Objective: To investigate the effects of motor laterality on the development of levodopa-induced dyskinesia (LID) in patients with de novo Parkinson’s disease (PD).

Background: LID occurs in most patients with PD within several years as a consequence of chronic dopamine replacement therapy. In general, younger age of onset and severity of PD, and higher doses and longer duration of levodopa treatment are closely associated with the early development of LID. Motor laterality, however, has not been assessed as a risk factor for LID.

Methods: We reviewed the medical records of 560 patients with PD who were treated with PD medications at least for 2.5 years from the Yonsei Parkinson Center database. Among them, 390 with documented right-handedness had asymmetric and lateralized motor symptoms (193 with right-side dominant PD and 197 with left-side dominant PD). We assessed the effects of motor laterality on the development of LID with Kaplan-Meier estimates and time-dependent Cox regression model based on the time point of 5 years, adjusting for the age of PD onset, dopamine transporter (DAT) availability of the posterior putamen, and levodopa-equivalent dose.

Results: The right-side-dominant PD group had milder parkinsonian motor symptoms compared with the left-side-dominant group, despite their comparable DAT availability in the posterior putamen. LID developed in 46 (23.4%) with right-side dominant PD (follow-up duration, 4.81 years) and in 35 (18.1%) patients with left-side dominant PD (follow-up duration, 4.73 years). The Kaplan-Meier analyses revealed that the left-side-dominant group developed LID earlier than the right-side-dominant group (PBreslow = 0.027). The time-dependent Cox regression model showed that the hazard ratio for the development of LID within 5 years of the left-side-dominant group was 1.978 (95% confidence interval, 1.066-3.669, p = 0.031) compared with the right-side dominant group, whereas the risk for developing LID after 5 years was similar between the two groups (p = 0.360).

Conclusions: These findings suggest that the plasticity of the striato-cortical motor networks may differ between the dominant and non-dominant hemispheres, which affects the risk for the early development of LID according to the motor laterality in patients with PD.

« Back to 2018 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/does-motor-laterality-affect-the-development-of-dyskinesia-in-patients-with-parkinsons-disease/