Parkinson's Disease and development of levodopa induced motor complications: Influence of baseline features and first medical approach

Abstract

BackgroundThe introduction of levodopa in clinical practice represents a hallmark in the treatment of the neurodegenerative disease, Parkinson's Disease. However, levodopa induced motor complications, namely dyskinesias and motor fluctuations, develop in the majority of Parkinson's Disease patients. Objectiveto identify which Parkinson's Disease's, patient's and therapeutics’ initial features are more associated with dyskinesias or motor fluctuations development. MethodsPatients with diagnosed Parkinson's Disease attending neurology outpatient clinic at Centro Hospitalar São João were selected. For this observational study, data was retrospectively collected from patient's clinical records. A survival analysis model with univariate and multivariate regression analysis was used. Results87 patients with a mean of 72±9.7 years were included. After a median follow-up of 6 (range 1–17) years, 35.6% patients developed dyskinesias; and with a median of 5 (range 1–16) years, 32.2% developed motor fluctuations. After multivariate analysis, the akinesia/rigidity subtype was found to have a higher risk of dyskinesias and motor fluctuations development. Age of onset ≤50 years was associated with motor fluctuations development. ConclusionIn conclusion, our results suggest that Parkinson's Disease patients’ initial characteristics, such as subtype or age of onset, are independently associated with the development of motor complications.