevalent in EOPD patients than in HCs and they are associated with DA intake, depression and a worse QoL. © 2016 Published by Elsevier B.V. Keywords: Parkinson's disease Early-onset Impulse control behavior Impulse control disorders Dopamine agonist Quality of life 1. Introduction Early-onset Parkinson's disease (EOPD) has been arbitrarily defined as parkinsonism with an onset before 45 years of age [1], although 40 and 50 years of age have also been used as the threshold in some studies [2–4]. A recent community-based study indicated a 3.6% prevalence of EOPD patients in the United Kingdom [5], a condition that is frequently characterized by slower disease progression, milder cognitive decline and earlier motor complications, such as fluctuations and dyskinesias [2]. Moreover, EOPD patients usually experience more significant psychiatric and behavioral symptoms, such as depression, anxiety and obsessive-compulsive disorders, the rates of which vary from 5% to 45% [2,6,7]. In PD patients, dopamine dysregulation syndrome and impulse con- trol disorders (ICDs) have often been associated with younger age and earlier disease onset [8–10], yet this issue has not been studied closely Journal of the Neurological Sciences 368 (2016) 150–154 ⁎ Corresponding author at: Department of Neurology, Hospital U Fundación Alcorcón, Calle Budapest 1, 28922 Alcorcón, Madrid, Spain. E-mail address: lvela@fhalcorcon.es (L. Vela). http://dx.doi.org/10.1016/j.jns.2016.07.003 0022-510X/© 2016 Published by Elsevier B.V. Contents lists available at ScienceDirect Journal of the Neurological Sciences journal homepage: www.elsevier.com/locate/jns