BACKGROUND Levodopa has a superior antiparkinsonian effect than dopamine agonists making it the standard of care for patients with Parkinson's disease (PD). During the initial stages, PD patients show a steady response to levodopa. Response fluctuations and levodopa-induced dyskinesias (LID) develop subsequently. The timing and onset of dyskinesias vary among individuals, and there are very few studies identifying the predictors of dyskinesia in India. AIMS We aimed to study the clinical profile, disability, and predictors of LID in a patient with PD. MATERIALS AND METHODS This was a cross-sectional observational study of consecutive patients with PD attending our movement disorder clinic. Patients on levodopa treatment with a minimum follow-up of 6 months were included in the study. All patients were observed before and after administration of levodopa to assess onset, duration of action, and timing of dyskinesias. Dyskinesias were video recorded and classified. Bivariate analysis was performed using Chi-square test or Fisher's exact test and multivariate analysis using binary logistic regression. RESULTS This study recruited 110 patients with PD on levodopa therapy. Thirty-one (28.1%) out of 110 had LID. Of these, 25 patients (80.6%) had on-time dyskinesia, 19 patients (61.3%) had off-time dystonia, and 13 patients (41.9%) had diphasic dyskinesia. Majority had only mild-to-moderate dyskinesia. Incapacitating dyskinesias were during off time, primarily affecting the foot. Age, disease duration, disease severity, duration of treatment, and total dose of levodopa were found to be predictors of LID. Multivariate regression analysis showed younger age and longer duration of levodopa treatment to be independent predictors for LID. CONCLUSIONS LID is fairly common in PD though not severely disabling. Patients with younger age of onset, longer disease duration, and severe disease were more likely to get early LID. We observed the lower prevalence of LID when initiating at lower doses and slow titration of levodopa.

中文翻译：

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左旋多巴诱发帕金森病运动障碍的预测因子。

背景技术与多巴胺激动剂相比，左旋多巴具有更好的抗帕金森病作用，使其成为帕金森病（PD）患者的标准治疗。在初始阶段，PD 患者对左旋多巴表现出稳定的反应。随后出现反应波动和左旋多巴诱导的运动障碍 (LID)。运动障碍的发生时间和发作因人而异，并且很少有研究确定印度运动障碍的预测因素。目的 我们旨在研究 PD 患者 LID 的临床特征、残疾和预测因素。材料和方法 这是一项横断面观察研究，对连续到我们运动障碍诊所就诊的 PD 患者进行。该研究包括接受左旋多巴治疗且至少随访 6 个月的患者。在给予左旋多巴之前和之后观察所有患者以评估发作、作用持续时间和运动障碍的时间。运动障碍被视频记录和分类。使用卡方检验或Fisher精确检验进行双变量分析，使用二元逻辑回归进行多变量分析。结果 本研究招募了 110 名接受左旋多巴治疗的 PD 患者。110 人中有 31 人 (28.1%) 患有 LID。其中，25 名患者（80.6%）有准时性运动障碍，19 名患者（61.3%）有非时性肌张力障碍，13 名患者（41.9%）有双相性运动障碍。大多数人只有轻度至中度的运动障碍。失能运动障碍发生在休息时间，主要影响足部。年龄、疾病持续时间、疾病严重程度、治疗持续时间和左旋多巴总剂量被发现是 LID 的预测因素。多变量回归分析显示年龄较小和左旋多巴治疗持续时间较长是 LID 的独立预测因素。结论 LID 在 PD 中相当常见，但不会严重致残。发病年龄较小、病程较长、病情较重的患者更容易出现早期 LID。我们观察到以较低剂量开始和缓慢滴定左旋多巴时 LID 的患病率较低。