Prevalence of wearing-off and dyskinesia among the patients with Parkinson’s disease on levodopa therapy: a multi-center registry survey in mainland China

Translational Neurodegeneration

Sheng-Di Chen^1,11  Jian Wang⁸  Yi-Ming Liu^1,10  Zhen-Guo Liu⁹  Chun-Feng Liu¹  An-Mu Xie⁴  Xiao-Chun Chen⁵  Xiao-Guang Luo⁷  Wei-Guo Liu²  Tao Feng³  Ming Shao⁶  Qin Xiao^1,11  Wei Chen^1,11 

[1] Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China;Department of Neurology, Nanjing Brain Hospital affiliated to Nanjing Medical University, Nanjing, China;Department of Neurology, Beijing Tiantan Hospital affiliated to Capital Medical University, Beijing, China;Department of Neurology, The Affiliated Hospital of Medical College Qingdao University, Qingdao, China;Department of Neurology, Union XieHe Hospital, Fujian Medical University, Fuzhou, China;Department of Neurology, The First Affiliated Hospital of Guangzhou Medical College, Guangzhou, China;Department of Neurology, The First Hospital of China Medical University, Shenyang, China;Department of Neurology, Huashan Hospital affiliated to Fudan University, Shanghai, China;Department of Neurology, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China;Department of Neurology, Qilu Hospital of Shandong University, Jinan, China;Department of Neurology, Rui Jin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Rui Jin 2nd Road 197, Shanghai 200025, China

关键词: Epidemiology;    Dyskinesia;    Wearing-off;    Parkinson’s disease;   

Others  :  1130932
DOI  :  10.1186/2047-9158-3-26

 received in 2014-10-13, accepted in 2014-11-26,  发布年份 2014

【 摘 要 】

Objective

Chronic levodopa (L-dopa) treatment in Parkinson’s disease (PD) is often associated with the development of motor complications, but the corresponding epidemiological data is rare in Chinese PD patients. The present survey was to investigate the prevalence rate of wearing-off (WO) and dyskinesia among the patients with PD in China.

Methods

From May 2012 to October 2012, a 3-step registry survey for wearing off (WO) and dyskinesia patients with PD receiving levodopa therapy was performed simultaneously at 28 movement disorders clinics in China.

Results

There were 1,558 PD patients fulfilling the inclusion criteria. Among them, 1,051 had at least one positive response of 9-item wearing off questionnaire (WOQ-9), 724 and 160 patients were finally diagnosed with WO and dyskinesia by movement disorders specialists, respectively. The overall prevalence rates of WO and dyskinesia were 46.5% (95% CI 44.0% - 48.9%) and 10.3% (95% CI 8.8% - 11.8%), respectively. The mean score of WOQ-9 for those with WO was 3.8 (SD = 1.8), with movement slowness being the most common motor symptoms and pain/aching being the most common non-motor symptoms. Better improvement of motor symptoms (n = 354, 87.8%) and long-term disease control and drug selection (n = 288, 71.5%) were the two most frequently considered factors when movement disorders specialists adjusted therapeutic strategies for patients with WO.

Conclusions

This survey provided the first multi-center epidemiological data of motor complications among PD patients on L-dopa therapy from mainland China. WO prevalence rate among Chinese PD patients was in line with, while dyskinesia prevalence rate was lower than previous reports from other Countries.

【 授权许可】

   
2014 Chen et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】

• [1]Stacy M: The wearing-off phenomenon and the use of questionnaires to facilitate its recognition in Parkinson's disease. J Neural Transm 2010, 117:837-846.
• [2]Schrag A, Quinn N: Dyskinesias and motor fluctuations in Parkinson's disease. A community-based study. Brain 2000, 123:2297-2305.
• [3]Ahlskog JE, Muenter MD: Frequency of levodopa-related dyskinesias and motor fluctuations as estimated from the cumulative literature. Mov Disord 2001, 16:448-458.
• [4]Kum WF, Gao J, Durairajan SS, Man SC, Xie LX, Lu JH, Fong WL, Li M: Risk factors in development of motor complications in Chinese patients with idiopathic Parkinson's disease. J Clin Neurosci 2009, 16:1034-1037.
• [5]Liu CF, Yin WH, Luo WF: Factors of dyskinesias and motor fluctuations in Parkinson's disease. Chin J Neurol 2003, 36:411-413.
• [6]Stacy MA, Murphy JM, Greeley DR, Stewart RM, Murck H, Meng X: The sensitivity and specificity of the 9-item Wearing-off Questionnaire. Parkinsonism Relat Disord 2008, 14:205-212.
• [7]Chan A, Cheung YF, Yeung MA, Yeung J, Chung TH, Tsang KL, Chan J, Lau C, Kwan P, Kuo SH, Mok V: A validation study of the Chinese wearing off questionnaire 9-symptom for Parkinson's disease. Clin Neurol Neurosurg 2011, 113:538-540.
• [8]Antonini A, Martinez-Martin P, Chaudhuri RK, Merello M, Hauser R, Katzenschlager R, Odin P, Stacy M, Stocchi F, Poewe W, Rascol O, Sampaio C, Schrag A, Stebbins GT, Goetz CG: Wearing-off scales in Parkinson's disease: critique and recommendations. Mov Disord 2011, 26:2169-2175.
• [9]Chen W, Chen S, Xiao Q, Wang G, Chen SD: Current clinical practice for Parkinson's disease among Chinese physicians, general neurologists and movement disorders specialists: a national survey. BMC Neurol 2012, 12:155. BioMed Central Full Text
• [10]Muller T: Drug therapy in patients with Parkinson's disease. Transl Neurodegener 2012, 1:10. BioMed Central Full Text
• [11]Benbir G, Ozekmekci S, Apaydin H, Delil S, Erginoz E: A hospital-based study: risk factors in development of motor complications in 555 Parkinson's patients on levodopa therapy. Clin Neurol Neurosurg 2006, 108:726-732.
• [12]Hughes AJ, Daniel SE, Kilford L, Lees AJ: Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 1992, 55:181-184.
• [13]Stacy M, Hauser R, Oertel W, Schapira A, Sethi K, Stocchi F, Tolosa E: End-of-dose wearing off in Parkinson disease: a 9-question survey assessment. Clin Neuropharmacol 2006, 29:312-321.
• [14]Tomlinson CL, Stowe R, Patel S, Rick C, Gray R, Clarke CE: Systematic review of levodopa dose equivalency reporting in Parkinson's disease. Mov Disord 2010, 25:2649-2653.
• [15]Richards M, Marder K, Cote L, Mayeux R: Interrater reliability of the Unified Parkinson's Disease Rating Scale motor examination. Mov Disord 1994, 9:89-91.
• [16]Guy W, AIMS: ECDEU Assessment Manual for Psychopharmacology. Washington, DC: Government Printing Office; 1976:534.
• [17]Lawton MP, Brody EM: Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969, 9:179-186.
• [18]Bares M, Rektorova I, Jech R, Farníková K, Roth J, Růžička E, Kaňovský P, Rektor I, Pavlík T, Uhlířová L, Vydlák J: Does WOQ-9 help to recognize symptoms of non-motor wearing-off in Parkinson's disease. J Neural Transm 2012, 119:373-380.
• [19]Stacy M, Bowron A, Guttman M, Hauser R, Hughes K, Larsen JP, LeWitt P, Oertel W, Quinn N, Sethi K, Stocchi F: Identification of motor and nonmotor wearing-off in Parkinson's disease: comparison of a patient questionnaire versus a clinician assessment. Mov Disord 2005, 20:726-733.
• [20]Stocchi F, Antonini A, Barone P, Tinazzi M, Zappia M, Onofrj M, Ruggieri S, Morgante L, Bonuccelli U, Lopiano L, Pramstaller P, Albanese A, Attar M, Posocco V, Colombo D, Abbruzzese G: Early DEtection of wEaring off in Parkinson disease: The DEEP study. Parkinsonism Relat Disord 2014, 20:204-211.
• [21]Juri-Claveria C, Aguirre-M C, Viviani-G P, Chana-Cuevas P: Risk factors associated with the development of motor complications in Parkinson's disease. A study in a Chilean population. Rev Neurol 2007, 45:77-80.
• [22]Yoritaka A, Shimo Y, Takanashi M, Fukae J, Hatano T, Nakahara T, Miyamato N, Urabe T, Mori H, Hattori N: Motor and non-motor symptoms of 1453 patients with Parkinson's disease: prevalence and risks. Parkinsonism Relat Disord 2013, 19:725-731.
• [23]Hauser RA, McDermott MP, Messing S: Factors associated with the development of motor fluctuations and dyskinesias in Parkinson disease. Arch Neurol 2006, 63:1756-1760.
• [24]Warren OC, Kieburtz K, Rascol O, Poewe W, Schapira AH, Emre M, Nissinen H, Leinonen M, Stocchi F: Factors predictive of the development of Levodopa-induced dyskinesia and wearing-off in Parkinson's disease. Mov Disord 2013, 28:1064-1071.
• [25]de Lau LM, Verbaan D, Marinus J, Heutink P, van Hilten JJ: Catechol-O-methyltransferase Val158Met and the risk of dyskinesias in Parkinson's disease. Mov Disord 2012, 27:132-135.
• [26]Foltynie T, Cheeran B, Williams-Gray CH, Edwards MJ, Schneider SA, Weinberger D, Rothwell JC, Barker RA, Bhatia KP: BDNF val66met influences time to onset of levodopa induced dyskinesia in Parkinson's disease. J Neurol Neurosurg Psychiatry 2009, 80:141-144.
• [27]Strong JA, Dalvi A, Revilla FJ, Sahay A, Samaha FJ, Welge JA, Gong J, Gartner M, Yue X, Yu L: Genotype and smoking history affect risk of levodopa-induced dyskinesias in Parkinson's disease. Mov Disord 2006, 21:654-659.
• [28]Witjas T, Kaphan E, Azulay JP, Blin O, Ceccaldi M, Pouget J, Poncet M, Chérif AA: Nonmotor fluctuations in Parkinson's disease: frequent and disabling. Neurology 2002, 59:408-413.