Objective: This cross-sectional study aimed at determining the relation between levels of drug-induced dyskinesia (DID), tremor, rigidity, bradykinesia, postural instability, as well as cognition and depression, with activity engagement and quality of life (QoL) in patients experiencing, or not, choreic-type DID.

Background: The impact of DID on the activities of daily living (ADL) and health related QoL of patients with PD is still debated. Several studies demonstrated the negative impact of DID, while other research point-out the impact of other motor dysfunctions like tremors, gait and mobility impairments, and cognition.

Methods: 121 patients diagnosed with PD and known to experience choreic-type DID were recruited to perform a series of ADL. Levels of DID, tremor and bradykinesia were measured using inertial sensors positioned on each body limb. Rigidity and postural instability were assessed using clinical evaluations. Cognition and depression were assessed using the questionnaires MMSE and GDS-15, respectively. Levels of symptomatology were measured during the best-ON period. Activity engagement (number of activities in which patients are engaged) and activities affected by the disease or age were assessed in patients and in gender-, age-matched controls using the Activity Card Sort (ACS). Health related QoL was assessed using the SF12 version 2. Patients were separated into 2 groups depending on the level of DID recorded during the experiment (present or not). Activity engagement and affected activities were compared between groups using ANCOVA controlling for age. QoL was compared between groups using Kruskal-Wallis tests. Spearman correlations were then calculated between symptomatology and ACS, as well as SF12 scores.

Results: Patients had a significantly lower activity engagement than controls and were significantly affected by PD. Spearman correlations revealed that DID was not related with activity engagement but with affected activities, meaning that patients with DID gave-up activities because of DID but started new ones, thus maintaining their level of engagement in ADL. Tremor, postural instability, cognition, and depression were all related with lower activity engagement, affected activities and QoL.

Conclusions: Tremor, postural instability, cognition and depression seem to have a larger impact on ADL and QoL than DID in patients with PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/mild-to-moderate-dyskinesia-is-not-significantly-related-to-the-level-of-activity-engagement-or-quality-of-life-of-patients-with-parkinsons-disease/