Levodopa‐Induced Dyskinesias are Frequent and Impact Quality of Life in Parkinson's Disease: A 5‐Year Follow‐Up Study
Diego Santos‐García, Teresa de Deus, Carlos Cores, María J. Feal Painceiras, María Cristina Íñiguez Alvarado, Lucía B. Samaniego, Antón López Maside, Silvia Jesús, Marina Cosgaya, Juan García Caldentey, Núria Caballol, Inés Legarda, Jorge Hernández‐Vara, Iria Cabo López, Lydia López Manzanares, Isabel González Aramburu, Asunción Ávila, Víctor Gómez‐Mayordomo, Víctor Nogueira, Julio Dotor García‐Soto, C. Borrue-Fernández, Berta Solano, María Álvarez Saúco, Lydia Vela, Sonia Escalante, Esther Cubo, Zebenzui Mendoza, Isabel Pareés, Pilar Sánchez Alonso, María G. Alonso Losada, Núria López Ariztegui, Itziar Gastón, Jaime Kulisevsky, Manuel Seijo, Caridad Valero, Rubén Alonso Redondo, Maríateresa Buongiorno, Carlos Ordás, Manuel Menéndez‐González, Darrian McAfee, Pablo Martínez‐Martín, Pablo Mir, COPPADIS Study Group
Abstract
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; R 2 = 0.62) and to develop disabling LID at V5 ( β = 0.088; P = 0.009; R 2 = 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.