Punding in Parkinson's disease: To a better understanding of a common phenomenon between Parkinson's disease and addictions

Abstract

Introduction

Punding is a stereotypical motor behaviour characterized by a repetitive, excessive and non-goal oriented activity that causes an important loss of time. Since its first description in psychostimulant addicts, data on punding has only derived from studies on Parkinsonian patients treated with dopaminergic drugs. Little is known in the literature about Parkinsonian patient's characteristics who suffer from punding.

Objective

We propose to study characteristics of Parkinsonian “punders” in order to investigate the pathophysiology of this phenomenon.

Methods

In this retrospective study, we use the “Ardouin Scale of Behavior in Parkinson's disease” database. This database was initially used to design a global scale to detect changes in mood and behavior of Parkinson's disease (PD) patients. We compared different variables between Parkinsonian patients who suffer from punding with non-punder Parkinsonian patients.

Results

Eighty of the 258 patients were identified as punders. In univariate analysis, the punder and non-punder groups differed statistically with regard to the age of diagnostic of PD, hypersexuality and dopaminergic agonist treatment. In multivariate analysis, the punder and non-punder groups only differed statistically with regard to dopaminergic agonist treatment (P = 0.05).

Conclusion

Dopaminergic agonist treatments appear to be more represented among patients with punding in our sample. Impulse control disorders (ICD) are known to be more common in patients treated by dopamine agonists. Punding could be considered as the most severe form of ICD that is linked to psychomotor stimulation and reward mechanisms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.