Abstract
ObjectiveChronic levodopa (L-dopa) treatment in Parkinson’s disease (PD) is often associated with the development of motor complications, but the corresponding epidemiological data is rare in Chinese PD patients. The present survey was to investigate the prevalence rate of wearing-off (WO) and dyskinesia among the patients with PD in China.MethodsFrom May 2012 to October 2012, a 3-step registry survey for wearing off (WO) and dyskinesia patients with PD receiving levodopa therapy was performed simultaneously at 28 movement disorders clinics in China.ResultsThere were 1,558 PD patients fulfilling the inclusion criteria. Among them, 1,051 had at least one positive response of 9-item wearing off questionnaire (WOQ-9), 724 and 160 patients were finally diagnosed with WO and dyskinesia by movement disorders specialists, respectively. The overall prevalence rates of WO and dyskinesia were 46.5% (95% CI 44.0% - 48.9%) and 10.3% (95% CI 8.8% - 11.8%), respectively. The mean score of WOQ-9 for those with WO was 3.8 (SD = 1.8), with movement slowness being the most common motor symptoms and pain/aching being the most common non-motor symptoms. Better improvement of motor symptoms (n = 354, 87.8%) and long-term disease control and drug selection (n = 288, 71.5%) were the two most frequently considered factors when movement disorders specialists adjusted therapeutic strategies for patients with WO.ConclusionsThis survey provided the first multi-center epidemiological data of motor complications among PD patients on L-dopa therapy from mainland China. WO prevalence rate among Chinese PD patients was in line with, while dyskinesia prevalence rate was lower than previous reports from other Countries.Electronic supplementary materialThe online version of this article (doi:10.1186/2047-9158-3-26) contains supplementary material, which is available to authorized users.
Highlights
Up to now, Levodopa (L-dopa) is still recognized as the most widely used and effective medication for Parkinson’s disease (PD), but long period therapy is often associated with the development of motor complications such as wearing-off (WO) and dyskinesia, which brought challenges for neurologists, and impaired daily living and poor life quality of PD patients
Cumulative evidence indicated that approximately 40% patients treated with L-dopa for 4–6 years experienced motor complications in Western Countries [2,3], whereas, the corresponding epidemiological data was rare in Chinese PD patients
Since the 9-item wearing-off questionnaire (WOQ-9) is a simple and highly-sensitive diagnostic screening scale for WO [6,7], we considered that WO was rarely present in patients with zero point on 9-item wearing off questionnaire (WOQ-9) as recommended by Movement Disorders Society (MDS) in 2011 [8]
Summary
Levodopa (L-dopa) is still recognized as the most widely used and effective medication for Parkinson’s disease (PD), but long period therapy is often associated with the development of motor complications such as wearing-off (WO) and dyskinesia, which brought challenges for neurologists, and impaired daily living and poor life quality of PD patients. Cumulative evidence indicated that approximately 40% patients treated with L-dopa for 4–6 years experienced motor complications in Western Countries [2,3], whereas, the corresponding epidemiological data was rare in Chinese PD patients. Heterogeneity exists in previous reports from Hong Kong [4] and Suzhou [5], China. Both of them were based on single center data with limited sample size. Since the 9-item wearing-off questionnaire (WOQ-9) is a simple and highly-sensitive diagnostic screening scale for WO [6,7], we considered that WO was rarely present in patients with zero point on WOQ-9 as recommended by Movement Disorders Society (MDS) in 2011 [8]
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