Risk Factors In Development Of Dyskinesias In Patients With Idiopathic Parkinson’s Disease

PARTⅠ The analysis of clinical features of dyskinesias in Parkinson’s disease.Objectives:To search the clinical features of dyskinesias in Parkinson’s disease.Patients and methods:The detailed information were recorded.patients were rated by Unified Parkinson’s disease rating scalel(UPDRS)and Hoehn-Yahn stage.We examined 250 PD patients on LD for the presence or absence of dyskinesia(DK±).Results:Of the 250 surveyed patients 69(27.6%) exhibited dyskinesias and 181(62.4%) did not. The mean age at onset of symptoms were earlier in DK(+) groups(p < 0.001). The duration of PD and treatment was longer in DK(+) groups(p < 0.001 and p < 0.001). The mean LD dose equivalent was significantly higher in DK(+) compared to DK(-) groups(666.3 mg/d versus 312.98 mg/d, p < 0.001). DK(p < 0.001) were more common in patients with TCS stages 3 and H&Y stages 3 ~ 4. UPDRS scores and TCS area were higher in DK(+) patients(p < 0.001 and p = 0.015). Serum uric acid(UA) concentration were lower in DK(+) patients(p < 0.001).Conclusion:DK was present in 27.6% of patients. Our results showed that the development of DK was associated with early onset PD, longer disease duration, higher mean LD dose and mean LD dose equivalent, longer LD use, higher TCS and H&Y stages, higher UPDRS scores and TCS area.PARTⅡ The multivariate analysis of related factors of dyskinesias in Parkinson’s disease.Objectives:dyskinesias induced by levodopa(L-dopa) treatment in Parkinson’s disease(PD) are not well documented in patients of Chinese ethnicity. We performed a cross-sectional study to identify the prevalence of dyskinesias and the risk factors for levodopa-induced dyskinesias in a population of 250 Chinese patients with PD.Patients and methods:We examined 250 PD patients on LD for the presence or absence of dyskinesia(DK±). Analysis of the nine factors which may influence the dyskinesias, Onset age and PD duration, The mean LD dose equivalent, Serum uric acid(UA) concentration, levodopa treatment time, TCS stages, H&Y stages, UPDRS scores and TCS area by Logistic regression.Results:Multivariate logistic regression analysis identified the mean LD dose equivalent(mean dose of treatment; OR 1.013; 95% CI 1.009—1.018), The duration of PD(OR 1.337; 95% CI 1.102—1.623) and Serum uric acid(UA) concentration(OR 0.977; 95% CI 0.966—0.987) as the main independent predictors.Conclusion:Our study results showed that serum UA concentration, disease duration and treatment parameters were associated with the occurrence of DK. Serum UA concentration may be a predictive factor for DK.