Impulsivity Traits in Parkinson's Disease: A Systematic Review and Meta-Analysis

Abstract

Background: In Parkinson's disease (PD), impulsivity as a personality trait may be linked to the risk of developing impulse control disorders (ICDs) during dopaminergic therapy. However, studies evaluating differences in trait impulsivity between patients with PD and healthy controls or between patients with PD with and without ICDs reported partly inconsistent findings.

Objectives: We conducted a systematic review and meta-analysis (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) of studies comparing Barratt Impulsiveness Scale (BIS-11) scores between patients with PD and healthy controls and between patients with PD with and without ICDs.

Methods: Eligible studies were identified through a systematic search in 3 databases. Mean differences with 95% confidence intervals (CIs) for BIS-11 total and subscale scores were separately calculated for studies comparing patients with PD and healthy controls and patients with PD with and without ICDs. Meta-regressions were performed to explore sources of heterogeneity (percentage of men, age, disease duration, and levodopa equivalent daily dose).

Results: A total of 40 studies were included in the quantitative analyses. BIS-11 total scores were significantly higher in patients with PD compared with healthy controls (mean difference 2.43; 95% CI, 1.03, 3.83), and in patients with PD with active ICDs compared with patients without ICDs (6.62; 95% CI, 5.01, 8.23). No significant moderators emerged by meta-regression analyses.

Conclusions: The present meta-analysis supports that impulsivity, as a personality trait, may characterize patients with PD, even in the absence of ICDs. Moreover, these data corroborate findings of clinical studies reporting higher levels of trait impulsivity in PD patients with ICDs compared with patients without ICDs.

Keywords: Barratt Impulsiveness Scale; Parkinson's disease; impulse control disorders; impulsivity.

FIG. 1

Preferred Reporting Items for Systematic Reviews and Meta‐Analyses flowchart (*see Supplementary Material S1 for details). BIS‐11, Barratt Impulsiveness Scale; ICDs, impulse control disorders; PD, Parkinson's disease.

FIG. 2

Barratt Impulsiveness Scale total scores in the 28 studies selected for the meta‐analysis comparing patients with Parkinson's disease (PD) to age‐matched healthy controls. CI, confidence interval; df, degree of freedom; SD, standard deviation.

FIG. 3

Barratt Impulsiveness Scale total scores in the 18 studies selected for the meta‐analysis comparing patients with Parkinson's disease (PD) with and without impulse control disorders (ICDs). CI, confidence interval; df, degree of freedom; SD, standard deviation.