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Motor complications in Parkinson's disease: 13-year follow-up of the CamPaIGN cohort.
Mov Disord. 2020 01; 35(1):185-190.MD

Abstract

BACKGROUND

Long-term population-representative data on motor fluctuations and levodopa-induced dyskinesias in Parkinson's disease is lacking.

METHODS

The Cambridgeshire Parkinson's Incidence from GP to Neurologist (CamPaIGN) cohort comprises incident PD cases followed for up to 13 years (n = 141). Cumulative incidence of motor fluctuations and levodopa-induced dyskinesias and risk factors were assessed using Kaplan-Meyer and Cox regression analyses.

RESULTS

Cumulative incidence of motor fluctuations and levodopa-induced dyskinesias was 54.3% and 14.5%, respectively, at 5 years and 100% and 55.7%, respectively, at 10 years. Higher baseline UPDRS-total and SNCA rs356219(A) predicted motor fluctuations, whereas higher baseline Mini-mental State Examination and GBA mutations predicted levodopa-induced dyskinesias. Early levodopa use did not predict motor complications. Both early motor fluctuations and levodopa-induced dyskinesias predicted reduced mortality in older patients (age at diagnosis >70 years).

CONCLUSIONS

Our data support the hypothesis that motor complications are related to the severity of nigrostriatal pathology rather than early levodopa use and indicate that early motor complications do not necessarily confer a negative prognosis. © 2019 International Parkinson and Movement Disorder Society.

Authors+Show Affiliations

Department of Neurology and Movement Disorder Center, College of Medicine, Seoul National University, Seoul, Korea.John van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.Department of Clinical & Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.John van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.John van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.John van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31965629

Citation

Kim, Han-Joon, et al. "Motor Complications in Parkinson's Disease: 13-year Follow-up of the CamPaIGN Cohort." Movement Disorders : Official Journal of the Movement Disorder Society, vol. 35, no. 1, 2020, pp. 185-190.
Kim HJ, Mason S, Foltynie T, et al. Motor complications in Parkinson's disease: 13-year follow-up of the CamPaIGN cohort. Mov Disord. 2020;35(1):185-190.
Kim, H. J., Mason, S., Foltynie, T., Winder-Rhodes, S., Barker, R. A., & Williams-Gray, C. H. (2020). Motor complications in Parkinson's disease: 13-year follow-up of the CamPaIGN cohort. Movement Disorders : Official Journal of the Movement Disorder Society, 35(1), 185-190. https://doi.org/10.1002/mds.27882
Kim HJ, et al. Motor Complications in Parkinson's Disease: 13-year Follow-up of the CamPaIGN Cohort. Mov Disord. 2020;35(1):185-190. PubMed PMID: 31965629.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Motor complications in Parkinson's disease: 13-year follow-up of the CamPaIGN cohort. AU - Kim,Han-Joon, AU - Mason,Sarah, AU - Foltynie,Thomas, AU - Winder-Rhodes,Sophie, AU - Barker,Roger A, AU - Williams-Gray,Caroline H, Y1 - 2019/11/11/ PY - 2019/03/14/received PY - 2019/08/12/revised PY - 2019/09/09/accepted PY - 2020/1/23/entrez PY - 2020/1/23/pubmed PY - 2020/12/18/medline KW - Parkinson's disease KW - levodopa-induced dyskinesias KW - motor complications KW - motor fluctuations SP - 185 EP - 190 JF - Movement disorders : official journal of the Movement Disorder Society JO - Mov Disord VL - 35 IS - 1 N2 - BACKGROUND: Long-term population-representative data on motor fluctuations and levodopa-induced dyskinesias in Parkinson's disease is lacking. METHODS: The Cambridgeshire Parkinson's Incidence from GP to Neurologist (CamPaIGN) cohort comprises incident PD cases followed for up to 13 years (n = 141). Cumulative incidence of motor fluctuations and levodopa-induced dyskinesias and risk factors were assessed using Kaplan-Meyer and Cox regression analyses. RESULTS: Cumulative incidence of motor fluctuations and levodopa-induced dyskinesias was 54.3% and 14.5%, respectively, at 5 years and 100% and 55.7%, respectively, at 10 years. Higher baseline UPDRS-total and SNCA rs356219(A) predicted motor fluctuations, whereas higher baseline Mini-mental State Examination and GBA mutations predicted levodopa-induced dyskinesias. Early levodopa use did not predict motor complications. Both early motor fluctuations and levodopa-induced dyskinesias predicted reduced mortality in older patients (age at diagnosis >70 years). CONCLUSIONS: Our data support the hypothesis that motor complications are related to the severity of nigrostriatal pathology rather than early levodopa use and indicate that early motor complications do not necessarily confer a negative prognosis. © 2019 International Parkinson and Movement Disorder Society. SN - 1531-8257 UR - https://www.unboundmedicine.com/medline/citation/31965629/Motor_complications_in_Parkinson's_disease:_13_year_follow_up_of_the_CamPaIGN_cohort_ L2 - https://doi.org/10.1002/mds.27882 DB - PRIME DP - Unbound Medicine ER -