IMPULSE CONTROL DISORDER ON PARKINSON’S DISEASE. A new approach from art?

 Aldinio V., Persi G., Bres Bullrich M., Sánchez de Paz P., Da Prat G., Parisi V., Rojas G., Gatto E.

 Sanatorio de la Trinidad Mitre, Ciudad Autónoma de Buenos Aires, Argentina

Objectives To describe the characteristics of three PD patients, nonprofessional artists who developed an artistic hyper productivity on dopaminergic agonists treatment.

Background On Parkinson's disease (PD), the artistic productivity apparition has been reported with the use of dopaminergic agonists, as an unusual expression of impulse control disorder (ICD). Dopamine is involved into motivation and reward behaviors. The mesolimbic dopaminergic activity has been associated with creative impulse, search of the new and the sensibility for new stimulus.

Methods There were included three patients with PD on pramipexole treatment (2 cases) and ropinirole treatment (1 case): 2 women, 1 man. Literature review.

Results Male patient, 58 years old, 10 years PD, with pramipexole it develops ludopathy. Because of torpid evolution, it's been decided to implement a deep brain stimulator that had to be removed due to an infection. It starts with ropinirole, concomitantly it develops passion for painting. Female patient, 53 years old, 6 years PD, with pramipexole it develops hypersexuality, rotates to rotigotine with no results, restarts pramipexole, it develops skills for painting and dancing salsa. Female patient, 49 years old, 12 years PD, with pramipexole it develops compulsive shopping, and it develops hyper productivity for painting, implementing new artistic techniques.

Conclusion The ICD, related with dopaminergic agonists, is usually reported as a serious adverse event of the therapy, interfering on a negative manner with the quality of life of PD patients and their families. In our study the patients under dopaminergic agonists treatments developed skills for painting and increased their previous ability. This raises the question of whether artistic hyper productivity can be defined like an ICD, because it gave a beneficial effect on our patient’s quality of life.