Motor complications in Parkinson's disease: results from 3343 patients followed for up to 12 years (original) (raw)

Gandhi, S. E. et al. (2024) Motor complications in Parkinson's disease: results from 3343 patients followed for up to 12 years.Movement Disorders Clinical Practice, 11(6), pp. 686-697. (doi: 10.1002/mdc3.14044) (PMID:38587023)

Abstract

Background Motor complications are well recognized in Parkinson's disease (PD), but their reported prevalence varies and functional impact has not been well studied. Objectives To quantify the presence, severity, impact and associated factors for motor complications in PD. Methods Analysis of three large prospective cohort studies of recent-onset PD patients followed for up to 12 years. The MDS-UPDRS part 4 assessed motor complications and multivariable logistic regression tested for associations. Genetic risk score (GRS) for Parkinson's was calculated from 79 single nucleotide polymorphisms. Results 3343 cases were included (64.7% male). Off periods affected 35.0% (95% CI 33.0, 37.0) at 4–6 years and 59.0% (55.6, 62.3) at 8–10 years. Dyskinesia affected 18.5% (95% CI 16.9, 20.2) at 4–6 years and 42.1% (38.7, 45.5) at 8–10 years. Dystonia affected 13.4% (12.1, 14.9) at 4–6 years and 22.8% (20.1, 25.9) at 8–10 years. Off periods consistently caused greater functional impact than dyskinesia. Motor complications were more common among those with higher drug doses, younger age at diagnosis, female gender, and greater dopaminergic responsiveness (in challenge tests), with associations emerging 2–4 years post-diagnosis. Higher Parkinson's GRS was associated with early dyskinesia (0.026 ≤ P ≤ 0.050 from 2 to 6 years). Conclusions Off periods are more common and cause greater functional impairment than dyskinesia. We confirm previously reported associations between motor complications with several demographic and medication factors. Greater dopaminergic responsiveness and a higher genetic risk score are two novel and significant independent risk factors for the development of motor complications.

Item Type:	Articles
Additional Information:	Funding Sources and Conﬂict of Interest: MAL received consultancy fees for advising on a secondary analysis of an RCT sponsored by North Bristol NHS trust. [...] HRM is a co-applicant on a patent application related to C9ORF72–Method for diagnosing a neurodegenerative disease (PCT/GB2012/052140). MTH received funding/grant support from Parkinson’s UK, Oxford NIHR BRC, University of Oxford, CPT, Lab10X, NIHR, Michael J. Fox Foundation, H2020 European Union, GE Healthcare and the PSP Association.
Keywords:	Parkinson’s, motor complications, dyskinesia, dystonia.
Status:	Published
Refereed:	Yes
Glasgow Author(s) Enlighten ID:	Grosset, Professor Donald and Grosset, Dr Katherine and Marshall, Dr Vicky and Gandhi, Sacha
Authors:	Gandhi, S. E., Zerenner, T., Nodehi, A., Lawton, M. A., Marshall, V., Al‐Hajraf, F., Grosset, K. A., Morris, H. R., Hu, M. T., Ben‐Shlomo, Y., and Grosset, D. G.
College/School:	College of Medical Veterinary and Life Sciences College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing College of Medical Veterinary and Life Sciences > School of Psychology & Neuroscience
Journal Name:	Movement Disorders Clinical Practice
Publisher:	Wiley
ISSN:	2330-1619
ISSN (Online):	2330-1619
Published Online:	08 April 2024
Copyright Holders:	Copyright © 2024 International Parkinson and Movement Disorder Society
First Published:	First published in Movement Disorders Clinical Practice 11(6):686-697
Publisher Policy:	Reproduced in accordance with the publisher copyright policy

University Staff: Request a correction | Enlighten Editors: Update this record

Deposit and Record Details

ID Code:	328003
Depositing User:	Publications Router
Datestamp:	08 Jul 2024 11:19
Last Modified:	15 Apr 2025 10:09
Date of acceptance:	19 March 2024
Date of first online publication:	8 April 2024
Date Deposited:	22 July 2024
Data Availability Statement:	No