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Abstract：
BACKGROUND: Levodopa-induced dyskinesias (LID) are frequent in Parkinson\'s disease (PD).
OBJECTIVE: To analyze the change in the frequency of LID over time, identify LID related factors, and characterize how LID impact on patients\' quality of life (QoL).
METHODS: PD patients from the 5-year follow-up COPPADIS cohort were included. LID were defined as a non-zero score in the item \"Time spent with dyskinesia\" of the Unified Parkinson\'s Disease Rating Scale-part IV (UPDRS-IV). The UPDRS-IV was applied at baseline (V0) and annually for 5 years. The 39-item Parkinson\'s disease Questionnaire Summary Index (PQ-39SI) was used to asses QoL.
RESULTS: The frequency of LID at V0 in 672 PD patients (62.4 ± 8.9 years old; 60.1% males) with a mean disease duration of 5.5 ± 4.3 years was 18.9% (127/672) and increased progressively to 42.6% (185/434) at 5-year follow-up (V5). The frequency of disabling LID, painful LID, and morning dystonia increased from 6.9%, 3.3%, and 10.6% at V0 to 17.3%, 5.5%, and 24% at V5, respectively. Significant independent factors associated with LID (P < 0.05) were a longer disease duration and time under levodopa treatment, a higher dose of levodopa, a lower weight and dose of dopamine agonist, pain severity and the presence of motor fluctuations. LID at V0 (β = 0.073; P = 0.027; R2 = 0.62) and to develop disabling LID at V5 (β = 0.088; P = 0.009; R2 = 0.73) were independently associated with a higher score on the PDQ-39SI.
CONCLUSIONS: LID are frequent in PD patients. A higher dose of levodopa and lower weight were factors associated to LID. LID significantly impact QoL.
OBJECTIVE: To analyze the change in the frequency of LID over time, identify LID related factors, and characterize how LID impact on patients\' quality of life (QoL).
METHODS: PD patients from the 5-year follow-up COPPADIS cohort were included. LID were defined as a non-zero score in the item \"Time spent with dyskinesia\" of the Unified Parkinson\'s Disease Rating Scale-part IV (UPDRS-IV). The UPDRS-IV was applied at baseline (V0) and annually for 5 years. The 39-item Parkinson\'s disease Questionnaire Summary Index (PQ-39SI) was used to asses QoL.
RESULTS: The frequency of LID at V0 in 672 PD patients (62.4 ± 8.9 years old; 60.1% males) with a mean disease duration of 5.5 ± 4.3 years was 18.9% (127/672) and increased progressively to 42.6% (185/434) at 5-year follow-up (V5). The frequency of disabling LID, painful LID, and morning dystonia increased from 6.9%, 3.3%, and 10.6% at V0 to 17.3%, 5.5%, and 24% at V5, respectively. Significant independent factors associated with LID (P < 0.05) were a longer disease duration and time under levodopa treatment, a higher dose of levodopa, a lower weight and dose of dopamine agonist, pain severity and the presence of motor fluctuations. LID at V0 (β = 0.073; P = 0.027; R2 = 0.62) and to develop disabling LID at V5 (β = 0.088; P = 0.009; R2 = 0.73) were independently associated with a higher score on the PDQ-39SI.
CONCLUSIONS: LID are frequent in PD patients. A higher dose of levodopa and lower weight were factors associated to LID. LID significantly impact QoL.
摘要：
背景：左旋多巴诱发的运动障碍（LID）在帕金森病（PD）中很常见。
目的：分析LID频率随时间的变化，确定LID相关因素，并描述LID对患者生活质量(QoL)的影响。
方法：纳入5年随访COPPADIS队列的PD患者。LID被定义为统一帕金森病评定量表第四部分（UPDRS-IV）的“运动障碍所花费的时间”项目中的非零得分。UPDRS-IV在基线(V0)和每年应用5年。使用39项帕金森病问卷汇总指数（PQ-39SI）评估QoL。
结果：672例PD患者（62.4±8.9岁；60.1％的男性）在V0时LID的频率为18.9％（127/672），平均疾病持续时间为5.5±4.3年，在5年随访（V5）时逐渐增加至42.6％（185/434）。禁用LID的频率，痛苦的盖子，早上肌张力障碍从6.9%增加，3.3%,和10.6%在V0到17.3%，5.5%,在V5时分别为24%。与LID相关的显著独立因素(P<0.05)是在左旋多巴治疗下病程和时间较长,更高剂量的左旋多巴,较低的体重和剂量的多巴胺激动剂，疼痛的严重程度和运动波动的存在。V0时的LID（β=0.073；P=0.027；R2=0.62）和V5时的致残LID（β=0.088；P=0.009；R2=0.73）与PDQ-39SI的较高得分独立相关。
结论：LID在PD患者中常见。较高剂量的左旋多巴和较低的体重是与LID相关的因素。LID显著影响QoL。
目的：分析LID频率随时间的变化，确定LID相关因素，并描述LID对患者生活质量(QoL)的影响。
方法：纳入5年随访COPPADIS队列的PD患者。LID被定义为统一帕金森病评定量表第四部分（UPDRS-IV）的“运动障碍所花费的时间”项目中的非零得分。UPDRS-IV在基线(V0)和每年应用5年。使用39项帕金森病问卷汇总指数（PQ-39SI）评估QoL。
结果：672例PD患者（62.4±8.9岁；60.1％的男性）在V0时LID的频率为18.9％（127/672），平均疾病持续时间为5.5±4.3年，在5年随访（V5）时逐渐增加至42.6％（185/434）。禁用LID的频率，痛苦的盖子，早上肌张力障碍从6.9%增加，3.3%,和10.6%在V0到17.3%，5.5%,在V5时分别为24%。与LID相关的显著独立因素(P<0.05)是在左旋多巴治疗下病程和时间较长,更高剂量的左旋多巴,较低的体重和剂量的多巴胺激动剂，疼痛的严重程度和运动波动的存在。V0时的LID（β=0.073；P=0.027；R2=0.62）和V5时的致残LID（β=0.088；P=0.009；R2=0.73）与PDQ-39SI的较高得分独立相关。
结论：LID在PD患者中常见。较高剂量的左旋多巴和较低的体重是与LID相关的因素。LID显著影响QoL。
