Risk factors for levodopa-induced dyskinesias in Parkinson's disease

Abstract

To identify putative risk factors for levodopa-induced dyskinesias we studied the effect of several clinical variables on the occurrence of dyskinesias in a series of 168 consecutive patients with Parkinson's disease treated for at least 6 months with levodopa. Of these, 108 (64%) developed dyskinesias after a mean duration of levodopa treatment of 51.4 +/- 43.3 months. Patients tended to suffer dyskinesias on the side of the body first affected by Parkinson's disease. The overall probability of developing dyskinesias increased with levodopa treatment duration, about 10% per year during the first 7 years. Univariate and multivariate logistic regression analysis identified the age at onset of Parkinson's disease (OR 0.923; 95% CI 0.883-0.964) and the initial levodopa dose (mean dose of the first 6 months of treatment; OR 1.004; 95% CI 1.002-1.006) as the main independent predictors. Survival curves showed that onset of Parkinson's disease at age 50 years or before (logrank, P < 0.05) and initial levodopa treatment with more than 600 mg/day (logrank, P < 0.05) were associated with a higher risk for the appearance of dyskinesias.

Forebrain Adenosine A2AReceptors Contribute to l-3,4-Dihydroxyphenylalanine-Induced Dyskinesia in Hemiparkinsonian Mice

“…This study indicated that the acute symptomatic (motor stimulant) effect of A 2A antagonists may allow for chronic use of lower doses of L-DOPA, which are associated with a reduced risk of developing dyskinesia (Grandas et al, 1999;Fahn et al, 2004). , a relatively specific A 2A receptor antagonist, reduces parkinsonian symptoms without appreciably inducing or exacerbating L-DOPA-induced dyskinesia in nonhuman primates (Grondin et al, 1999;Kanda et al, 2000;Jenner, 2003Jenner, , 2005Kase et al, 2003;Xu et al, 2005).…”

Validation of a New Scoring Scale for Behavioral Assessment of L-Dopa-Induced Dyskinesia in the Rat: A New Tool for Early Decision-Making in Drug Development

“…However, after several years of treatment, L-dopa-induced dyskinesia (LID) occurs in the majority of patients 1,[3][4][5] . These highly debilitating motor complications manifest as a variety of abnormal involuntary movements (AIMs), including severe and painful dystonic cramps (sustained abnormal muscle contractions), hyperkinetic and purposeless (choreiform) movements [5][6][7] .…”

Serotonin-to-dopamine transporter ratios in Parkinson disease

“…Previous studies looking for clinical risk factors in LIDs have shown that the occurrence of LIDs is linked with younger age at onset of PD, [31][32][33] as well as with longer disease duration. 32,34 The LIDs and non-LIDs groups of our PD cohort were clinically different (so that reached statistical significance) for sex, age, disease duration, the duration on dopaminergic medication, and LED Total .…”