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Clinical phenotype and risk of levodopa-induced dyskinesia in Parkinson's disease.
J Neurol. 2016 May; 263(5):888-894.JN

Abstract

It is unclear whether patients with different clinical phenotypes of Parkinson's disease (PD) differ in their risk of developing levodopa-induced dyskinesia. We evaluated the possible association between clinical phenotypes and risk of levodopa-induced dyskinesia in PD patients using a case-control design. The FRAGAMP study is a large Italian multicenter study. Patients affected by PD diagnosed according to the Gelb's criteria were enrolled and underwent a face-to-face interview. Clinical scales were used to evaluate motor and cognitive impairment. Presence of dyskinesia was assessed by the item 32 of the UPDRS section IV. On the basis of the most prominent motor symptoms at onset PD, patients were classified as tremor-dominant, akinetic-rigid, or mixed type. 485 PD patients (292 men; mean age 65.6 ± 9.8) were enrolled in the study of whom 128 (26.4 %) presented levodopa-induced dyskinesia. Of the 485 patients, 311 (64.1 %) were classified as tremor-dominant, 104 (21.4 %) as Akinetic-Rigid and 70 (14.4 %) as mixed type. Multivariate logistic regression analysis showed a significant negative association between tremor-dominant phenotype and levodopa-induced dyskinesia (adjusted OR 0.48; 95 % CI 0.23-1.00; p value 0.05). When analysis was stratified by age at onset a stronger negative association was found among the late onset (>50 years) PD patients (OR 0.28; 95 % CI 0.11-0.70; p value 0.007) while no association was found among patients with an early onset. Our findings support the hypothesis that the occurrence of resting tremor as an initial manifestation of PD may predict a lower probability of developing levodopa-induced dyskinesia.

Authors+Show Affiliations

Section of Neurosciences, Department G.F. Ingrassia, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.Section of Neurosciences, Department G.F. Ingrassia, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.Istituto di Bioimmagini e Fisiologia Molecolare, Consiglio Nazionale delle Ricerche, Catanzaro, Italy.Clinica Neurologica, Università "Magna Græcia" di Catanzaro, Catanzaro, Italy.Dipartimento di Scienze mediche di base, neuroscienze e organi di senso, Università di Bari, Bari, Italy.Dipartimento di Scienze mediche di base, neuroscienze e organi di senso, Università di Bari, Bari, Italy.Divisione di Neurologia, Ospedale Misericordia, Grosseto, Italy.Dipartimento di Neuroscienze, Università di Messina, Messina, Italy.Dipartimento di Medicina e Chirurgia, Università degli Studi di Salerno, Salerno, Italy.Istituto di Bioimmagini e Fisiologia Molecolare, Consiglio Nazionale delle Ricerche, Catanzaro, Italy. Clinica Neurologica, Università "Magna Græcia" di Catanzaro, Catanzaro, Italy.Section of Neurosciences, Department G.F. Ingrassia, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy. m.zappia@unict.it.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

26964541

Citation

Nicoletti, Alessandra, et al. "Clinical Phenotype and Risk of Levodopa-induced Dyskinesia in Parkinson's Disease." Journal of Neurology, vol. 263, no. 5, 2016, pp. 888-894.
Nicoletti A, Mostile G, Nicoletti G, et al. Clinical phenotype and risk of levodopa-induced dyskinesia in Parkinson's disease. J Neurol. 2016;263(5):888-894.
Nicoletti, A., Mostile, G., Nicoletti, G., Arabia, G., Iliceto, G., Lamberti, P., Marconi, R., Morgante, L., Barone, P., Quattrone, A., & Zappia, M. (2016). Clinical phenotype and risk of levodopa-induced dyskinesia in Parkinson's disease. Journal of Neurology, 263(5), 888-894. https://doi.org/10.1007/s00415-016-8075-6
Nicoletti A, et al. Clinical Phenotype and Risk of Levodopa-induced Dyskinesia in Parkinson's Disease. J Neurol. 2016;263(5):888-894. PubMed PMID: 26964541.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical phenotype and risk of levodopa-induced dyskinesia in Parkinson's disease. AU - Nicoletti,Alessandra, AU - Mostile,Giovanni, AU - Nicoletti,Giuseppe, AU - Arabia,Gennarina, AU - Iliceto,Giovanni, AU - Lamberti,Paolo, AU - Marconi,Roberto, AU - Morgante,Letterio, AU - Barone,Paolo, AU - Quattrone,Aldo, AU - Zappia,Mario, Y1 - 2016/03/10/ PY - 2015/12/10/received PY - 2016/02/15/accepted PY - 2016/02/15/revised PY - 2016/3/12/entrez PY - 2016/3/12/pubmed PY - 2017/4/5/medline KW - Akinetic-rigid KW - Clinical phenotype KW - Dyskinesia KW - Parkinson’s disease KW - Tremor-dominant SP - 888 EP - 894 JF - Journal of neurology JO - J Neurol VL - 263 IS - 5 N2 - It is unclear whether patients with different clinical phenotypes of Parkinson's disease (PD) differ in their risk of developing levodopa-induced dyskinesia. We evaluated the possible association between clinical phenotypes and risk of levodopa-induced dyskinesia in PD patients using a case-control design. The FRAGAMP study is a large Italian multicenter study. Patients affected by PD diagnosed according to the Gelb's criteria were enrolled and underwent a face-to-face interview. Clinical scales were used to evaluate motor and cognitive impairment. Presence of dyskinesia was assessed by the item 32 of the UPDRS section IV. On the basis of the most prominent motor symptoms at onset PD, patients were classified as tremor-dominant, akinetic-rigid, or mixed type. 485 PD patients (292 men; mean age 65.6 ± 9.8) were enrolled in the study of whom 128 (26.4 %) presented levodopa-induced dyskinesia. Of the 485 patients, 311 (64.1 %) were classified as tremor-dominant, 104 (21.4 %) as Akinetic-Rigid and 70 (14.4 %) as mixed type. Multivariate logistic regression analysis showed a significant negative association between tremor-dominant phenotype and levodopa-induced dyskinesia (adjusted OR 0.48; 95 % CI 0.23-1.00; p value 0.05). When analysis was stratified by age at onset a stronger negative association was found among the late onset (>50 years) PD patients (OR 0.28; 95 % CI 0.11-0.70; p value 0.007) while no association was found among patients with an early onset. Our findings support the hypothesis that the occurrence of resting tremor as an initial manifestation of PD may predict a lower probability of developing levodopa-induced dyskinesia. SN - 1432-1459 UR - https://www.unboundmedicine.com/medline/citation/26964541/Clinical_phenotype_and_risk_of_levodopa_induced_dyskinesia_in_Parkinson's_disease_ L2 - https://dx.doi.org/10.1007/s00415-016-8075-6 DB - PRIME DP - Unbound Medicine ER -