Risk factors and predictors of levodopa-induced dyskinesia among multiethnic Malaysians with Parkinson's disease

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Abstract

Chronic pulsatile levodopa therapy for Parkinson's disease (PD) leads to the development of motor fluctuations and dyskinesia. We studied the prevalence and predictors of levodopa-induced dyskinesia among multiethnic Malaysian patients with PD. Methods: This is a cross-sectional study involving 95 patients with PD on uninterrupted levodopa therapy for at least 6 months. The instrument used was the UPDRS questionnaires. The predictors of dyskinesia were determined using multivariate logistic regression analysis. Results: The mean age was 65.6 ± 8.5 years. The mean onset age was 58.5 ± 9.8 years. The median disease duration was 6 (7) years. Dyskinesia was present in 44% (n = 42) with median levodopa therapy of 3 years. There were 64.3% Chinese, 31% Malays, and 3.7% Indians and other ethnic groups. Eighty-one percent of patients with dyskinesia had clinical fluctuations. Patients with dyskinesia had lower onset age (p < 0.001), longer duration of levodopa therapy (p < 0.001), longer disease duration (p < 0.001), higher total daily levodopa dose (p < 0.001), and higher total UPDRS scores (p = 0.005) than patients without dyskinesia. The three significant predictors of dyskinesia were duration of levodopa therapy, onset age, and total daily levodopa dose. Conclusions: The prevalence of levodopa-induced dyskinesia in our patients was 44%. The most significant predictors were duration of levodopa therapy, total daily levodopa dose, and onset age.

Original languageEnglish
Pages (from-to)187-191
Number of pages5
JournalInternational Journal of Neuroscience
Volume124
Issue number3
DOIs
Publication statusPublished - Mar 2014

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Dyskinesias
Levodopa
Parkinson Disease
Age of Onset
Therapeutics
Ethnic Groups
Cross-Sectional Studies
Logistic Models
Regression Analysis

Keywords

  • Dyskinesia
  • Levodopa
  • Parkinson's disease
  • Predictors

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

@article{0c301717e765425baba69a31a373232a,
title = "Risk factors and predictors of levodopa-induced dyskinesia among multiethnic Malaysians with Parkinson's disease",
abstract = "Chronic pulsatile levodopa therapy for Parkinson's disease (PD) leads to the development of motor fluctuations and dyskinesia. We studied the prevalence and predictors of levodopa-induced dyskinesia among multiethnic Malaysian patients with PD. Methods: This is a cross-sectional study involving 95 patients with PD on uninterrupted levodopa therapy for at least 6 months. The instrument used was the UPDRS questionnaires. The predictors of dyskinesia were determined using multivariate logistic regression analysis. Results: The mean age was 65.6 ± 8.5 years. The mean onset age was 58.5 ± 9.8 years. The median disease duration was 6 (7) years. Dyskinesia was present in 44{\%} (n = 42) with median levodopa therapy of 3 years. There were 64.3{\%} Chinese, 31{\%} Malays, and 3.7{\%} Indians and other ethnic groups. Eighty-one percent of patients with dyskinesia had clinical fluctuations. Patients with dyskinesia had lower onset age (p < 0.001), longer duration of levodopa therapy (p < 0.001), longer disease duration (p < 0.001), higher total daily levodopa dose (p < 0.001), and higher total UPDRS scores (p = 0.005) than patients without dyskinesia. The three significant predictors of dyskinesia were duration of levodopa therapy, onset age, and total daily levodopa dose. Conclusions: The prevalence of levodopa-induced dyskinesia in our patients was 44{\%}. The most significant predictors were duration of levodopa therapy, total daily levodopa dose, and onset age.",
keywords = "Dyskinesia, Levodopa, Parkinson's disease, Predictors",
author = "Hashim, {H. Z.} and {Mohamed Ibrahim}, Norlinah and {Wan Yahya}, {Wan Nur Nafisah} and Tan, {Hui Jan} and Ali, {Raymond Azman} and {Mohd. Tamil}, Azmi",
year = "2014",
month = "3",
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T1 - Risk factors and predictors of levodopa-induced dyskinesia among multiethnic Malaysians with Parkinson's disease

AU - Hashim, H. Z.

AU - Mohamed Ibrahim, Norlinah

AU - Wan Yahya, Wan Nur Nafisah

AU - Tan, Hui Jan

AU - Ali, Raymond Azman

AU - Mohd. Tamil, Azmi

PY - 2014/3

Y1 - 2014/3

N2 - Chronic pulsatile levodopa therapy for Parkinson's disease (PD) leads to the development of motor fluctuations and dyskinesia. We studied the prevalence and predictors of levodopa-induced dyskinesia among multiethnic Malaysian patients with PD. Methods: This is a cross-sectional study involving 95 patients with PD on uninterrupted levodopa therapy for at least 6 months. The instrument used was the UPDRS questionnaires. The predictors of dyskinesia were determined using multivariate logistic regression analysis. Results: The mean age was 65.6 ± 8.5 years. The mean onset age was 58.5 ± 9.8 years. The median disease duration was 6 (7) years. Dyskinesia was present in 44% (n = 42) with median levodopa therapy of 3 years. There were 64.3% Chinese, 31% Malays, and 3.7% Indians and other ethnic groups. Eighty-one percent of patients with dyskinesia had clinical fluctuations. Patients with dyskinesia had lower onset age (p < 0.001), longer duration of levodopa therapy (p < 0.001), longer disease duration (p < 0.001), higher total daily levodopa dose (p < 0.001), and higher total UPDRS scores (p = 0.005) than patients without dyskinesia. The three significant predictors of dyskinesia were duration of levodopa therapy, onset age, and total daily levodopa dose. Conclusions: The prevalence of levodopa-induced dyskinesia in our patients was 44%. The most significant predictors were duration of levodopa therapy, total daily levodopa dose, and onset age.

AB - Chronic pulsatile levodopa therapy for Parkinson's disease (PD) leads to the development of motor fluctuations and dyskinesia. We studied the prevalence and predictors of levodopa-induced dyskinesia among multiethnic Malaysian patients with PD. Methods: This is a cross-sectional study involving 95 patients with PD on uninterrupted levodopa therapy for at least 6 months. The instrument used was the UPDRS questionnaires. The predictors of dyskinesia were determined using multivariate logistic regression analysis. Results: The mean age was 65.6 ± 8.5 years. The mean onset age was 58.5 ± 9.8 years. The median disease duration was 6 (7) years. Dyskinesia was present in 44% (n = 42) with median levodopa therapy of 3 years. There were 64.3% Chinese, 31% Malays, and 3.7% Indians and other ethnic groups. Eighty-one percent of patients with dyskinesia had clinical fluctuations. Patients with dyskinesia had lower onset age (p < 0.001), longer duration of levodopa therapy (p < 0.001), longer disease duration (p < 0.001), higher total daily levodopa dose (p < 0.001), and higher total UPDRS scores (p = 0.005) than patients without dyskinesia. The three significant predictors of dyskinesia were duration of levodopa therapy, onset age, and total daily levodopa dose. Conclusions: The prevalence of levodopa-induced dyskinesia in our patients was 44%. The most significant predictors were duration of levodopa therapy, total daily levodopa dose, and onset age.

KW - Dyskinesia

KW - Levodopa

KW - Parkinson's disease

KW - Predictors

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