TY - JOUR
T1 - Levodopa-induced dyskinesia in dementia with Lewy bodies and Parkinson disease with dementia
AU - Turcano, Pierpaolo
AU - Stang, Cole D.
AU - Bower, James H.
AU - Ahlskog, J. Eric
AU - Boeve, Bradley F.
AU - Mielke, Michelle M.
AU - Savica, Rodolfo
N1 - Funding Information:
The work was supported by the National Institute on Aging of the National Institutes of Health (R01 AG034676) and by the Mayo Foundation for Medical Education and Research.
Funding Information:
P. Turcano and C.D. Stang report no disclosures. J.H. Bower receives funding from the Parkinson’s Disease Foundation, Inc. J.E. Ahlskog receives royalties from Oxford University Press for 3 recently published books. B.F. Boeve receives funding from the National Institute on Aging, the National Institute of Neurological Disorders and Stroke, the Lewy Body Dementia Association, GE Healthcare, Axovant Sciences, Inc., and Biogen. M.M. Mielke receives funding from the NIH and unrestricted research grants from Biogen and Lundbeck. She has consulted for Lysosomal Therapeutics, Inc, and Eli Lilly R. Savica receives funding from the National Institute on Aging, the National Institute of Neurological Disorders and Stroke, and the Parkinson’s Disease Foundation, Inc. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.
Publisher Copyright:
© American Academy of Neurology.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - ObjectiveTo investigate the frequency of levodopa-induced dyskinesia in dementia with Lewy bodies (DLBs) and Parkinson disease with dementia (PDD) and compare these frequencies with patients with incident Parkinson disease (PD) through a population-based cohort study.MethodsWe identified all patients with DLB, PDD, and PD without dementia in a 1991-2010 population-based parkinsonism-incident cohort, in Olmsted County, Minnesota. We abstracted information about levodopa-induced dyskinesia. We compared patients with DLB and PDD with dyskinesia with patients with PD from the same cohort.ResultsLevodopa use and dyskinesia data were available for 141/143 (98.6%) patients with a diagnosis of either DLB or PDD; 87 (61.7%), treated with levodopa. Dyskinesia was documented in 12.6% (8 DLB and 3 PDD) of levodopa-treated patients. Among these patients, median parkinsonism diagnosis age was 74 years (range: 64-80 years); 63.6%, male. The median interval from levodopa initiation to dyskinesia onset was 2 years (range: 3 months-4 years); the median daily levodopa dosage was 600 mg (range: 50-1,600 mg). Dyskinesia severity led to levodopa adjustments in 5 patients, and all improved. Patients with dyskinesia were diagnosed with parkinsonism at a significantly younger age compared with patients without dyskinesia (p < 0.001). Levodopa dosage was unrelated to increased risk of dyskinesias among DLB and PDD. In contrast, 30.1% of levodopa-treated patients with PD developed dyskinesia. In age-, sex-, and levodopa dosage-adjusted models, Patients with DLB and PDD each had lower odds of developing dyskinesia than patients with PD (odds ratio = 0.42, 95% CI 0.21-0.88; p = 0.02).ConclusionsThe dyskinesia risk for levodopa-treated patients with DLB or PDD was substantially less than for levodopa-treated patients with PD.
AB - ObjectiveTo investigate the frequency of levodopa-induced dyskinesia in dementia with Lewy bodies (DLBs) and Parkinson disease with dementia (PDD) and compare these frequencies with patients with incident Parkinson disease (PD) through a population-based cohort study.MethodsWe identified all patients with DLB, PDD, and PD without dementia in a 1991-2010 population-based parkinsonism-incident cohort, in Olmsted County, Minnesota. We abstracted information about levodopa-induced dyskinesia. We compared patients with DLB and PDD with dyskinesia with patients with PD from the same cohort.ResultsLevodopa use and dyskinesia data were available for 141/143 (98.6%) patients with a diagnosis of either DLB or PDD; 87 (61.7%), treated with levodopa. Dyskinesia was documented in 12.6% (8 DLB and 3 PDD) of levodopa-treated patients. Among these patients, median parkinsonism diagnosis age was 74 years (range: 64-80 years); 63.6%, male. The median interval from levodopa initiation to dyskinesia onset was 2 years (range: 3 months-4 years); the median daily levodopa dosage was 600 mg (range: 50-1,600 mg). Dyskinesia severity led to levodopa adjustments in 5 patients, and all improved. Patients with dyskinesia were diagnosed with parkinsonism at a significantly younger age compared with patients without dyskinesia (p < 0.001). Levodopa dosage was unrelated to increased risk of dyskinesias among DLB and PDD. In contrast, 30.1% of levodopa-treated patients with PD developed dyskinesia. In age-, sex-, and levodopa dosage-adjusted models, Patients with DLB and PDD each had lower odds of developing dyskinesia than patients with PD (odds ratio = 0.42, 95% CI 0.21-0.88; p = 0.02).ConclusionsThe dyskinesia risk for levodopa-treated patients with DLB or PDD was substantially less than for levodopa-treated patients with PD.
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U2 - 10.1212/CPJ.0000000000000703
DO - 10.1212/CPJ.0000000000000703
M3 - Article
AN - SCOPUS:85084571711
VL - 10
SP - 156
EP - 161
JO - Neurology: Clinical Practice
JF - Neurology: Clinical Practice
SN - 2163-0402
IS - 2
ER -