Gender Is the Main Predictor of Wearing-Off and Dyskinesia in Levodopa-Naïve Patients with Parkinson's Disease.
Gender Is the Main Predictor of Wearing-Off and Dyskinesia in Levodopa-Naïve Patients with Parkinson's Disease.
Where did the research take place?
The study site has not been established. Author addresses may differ from where the research occurred.
Salerno, IT · Author affiliation
Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," Neuroscience Section, University of Salerno, Salerno, Italy.Location evidence
Catanzaro, IT · Author affiliation
Department of Medical and Surgical Sciences, Institute of Neurology, Magna Græcia University, Catanzaro, Italy.Location evidence
Genoa, IT · Author affiliation
Department of Experimental Medicine (DIMES), Section of Human Physiology, University of Genoa, Genoa, Italy.Location evidence
Como, IT · Author affiliation
Neurorehabilitation Unit, Parkinson's Disease and Movement Disorders Center, Moriggia-Pelascini Hospital, Como, Italy.Location evidence
Milan, IT · Author affiliation
Medical Genetics and Neurogenetics Unit, Fondazione IRCCS Istituto Neurologico "C. Besta", Milano, Italy.Location evidence
Pisa, IT · Author affiliation
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.Location evidence
Catania, IT · Author affiliation
Neurologic Unit, AOU "Policlinico-San Marco," Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, University of Catania, Catania, Italy.Location evidence
Naples, IT · Author affiliation
Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.Location evidence
Centro, IT · Author affiliation
Centro Parkinson e Parkinsonismi, Milan, Italy.Location evidence
Pavia, IT · Author affiliation
Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, Pavia, Italy.Location evidence
Rome, IT · Author affiliation
IRCCS San Raffaele, Rome, Italy.Location evidence
Bologna, IT · Author affiliation
IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy.Location evidence
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Original abstract
BACKGROUND: Evidence suggests that female gender represents a risk factor for the development of motor/nonmotor fluctuations and dyskinesia in Parkinson's disease (PD). So far, no prospective study has analyzed this aspect in relation to the introduction of levodopa treatment. OBJECTIVE: This prospective multicenter study aims to assess the development of motor/nonmotor fluctuations and dyskinesia based on gender over a 2-year observation period in PD patients starting levodopa. METHODS: Two hundred and eighty-nine PD patients requiring levodopa at baseline were enrolled at 17 Movement Disorders Centers and followed for 2 years. Gender differences in the development of fluctuations, defined as a score ≥2 in the 19-item Wearing-Off Questionnaire, and dyskinesia, defined by Movement Disorders Society Unified Parkinson's Disease Rating Scale Part IV (MDS-UPDRS-IV) score >0 on item 4.1 were assessed. Baseline predictors of such complications were evaluated by stepwise multivariate logistic regression analysis. RESULTS: Two hundred and sixteen patients (139 men, 77 women) completed the follow-up (M24). By M24, 53,2% of men and 64.9% of women had fluctuations (P = 0.048), whereas 5% of men and 14.3% of women developed dyskinesia (P = 0.0185). Multivariate analysis showed that female gender significantly predicted wearing-off (Odds ratio [OR] = 1.930; P = 0.0333), whereas older age was a significant protective factor (for 5-year increase: OR = 0.712; P < 0.0001). Multivariate analysis showed that gender (OR = 3.405; P = 0.0228) and MDS-UPDRS Part III score (for a 5-unit increase: OR = 1.281; P = 0.0239) were significant predictors of dyskinesia at M24. CONCLUSIONS: Female gender was the strongest predictor of fluctuations and dyskinesia after 2-year intake of levodopa. This finding could have important implications for the development of gender-oriented therapeutic recommendations in early PD.