Supplementary Material for: Neuropsychiatric Traits Associated with Refractory Impulse Control Disorder in Parkinson’s Disease

<b><i>Introduction:</i></b> Impulse control disorder (ICD) in Parkinson’s disease (PD) is a critical nonmotor symptom with personality or neuropsychiatric traits contributing to ICD. <b><i>Objective:</i></b> This study aimed to identify predictive traits for persistent or paradoxical aggravation of ICD after dopamine agonist substitution therapy for ICD in PD. <b><i>Methods:</i></b> We conducted a case-control study using a database of a multicenter intervention trial for ICD in PD. The poor-outcome group was defined by showing paradoxical increases in ICD behaviors after the substitution of dopamine agonists with levodopa. We analyzed the pre-intervention personality traits associated with the poor outcome and also evaluated the risk traits for refractory ICD using a receiver-operating characteristic (ROC) curve analysis. <b><i>Results:</i></b> The poor-outcome group showed higher levels of anger expression (<i>p =</i>0.007) and obsessive-compulsive traits (<i>p =</i>0.009) compared with the good-outcome group at the pre-intervention state. In the ROC curve analysis, the Obsessive-Compulsive Inventory showed the highest area under the curve with 80.0% sensitivity and 74.3% specificity in discriminating against the poor-outcome group. <b><i>Conclusions:</i></b> Our results suggest that assessment of obsessive compulsiveness may be useful for predicting the refractoriness of ICD behaviors in planning an interventional treatment for ICD in PD.

<b><i>引言：</i></b> 帕金森病（Parkinson’s disease, PD）伴发的冲动控制障碍（Impulse control disorder, ICD）是一类关键的非运动症状，人格或神经精神特质可促发该病症。<b><i>目的：</i></b> 本研究旨在明确帕金森病冲动控制障碍患者接受多巴胺能激动剂替代治疗后，出现冲动控制障碍持续存在或反常加重的预测特质。<b><i>方法：</i></b> 本研究采用帕金森病冲动控制障碍多中心干预试验的数据库开展病例对照研究。将多巴胺能激动剂换用左旋多巴后，冲动控制障碍行为出现反常加重的患者定义为预后不良组。本研究分析了与不良预后相关的干预前人格特质，并通过受试者工作特征（Receiver-operating characteristic, ROC）曲线分析评估了冲动控制障碍难治性的风险特质。<b><i>结果：</i></b> 干预前，预后不良组患者的愤怒表达水平（<i>p =</i>0.007）与强迫特质（<i>p =</i>0.009）均显著高于预后良好组。受试者工作特征曲线分析显示，强迫量表（Obsessive-Compulsive Inventory）在区分预后不良组时的曲线下面积最高，灵敏度为80.0%，特异度为74.3%。<b><i>结论：</i></b> 本研究结果提示，在制定帕金森病冲动控制障碍的干预治疗方案时，对强迫特质进行评估，或可有效预测冲动控制障碍行为的难治性。