TABLE 3.
Study characteristics and summary of findings of studies on treatment of punding in PD
| Author, year | Study design | Groups | Sample size | mean age (SD or range) | Sex, male | Outcome measure methods | Intervention | Main findings |
|---|---|---|---|---|---|---|---|---|
| Fasano et al, 2011 28 | Prospective open‐label study | PD‐punders | 10 | 61.1 ± 12.5 | 7 (70.0) | Clinical evaluations (assessment of side‐effects, UPDRS‐III, and PRS‐II) | Multistep algorithm for medical management of punding |
‐Reduction of levodopa therapy was efficacious in 2 cases. ‐Amantadine was effective in controlling punding in 4 cases. ‐Quetiapine was mildly efficacious in 2 cases. |
| Ávila et al, 2011 29 | Prospective cohort study | PD patients with ICBs | 25 | 74.0 ± 6.7 | 19 (76.0) |
Structures clinical interview (included information on any intervention for ICBs) Questionnaires UPDRS HY |
Increase or decrease of PD pharmacotherapy, use of psychotropic medication, psychosocial treatment. |
‐Of the 11 patients with punding, these symptoms remained unchanged in 9 patients (81.82%) independently of changes in dopaminergic drugs. ‐Only 2 (18.18%) patients reported experiencing a full or partial remission of their punding symptoms over time; both had discontinued or decreased their doses of DA and had modified the psychiatric treatment. |
| Lhommée et al, 2012 30 | Prospective cohort study | PD patients | 63 | 57.8 ± 7.2 | 40 (63.5) |
Ardouin scale MINI MDRS UPDRS III |
STN DBS | ‐1 patient diagnosed with punding at preoperative assessment showed clear improvement of the symptoms at 1‐year assessment after surgery. |
| Catalán et al, 2013 31 | Prospective cohort study | PD patients | 8 | 67.9 ± 10.9 | 7 (87.5) | Motor complications and behavioral disorders assessments | JLI | ‐ Of the 5 patients with punding, symptoms improved in all but disappeared completely in only 1. |
| Nardone et al, 2014 32 | Randomized control trial | PD‐Punders | 4 | 65.8 (62–70) | 3 (75.0) |
PRS OCI‐distress subscale scores HAM‐A HAM‐D |
rTMS and sham stimulation | LF‐rTMS produced a transient beneficial effect in PD patients with punding. |
| Healthy controls | 8 | 65.2 (59–71) | 7 (77.8) |
Abbreviations: PD, Parkinson's disease; SD, standard deviation; UPDRS‐III, Unified Parkinson's Disease Rating Scale motor score; PRS, Punding Rating Scale; ICB, impulse compulsive behavior; HY, Hoehn and Yahr scale; DA, dopamine agonists; MINI, Mini International Neuropsychiatric Interview; MDRS, Mattis Dementia Rating Scale; STN, subthalamic nucleus; DBS, deep brain stimulation; JLI, jejunal levodopa infusion; PRS, Punding Rating Scale; OCI, Obsessive–Compulsive Inventory; HAM‐A, Hamilton Anxiety Scale; HAM‐D, Hamilton Depression Rating Scale; rTMS, repetitive transcranial magnetic stimulation; LF, low frequency.