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Does the Side Onset of Parkinson's Disease Influence the Time to Develop Levodopa-Induced Dyskinesia?

Authors
 Chung, Seok Jong  ;  Yoo, Han Soo  ;  Lee, Hye Sun  ;  Lee, Phil Hyu  ;  Sohn, Young H. 
Citation
 JOURNAL OF PARKINSONS DISEASE, Vol.9(1) : 241-247, 2019 
Journal Title
JOURNAL OF PARKINSONS DISEASE
ISSN
 1877-7171 
Issue Date
2019
Keywords
Dyskinesia ; Parkinson’s disease ; laterality of motor control ; neural plasticity ; risk factors
Abstract
BACKGROUND: Aberrant plasticity is closely linked to the development of levodopa-induced dyskinesia (LID) in Parkinson's disease (PD).

OBJECTIVE: This study investigated whether dominant-side patients with PD exhibit a shorter time to LID development, based on the hypothesis that the dominant hemisphere may have greater plasticity than non-dominant-side patients.

METHODS: We analyzed data from 387 right-handed patients with PD who exhibited asymmetric motor deficits and received PD medications for ≥2 years (191 dominant-side and 196 non-dominant-side patients). The influence of side onset on time for LID development was assessed by Kaplan-Meier estimates and time-dependent Cox regression models based on the 5-year time point, after adjusting for age at PD onset, dopamine transporter activity in the posterior putamen, and daily levodopa dose.

RESULTS: LID developed in 46 (23.4%) patients with non-dominant-side PD and in 35 (18.1%) patients with dominant-side PD. The Kaplan-Meier analyses revealed that non-dominant-side patients developed LID earlier than dominant-side patients (p = 0.027). The time-dependent Cox regression models showed that the risk of LID within 5 years of treatment was significantly higher in non-dominant-side than in dominant-side patients (hazard ratio 1.954; p = 0.034), whereas the risk after 5 years was similar between groups (p = 0.528).

CONCLUSIONS: The present study demonstrated that LID developed earlier in non-dominant-side than in dominant-side patients with PD. These results suggested a greater potential of synaptic plasticity in the dominant hemisphere that may exert a protective role for the development of LID compared to the non-dominant hemisphere.
Full Text
https://content.iospress.com/articles/journal-of-parkinsons-disease/jpd181512
DOI
10.3233/JPD-181512
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Yoo, Han Soo(유한수) ORCID logo https://orcid.org/0000-0001-7846-6271
Chung, Seok Jong(정석종) ORCID logo https://orcid.org/0000-0001-6086-3199
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/169505
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