Levodopa-Induced Dyskinesias are Frequent and Impact Quality of Life in Parkinson's Disease: A 5-Year Follow-Up Study.

IF 2.6 4区医学 Q2 CLINICAL NEUROLOGY Movement Disorders Clinical Practice Pub Date : 2024-07-01 Epub Date: 2024-05-15 DOI:10.1002/mdc3.14056

Diego Santos-García, Teresa de Deus, Carlos Cores, Maria J Feal Painceiras, María C Íñiguez Alvarado, Lucía B Samaniego, Antón López Maside, Silvia Jesús, Marina Cosgaya, Juan García Caldentey, Nuria Caballol, Ines Legarda, Jorge Hernández-Vara, Iria Cabo López, Lydia López Manzanares, Isabel González-Aramburu, Asunción Ávila, Víctor Gómez-Mayordomo, Víctor Nogueira, Julio Dotor García-Soto, Carmen Borrué-Fernández, Berta Solano, María Álvarez Sauco, Lydia Vela, Sonia Escalante, Esther Cubo, Zebenzui Mendoza, Isabel Pareés, Pilar Sánchez Alonso, Maria G Alonso Losada, Nuria López-Ariztegui, Itziar Gastón, Jaime Kulisevsky, Manuel Seijo, Caridad Valero, Ruben Alonso Redondo, Maria Teresa Buongiorno, Carlos Ordás, Manuel Menéndez-González, Darrian McAfee, Pablo Martinez-Martin, Pablo Mir

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Abstract

Background: Levodopa-induced dyskinesias (LID) are frequent in Parkinson's disease (PD).

Objective: To analyze the change in the frequency of LID over time, identify LID related factors, and characterize how LID impact on patients' quality of life (QoL).

Patients and methods: PD patients from the 5-year follow-up COPPADIS cohort were included. LID were defined as a non-zero score in the item "Time spent with dyskinesia" of the Unified Parkinson's Disease Rating Scale-part IV (UPDRS-IV). The UPDRS-IV was applied at baseline (V0) and annually for 5 years. The 39-item Parkinson's disease Questionnaire Summary Index (PQ-39SI) was used to asses QoL.

Results: The frequency of LID at V0 in 672 PD patients (62.4 ± 8.9 years old; 60.1% males) with a mean disease duration of 5.5 ± 4.3 years was 18.9% (127/672) and increased progressively to 42.6% (185/434) at 5-year follow-up (V5). The frequency of disabling LID, painful LID, and morning dystonia increased from 6.9%, 3.3%, and 10.6% at V0 to 17.3%, 5.5%, and 24% at V5, respectively. Significant independent factors associated with LID (P < 0.05) were a longer disease duration and time under levodopa treatment, a higher dose of levodopa, a lower weight and dose of dopamine agonist, pain severity and the presence of motor fluctuations. LID at V0 (β = 0.073; P = 0.027; R² = 0.62) and to develop disabling LID at V5 (β = 0.088; P = 0.009; R² = 0.73) were independently associated with a higher score on the PDQ-39SI.

Conclusion: LID are frequent in PD patients. A higher dose of levodopa and lower weight were factors associated to LID. LID significantly impact QoL.

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左旋多巴诱发的运动障碍频繁发生并影响帕金森病患者的生活质量：一项为期 5 年的随访研究

背景：左旋多巴诱发的运动障碍（LID）在帕金森病（PD）中很常见：分析左旋多巴诱发运动障碍的频率随时间的变化，确定与左旋多巴诱发运动障碍相关的因素，并描述左旋多巴诱发运动障碍对患者生活质量（QoL）的影响：纳入 COPPADIS 5 年随访队列中的帕金森病患者。LID 的定义是在统一帕金森病评分量表第四部分（UPDRS-IV）的 "运动障碍时间 "项目中得分不为零。UPDRS-IV在基线（V0）时使用，5年内每年使用一次。39项帕金森病问卷总结指数（PQ-39SI）用于评估QoL：在平均病程为 5.5 ± 4.3 年的 672 名帕金森病患者（62.4 ± 8.9 岁；60.1% 为男性）中，V0 阶段的 LID 发生率为 18.9% (127/672)，随访 5 年（V5）时，LID 发生率逐渐升高至 42.6% (185/434)。致残性 LID、疼痛性 LID 和晨间肌张力障碍的发生率分别从 V0 时的 6.9%、3.3% 和 10.6% 增加到 V5 时的 17.3%、5.5% 和 24%。与LID相关的重要独立因素（P 2 = 0.62）和在V5时发展为致残性LID的独立因素（β = 0.088; P = 0.009; R2 = 0.73）与PDQ-39SI的较高得分相关：结论：LID在帕金森病患者中很常见。结论：LID在帕金森病患者中很常见，左旋多巴剂量较高和体重较轻是导致LID的相关因素。LID严重影响患者的生活质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Movement Disorders Clinical Practice CLINICAL NEUROLOGY-

CiteScore

4.00

自引率

7.50%

发文量

218

期刊介绍： Movement Disorders Clinical Practice- is an online-only journal committed to publishing high quality peer reviewed articles related to clinical aspects of movement disorders which broadly include phenomenology (interesting case/case series/rarities), investigative (for e.g- genetics, imaging), translational (phenotype-genotype or other) and treatment aspects (clinical guidelines, diagnostic and treatment algorithms)

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