Dyskinesias and motor fluctuations in Parkinson's disease - A community-based study

We investigated the prevalence of dyskinesias and motor fluctuations, and t he factors determining their occurrence, in a community-based population of patients with Parkinson's disease. Among 124 patients with Parkinson's dis ease, 87 (70%) had received a levodopa preparation. Among these 87 patients , 28% were experiencing treatment-induced dyskinesias and 40% response fluc tuations. The prevalence of motor fluctuations was best predicted by diseas e duration and dose of levodopa, whereas dyskinesias could be best predicte d by duration of treatment, Patients with a shorter time from symptom onset to initiation of levodopa and younger patients had developed motor complic ations earlier, and patients who had started treatment with a dopamine agon ist had developed these treatment complications later, Although a satisfact ory response to medication was associated with higher rates of motor compli cations, poor or moderate response was associated with lower quality of lif e in patients with a disease duration of less than or equal to5 years or gr eater than or equal to 10 years. We conclude that motor fluctuations are mo st strongly related to disease duration and dose of levodopa, and dyskinesi as to duration of levodopa treatment, However, poorer quality of life assoc iated with inadequate dosage of levodopa may be the price for a low rate of motor complications in patients,vith Parkinson's disease.