Abstract
IntroductionThe brittle response (BR) in patients with Parkinson’s disease (PD) refers to a special type of levodopa‐induced dyskinesia (LID). This study aimed to describe the clinical characteristics of BR patients and to analyze the associated risk factors.MethodsA retrospective study was conducted to analyze the data of 97 patients with PD. Patients were divided into a BR group and a non‐brittle response (NBR) group. Demographic and clinical data, motor symptoms, and non‐motor symptoms of the two groups were assessed.ResultsAmong 97 PD patients, 11 were in the BR group and 86 were in the NBR group. The proportion of female patients was 72.7% and 38.3%, respectively, in the BR and NBR groups (P < 0.05). Compared to NBR patients, BR patients had relatively low body weight, low BMI, long disease duration, high levodopa equivalent daily dosage (LEDD), and high levodopa dose per weight (P < 0.05). The BR group had significantly higher scores of UPDRS (II, III, and IV) (P < 0.05). But no difference was found in the UPDRS I, emotional state, cognitive status, and accompanied by REM sleep behavior disorder (RBD) (P> 0.05). Multivariate logistic regression analysis showed that BR patients had lower body weight and higher levodopa dose per weight.ConclusionBR is associated with being female, low body weight, low BMI, long disease duration, high LEDD, and high levodopa dose per weight. Body weight and levodopa dose per body weight are independent risk factors for BR.
Highlights
The brittle response (BR) in patients with Parkinson’s disease (PD) refers to a special type of levodopa-induced dyskinesia (LID)
Dyskinesia may appear in only a small number of PD patients even if they are taking a small dose of levodopa at each scheduled time, suggesting that these patients cannot withstand a large dose of levodopa, resulting in poor control of their PD symptoms
Patients’ demographic and clinical data were collected, including gender, present age, age of onset, height, body weight, body mass index (BMI), disease duration, UPDRS I to IV scores, the Hoehn &Yahr scale (H & Y scale), current drugs taken and dosages, levodopa equivalent daily dosage (LEDD), and levodopa dose per a 2020 The Authors
Summary
The brittle response (BR) in patients with Parkinson’s disease (PD) refers to a special type of levodopa-induced dyskinesia (LID). This study aimed to describe the clinical characteristics of BR patients and to analyze the associated risk factors. Compared to NBR patients, BR patients had relatively low body weight, low BMI, long disease duration, high levodopa equivalent daily dosage (LEDD), and high levodopa dose per weight (P < 0.05). Conclusion: BR is associated with being female, low body weight, low BMI, long disease duration, high LEDD, and high levodopa dose per weight. About 40% of patients treated with levodopa for 4– 6 years are reported to develop LID.[2] the higher the daily dose of levodopa, the greater the risk of developing dyskinesia. The concept of PD “brittle response” (BR) was proposed to describe this phenomenon.[3,4] few reports are found on BR, this study aimed to analyze the risk factors of BR in order to take measures to prevent
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