PREDICTING THE RISK OF DYSKINESIA DEVELOPMENT IN PARKINSON

摘要

Background: Parkinson"s Disease is a neurodegenerative disease characterized by motor and non-motor findings. Motor findings generally start with involvement of a single extremity and progress throughout life; asymmetrical involvement continues with clinical findings typically predominant in the first involved side. Parkinson"s Disease is divided into two phenotypes, tremor dominant, and non-tremor dominant. We aimed to investigate and compare the incidence of dyskinesia development and other clinical parameters such as age, gender, disease duration, and treatment between the tremor dominant and non-tremor dominant phenotypes of idiopathic Parkinson"s Disease. Methods: We conducted a retrospective study of 502 patients (183 females, 319 male) with idiopathic Parkinson"s Disease. Results: Two hundred eighty-five (56%) patients had tremor dominant phenotype and 217 (44%) had non-tremor dominant. Dyskinesia was observed in 29% of the patients overall, 24% of the tremor dominant patients, and 35% of the non-tremor dominant patients. Dyskinesia incidence was significantly greater in the non-tremor dominant group than the tremor dominant group (p=0.006). Average age at diagnosis in patients who developed dyskinesia 57±12.9 years and who did not 64±11.1 years. Thirty-four (24 tremor dominant, 10 non-tremor dominant) patients had a family member with Parkinson"s Disease. Thirteen patients (5 tremor dominant, 8 non-tremor dominant) with a positive family history developed dyskinesia. The incidence of dyskinesia development according to clinical phenotype was independent from family history and was greater in the NTD group (p=0.02). Levodopa treatment was received by 421 (83%) patients; the incidence of dyskinesia development who used levodopa was 33% (p0.001). Conclusions: Patients with non-tremor dominant phenotype of Idiopathic Parkinson"s Disease have a significantly higher risk of developing dyskinesia and should be closely clinically followed.