Impulse control and related disorders in Parkinson's disease patients treated with bilateral subthalamic nucleus stimulation: A review

Martijn Broen*, Annelien Duits, Veerle Visser-Vandewalle, Yasin Temel, Ania Winogrodzka

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Recently, impulse control and related disorders including punding and the dopamine dysregulation syndrome (DDS) have been increasingly recognized in treated patients with Parkinson's disease (PD). Especially the impulse control disorders (ICD) such as pathological gambling, hypersexuality, compulsive eating and buying may have dramatic repercussions on family, personal and professional life. Drug replacement therapy (DRT) is believed to play an important role in the onset of these behavioral disturbances. Although deep brain stimulation (DBS) of the subthalamic nucleus (STN) might be a therapeutic option for those patients with DRT-related behavior, it may also induce ICD. So far, little is known about the relationship between STN DBS and impulse control and related disorders. Our aim was to review the current knowledge on this relationship in PD patients. The available studies showed that stimulation of the STN is associated with both favorable and negative outcome in terms of impulse control and related disorders. Preoperative disorders may resolve or improve after STN DBS, but these can also worsen or show no change at all. Moreover, STN DBS can also reveal or even induce ICD. Possible explanations for this variability are proposed and suggestions for clinical management are given.
Original languageEnglish
Pages (from-to)413-417
JournalParkinsonism & Related Disorders
Issue number6
Publication statusPublished - Jul 2011


  • Parkinson's disease (PD)
  • Impulse control disorder (ICD)
  • Pathological gambling (PG)
  • Punding
  • Dopamine dysregulation syndrome (DDS)
  • Drug replacement therapy (DRT)
  • Deep brain stimulation (DBS)
  • Subthalamic nucleus (STN)

Cite this