Objective: The aim of this study is to compare the level of mild cognitive impairment in Parkinson’s disease patients with and without levodopa-induced dyskinesia. Additionally, we seek to explore the correlation between cognitive impairment and levodopa-induced dyskinesia in these patients.

Background: Levodopa serves as the primary treatment for Parkinson’s disease. However, prolonged use can lead to levodopa-induced dyskinesia (LID), a significant concern.In patients experiencing dyskinesia, oscillatory activity in the 7.5–10 Hz range has been observed in regions covering the primary motor and supplementary motor areas. Dysfunction in various cognitive domains in PD has been linked to decreased activity in the prefrontal cortex, striatum, and thalamus, particularly in frontal striatum regions. This suggests a pathophysiological connection between cognitive impairment and neurobiological changes in specific brain regions.

Method: A comparative cross-sectional study on 70 Parkinson’s Disease patients recruited from Ain Shams University’s movement disorders outpatient clinic. Among them, 35 patients exhibited (LID), while the remaining 35 patients showed no dyskinesia. All participants underwent assessment using the following scales: (MDS-UPDRS), (UDysRS), (PDQ-39), Parkinson’s Disease Cognitive Rating Scale (PD-CRS), (NMSS), and (QUIP-RS).

Results: There was a significant statistical difference in the total PD-CRS scores between the group with dyskinesia(A) and the group without dyskinesia (B), with scores of 78.6±15.9 and 97.4±15.91, respectively, and a p-value of < 0.001. Strong correlations were found between Group A and Group B regarding PD-CRS scores and UDysRS Total scores, suggesting a robust relationship between cognitive function and levodopa-induced dyskinesia (LID) in PD patients, with a correlation coefficient of r=-0.526 and a p-value of <0.001. Additionally, Group A exhibited a significantly higher PDQ39 Summary Index (44.8 ± 10.58) compared to Group B (29.0 ± 8.29) (p < 0.001).

Conclusion: Mild cognitive impairment and levodopa-induced dyskinesia are linked in Parkinson’s disease, potentially indicating shared underlying mechanisms. Moreover, the presence of levodopa-induced dyskinesia may necessitate vigilant monitoring of cognitive function for early intervention in Parkinson’s disease dementia.

Demographic Data

PD with Dyskinesia and PD without

PD-CRS total score in both groups

Comparison Regrading NMSS Domains

Correlation between UDysRS and PD-CRS

Comparison regarding NMSS categories

Levodopa Equivalent Dose in Both Groups

Duration of Levodopa Dose in Both Groups

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MDS Abstracts - https://www.mdsabstracts.org/abstract/correlation-between-mild-cognitive-impairment-and-levodopa-induced-dyskinesia-in-parkinsons-disease-patients/