ABSTRACT
INTRODUCTION: The treatment of Parkinson's disease (PD) is based on the use of levodopa and/or dopaminergic agonists. This treatment is associated with motor complications in around 50% of the patients over 5 years of treatment. Numerous risk factors have been related to the onset of this motor complications. AIM: To describe the prevalence and risk factors associated with the occurrence of motor complications in our population. PATIENTS AND METHODS: PD patients in control in a movement disorders center were consecutively recruited. Using a multivariate logistic regression model the risk factors associated with the onset of MC were determined. RESULTS: 124 patients were evaluated. Mean age was 66,2 +/- 10,1 years, the years of PD evolution were 8,1 +/- 5,2 years, the on UPDRS score was 27,7 +/- 14,8 points. A 62% of the patients presented at least one motor complication, a 52% with wearing off and a 47,2% dyskinesias. Both motor complications were present in 39%. The multivariate analysis showed that that female sex and the dose of levodopa equivalents were the risk factors for the occurrence of dyskinesias. For the wearing off the main risk factor were the years of evolution of the PD. CONCLUSIONS: This study shows that the time of evolution of the PD is the main risk factor for the wearing off and the female sex and the dose of levodopa equivalents are the risk factor for the development of dyskinesias. These results are in agreement with the previously reported in the literature for other populations.
Subject(s)
Movement Disorders/etiology , Parkinson Disease/complications , Aged , Antiparkinson Agents/adverse effects , Chile , Disease Progression , Dopamine Agonists/adverse effects , Female , Humans , Levodopa/adverse effects , Middle Aged , Movement Disorders/physiopathology , Multivariate Analysis , Parkinson Disease/drug therapy , Parkinson Disease/physiopathology , Risk FactorsABSTRACT
Introducción. El tratamiento de la enfermedad de Parkinson (EP) se basa principalmente en el uso de levodopa y/o agonistas dopaminérgicos. Este tratamiento se asocia con complicaciones motoras aproximadamente en el 50% de los pacientes a los cinco años. Existen diversos factores de riesgo para el desarrollo de estas complicaciones descritos en otras poblaciones. Objetivo. Describir la prevalencia y factores de riesgo para la aparición de complicaciones motoras en nuestra población de portadores de EP. Pacientes y métodos. Consecutivamente se reclutaron portadores de EP. Mediante un modelo de regresión logística multivariada se determinaron los factores de riesgo asociados con el desarrollo de las complicaciones motoras. Resultados. Se evaluaron 124 pacientes, con una edad media de 66,2 ± 10,1 años, tiempo medio de evolución de la EP de 8,1 ± 5,2 años, y estado motor on mediante UPDRS-III de 27,7 ± 14,8 puntos. Un 62% presentó alguna complicación motora, un 52% deterioro de fin de dosis, un 47,2% discinesias y un 39% ambas complicaciones motoras. El análisis multivariado mostró que el sexo femenino y la dosis de equivalentes de levodopa son los principales factores de riesgo para la aparición de discinesias, mientras que el tiempo de evolución lo es para el desarrollo de deterioro de fin de dosis. Conclusiones. El tiempo de evolución de la EP es el principal factor de riesgo para el desarrollo de deterioro de fin de dosis, mientras que la dosis de fármacos dopaminérgicos y el sexo femenino son los principales para el desarrollo de discinesias. Estos resultados obtenidos en nuestra población son similares a los comunicados en otras series
Introduction. The treatment of Parkinsons disease (PD) is based on the use of levodopa and/or dopaminergic agonists. This treatment is associated with motor complications in around 50% of the patients over 5 years of treatment. Numerous risk factors have been related to the onset of this motor complications. Aim. To describe the prevalence and risk factors associated with the occurrence of motor complications in our population. Patients and methods. PD patients in control in a movement disorders center were consecutively recruited. Using a multivariate logistic regression model the risk factors associated with the onset of MC were determined. Results. 124 patients were evaluated. Mean age was 66,2 ± 10,1 years, the years of PD evolution were 8,1 ± 5,2 years, the on UPDRS score was 27,7 ± 14,8 points. A 62% of the patients presented at least one motor complication, a 52% with wearing off and a 47,2% dyskinesias. Both motor complications were present in 39%. The multivariate analysis showed that that female sex and the dose of levodopa equivalents were the risk factors for the occurrence of dyskinesias. For the wearing off the main risk factor were the years of evolution of the PD. Conclusions. This study shows that the time of evolution of the PD is the main risk factor for the wearing off and the female sex and the dose of levodopa equivalents are the risk factor for the development of dyskinesias. These results are in agreement with the previously reported in the literature for other populations
