Risk factors for levodopa-induced dyskinesia in Parkinson’s disease patients

Gordana M Djurić; Vladana Marković; Tatjana Pekmezović; Aleksandra Tomić; Nikola Kresojević; Vladimir Kostić; Marina Svetel

doi:10.2298/VSP150723264D

Gordana M Djurić Railway Health Care Institute, Belgrade, Serbia
Vladana Marković Clinical Center of Serbia, Neurology Clinic, Belgrade, Serbia
Tatjana Pekmezović Faculty of Medicine, Institute of Epidemiology, Belgrade, Serbia
Aleksandra Tomić Clinical Center of Serbia, Neurology Clinic, Belgrade, Serbia
Nikola Kresojević Clinical Center of Serbia, Neurology Clinic, Belgrade, Serbia
Vladimir Kostić Clinical Center of Serbia, Neurology Clinic, Belgrade, Serbia
Marina Svetel Clinical Center of Serbia, Neurology Clinic, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP150723264D

Keywords: parkinson disease, disease progression, levodopa, dyskinesia, drug-induced, risk factors, surveys and questionnaires,

Abstract

Background/Aim. Levodopa, the precursor of dopamine, is a substitute therapy for Parkinson's disease. Long-term application of levodopa causes fluctuation in motor response and the occurrence of involuntary movements or dyskinesia. The aim of this study was to assess the risk factors for dyskinesia in Parkinson’s disease (PD) patients undergoing treatment with levodopa. Methods. We included 177 consecutive outpatients with PD, who had been undergoing treatment for at least six months. A semi-structured interview was used to collect demographic and clinical data as well as a number of clinical scales. Results. Patients with dyskinesia (n = 90) were younger at disease onset and had longer disease duration. They had higher Unified Parkinson's Disease Rating Scale (UPDRS) scores and more frequently had other motor complications, such as wearing-off and freezing of gait, as well as non-motor ones, such as psychosis. They took higher levodopa doses and levodopa equivalent doses and were on levodopa therapy for a longer period of time. Multivariate analysis yielded that independent risk factors for dyskinesia were: disease duration of longer than 10 years [relative risk (RR = 2.90), 95% confidence interval (CI) 1.19–7.10; p = 0.019), dopaminergic treatment duration of longer than 94 months (RR = 3.21, 95% confidence interval (CI) 1.05–9.87; p = 0.041) and levodopa dosage of higher than 537 mg (RR = 3.62, 95%IP 1.57–8.35; p = 0.002). Conclusion. We highlight the importance of known risk factors for dyskinesia and their occurrence in the context of advanced, complicated disease.

Author Biography

Gordana M Djurić, Railway Health Care Institute, Belgrade, Serbia

drc sci med, specijalista neurologije

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