Parkinsonian Symptoms, Not Dyskinesia, Negatively Affect Active Life Participation of Dyskinetic Patients with Parkinson’s Disease

Tremor and Other Hyperkinetic Movements

article

Etienne Goubault¹  Sarah Bogard²  Pierre J. Blanchet¹  Erwan Bézard⁵  Claude Vincent⁷  Davide Martino⁸  Justyna Sarna⁹  Oury Monchi⁹  Christian Duval² 

[1] Laboratoire de Simulation et Modélisation du Mouvement, Université de Montréal;Département des Sciences de l’activité physique, Université du Québec à Montréal;Centre de Recherche de l’Institut universitaire de gériatrie de Montréal;Département de médecine, CHU Montréal;Université de Bordeaux, Institut des Maladies Neurodégénératives;Centre National de la Recherche Scientifique Unité Mixte de Recherche, Institut des Maladies Neurodégénératives;Université Laval;Cumming School of Medicine, Department of Clinical Neurosciences, University of Calgary;Hotchkiss Brain Institute, Department of Clinical Neurosciences, University of Calgary

关键词: Parkinson’s disease;    Levodopa-induced dyskinesia;    Participation;    Every-day life;    Activity engagement;   

DOI  :  10.5334/tohm.403

学科分类：社会科学、人文和艺术（综合）

来源: Ubiquity Press

【 摘 要 】

Background: The impact of slight-to-moderate levodopa-induced dyskinesia (LID) on the level of participation in active life in patients with Parkinson’s disease (PD) has never been objectively determined. Methods: Levels of LID, tremor and bradykinesia were measured during best-ON state in 121 patients diagnosed with PD and having peak-dose LID using inertial sensors positioned on each body limb. Rigidity and postural instability were assessed using clinical evaluations. Cognition and depression were assessed using the MMSE and the GDS-15. Participation in active life was assessed in patients and in 69 healthy controls using the Activity Card Sort (ACS), which measures levels of activity engagement and activities affected by the symptomatology. Outcome measures were compared between patients and controls using ANCOVA, controlling for age or Wilcoxon-Mann-Whitney tests. Spearman correlations and multivariate analyses were then performed between symptomatology and ACS scores. Results: Patients had significantly lower activity engagement than controls and had significantly affected activities. LID was neither associated with activity engagement nor affected activities. Higher levels of tremor, postural instability, cognitive decline and depression were associated with lower activity engagement and higher affected activities. Multivariate analyses revealed that only tremor, postural instability and depression accounted significantly in the variances of these variables. Discussion: Slight-to-moderate LID had little impact compared to other symptoms on the level of participation in active life, suggesting that other symptoms should remain the treatment priority to maintain the level of participation of patients in an active lifestyle.

【 授权许可】

CC BY