The Clinical And Experimental Study Of Levodopa-induced Dyskinesia And Motor Fluctuation In Parkinson's Disease

Objective: We investigate not only the prevalence of levodopa-induced dyskinesias and motor fluctuation in Parkinson's disease but also the factors which determine their occurrence and the effects of dyskinesias and motor fluctuation to the quality of life in Parkinson'disease.Methods: Sixty-three patients were examined and diagnosed as Parkinson's disease according to strict clinical diagnostic criteria. Informations were collected by a trained investigator from all cases with a standardized questionnaire in face-to-face interviews to find if they had experienced dyskinesias or motor fluctuations. The data was analysized with SPSS 10.0 statistic software.Results: Among 63 patients, 36(57.1%) experienced motor fluctuation and 11(17.5%) dyskinesias. The mean dose of L-dopa and the scores of UPDRS in "off' was positively correlated with dyskinesias. The treatment duration was positively correlated with motor fluctuation. Smoking and controlled release cabidopa/levodopa may be helpful to reduce motor fluctuation. The main subtype of motor fluctuation was wearing-off and that of dyskinesias was dystonia. Chorea and "on-off"was few while no billism and myoclonus were found.The quality of life (QoL) in PD moderately declined. The QoL in PD was greatly influenced by disease duration and severity of disease. PDQ was associated with depression but not with L-dopa dosage, levodopa-induced dyskinesia, motor fluctuation or mental state.Conclusions: The rate of motor fluctuation is approximately equal with the result reported in other countrys while the rate of dyskinesias was relatively lower. Thetreatment duration was the risk factor of motor fluctuation. The mean dose of L-dopa and the scores of UPDRS in "off' was the risk factor of dyskinesias. Disease duration , severity of disease and depression play a key role in the QoL in PD. We suspect inadequate levodopa dosage brought about the result that PDQ was not associated with L-dopa dosage, dyskinesia or motor fluctuation. Adequate dopaminergic drugs or deep brain stimulation were recommended to improve the symptoms and QoL of PD.