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Original Article Parkinson’s Disease, Impulsive-Compulsive Behaviors and Health-Related Quality of Life
Marie Grall-Bronnec1,2corresp_icon, Audrey Verholleman1, Caroline Victorri-Vigneau2,3, Juliette Leboucher1, Elsa Thiabaud1, Jean-Benoit Hardouin2,4, Benoit Schreck1,2, Tiphaine Rouaud5, Monica Roy5, Pascal Derkinderen5,6, Gaëlle Challet-Bouju1,2

DOI: https://doi.org/10.14802/jmd.23042 [Accepted]
Published online: November 6, 2023
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1Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, F-44000 Nantes, France
2Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients centered outcomes and HEalth ResEarch, SPHERE, F-44000 Nantes, France
3Nantes Université, CHU Nantes, Department of Pharmacology, F-44000 Nantes, France
4Nantes Université, CHU Nantes, Biostatistics and Methodology Unit, Department of Clinical Research and Innovation, F-44000 Nantes, France
5Nantes Université, CHU Nantes, Department of Neurology, F-44000 Nantes, France
6Nantes Université, CHU Nantes, INSERM, CIC 1314, F-44000, Nantes, France
Corresponding author:  Marie Grall-Bronnec, Tel: 33 (0)2 40 84 61 16, Fax: 33 (0)2 40 84 61 18, 
Email: marie.bronnec@chu-nantes.fr
Received: 1 March 2023   • Revised: 30 June 2023   • Accepted: 3 November 2023

Objective
A large body of literature has examined the links between the use of dopamine replacement therapy (DRT) in Parkinson’s disease (PD) and the development of “impulsive-compulsive behaviors” (ICBs). Little is known regarding the link between the development of ICBs and health-related quality of life (HRQOL). We aimed to explore the factors that are associated with poorer HRQOL, especially in relation to DRT-induced ICBs, in a sample of PD patients.
Methods
The PARKADD (PARK: PARKinson’s disease; ADD: behavioral ADDictions) study was a prospective case‒control study initially designed to assess the factors associated with ICBs in PD patients. A prospective clinical follow-up was added, aiming to capture the long-term evolution of HRQOL in relation to ICBs occurring or worsening after the beginning of PD. We focused on sociodemographic and PD characteristics and the history or presence of ICBs. HRQOL was measured using the Parkinson Disease Questionnaire-8. A multivariate linear regression was performed to identify factors related to poorer HRQOL.
Results
A total of 169 patients were eligible for the follow-up study. The presence of an ICB, a higher levodopa equivalent daily dose (LEDD) and a longer PD duration were significantly associated with poorer HRQOL, with an interaction between LEDD and PD duration.
Conclusions
The presence of an ICB was related to poorer HRQOL and should be considered a crucial factor for the management of PD patients. Several studies were recently published that provide guidelines for the management of these patients, with recommendations based on two key principles: prevention and specific treatment.

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