If this is not your name, click here.
| | If this is not your name, click here. | | |
| | Contact Us | Order Now | Journals | Bookstore | Register a colleague | | |
| |  Resting Tremor Among Several Factors Associated With the Development, Severity of Levodopa-Induced Dyskinesia: Presented at MDS By Jenny Powers PARIS -- June 10, 2009 -- The development and severity of levodopa (L-dopa)-induced dyskinesia (LID) in patients with Parkinson’s disease (PD) is associated not only by treatment with L-dopa but also with several factors of the patient’s PD progression, according to a study reported here on June 9 at the Movement Disorder Society’s (MDS) 13th International Congress of Parkinson’s Disease and Movement Disorders. Treatment of PD with L-dopa often results in the development of LID. However the length of time the patient has had PD and the age of onset also correlate with the development of LID. The investigators were interested in finding other clinical factors that may influence the severity and development of LID. Stephan Kipfer, MD, University Hospital of Bern, Bern, Switzerland, performed a retrospective analysis of 97 patients with PD who were treated with L-dopa to determine which PD symptoms are associated with LID. Specifically, they investigated PD symptoms including tremor, bradykinesia, and rigidity to determine whether they are differentially linked to LID severity. They performed nonparametric Spearman correlations between the severity of LID, as assessed by the Unified PD Rating Scale IV (UPDRS IV) and the Abnormal Involuntary Movement Scale (AIMS), and the following variables: duration of L-dopa treatment and actual L-dopa dose (calculated L-dopa equivalent dose), age at PD onset, PD duration, stage of disease (Hoehn & Yahr score), and motor performance (UPDRS III). Additionally they sought to determine if the initial symptoms at diagnosis predict or influence the outcome of developing dyskinesia (in UPDRS IV, t test). The researchers found that LID severity, as scored by UPDRS IV and AIMS, was significantly associated with a cluster of clinical factors that included higher actual L-dopa dose, a longer duration of PD, a higher stage of disease, and younger age at PD onset. Elevated AIMS score was associated with a lower severity of resting tremor throughout the disease course. The degree of rigidity or bradykinesia was not associated with a high AIMS score. Patients who initially presented with tremor had a mean UPDRS IV score of 4.4 versus 8.6 in the nontremor group (t test, P < .01) despite similar UPDRS III scores in both groups. The conclusions drawn by the authors were that not only the stage of the disease but also the type of the predominant symptoms, specifically resting tremor, might influence the development and expression of LID, in addition to the known risk factors of high L-dopa dose and young age at PD onset. [Presentation title: Clinical Signs Associated With Levodopa-Induced Dyskinesia in Parkinson’s Disease. Abstract TU-190]
|
