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Assessment of Clinical and Demographic Factors Influencing the Severity of Levodopa-Induced Dyskinesia
Published online by Cambridge University Press: 04 December 2025
Abstract
Background:
Levodopa-induced dyskinesia (LID) is a disabling symptom of Parkinson’s disease (PD). There have been prior attempts to find risk factors contributing to this symptom, but risk factors for the severity of LID have not been comprehensively studied. We aimed to evaluate factors that correlate with LID severity in patients with PD based on the Unified Dyskinesia Rating Scale (UDysRS).
Methods:
A cross-sectional study was designed on 52 idiopathic PD patients who were referred for LID between 2023 and 2024. Their demographic and clinical records were studied. Furthermore, cognitive decline (MoCA), PD severity (Hoehn and Yahr) and the severity of dyskinesia (UDysRS) were examined. The association between factors and LID severity was evaluated by carrying out univariate regression and multivariate regression backward elimination analysis.
Results:
The mean age of patients with LID was 59.9 ± 11.4 years. Results of univariate regression analysis indicated that male sex (β = −0.24, P = 0.04), BMI (β = −0.3, P = 0.005), H&Y (β = 0.4, P = 0.002), diabetes mellitus (β = 0.3, P = 0.018) and levodopa dosage per kilogram (β = 0.37, P = 0.01) were significant factors involved in the severity of dyskinesia. The univariate regression model results showed that lack of constipation (P = 0.04), hyperlipidemia (P = 0.04) and total daily levodopa dosage per kilogram (P = 0.01) were associated with the severity of end-dose dystonia.
Conclusion:
This study revealed that female sex, more advanced PD, diabetes mellitus, daily levodopa dosage per kilogram body weight and BMI are associated with the severity of LID. Also, it suggests that hyperlipidemia and lack of constipation are associated with the severity of end-dose dystonia.
Résumé
Évaluation des facteurs cliniques et démographiques influençant la gravité de la dyskinésie induite par la lévodopa.
La dyskinésie induite par la lévodopa (DIL) est un symptôme invalidant de la maladie de Parkinson (MP). On a tenté à quelques reprises d’identifier les facteurs de risque contribuant à ce symptôme, mais les facteurs liés à la gravité de la LID n’ont pas fait l’objet d’études approfondies. En résumé, notre objectif était d’évaluer les facteurs corrélés à la gravité de la LID chez des patients atteints de la MP, et ce, à partir du Unified Dyskinesia Rating Scale (UDysRS).
Une étude transversale a été menée auprès de 52 patients atteints de MP idiopathique qui ont été orientés entre 2023 et 2024 vers un spécialiste en raison d’une DIL. Leurs dossiers démographiques et cliniques ont été étudiés. En outre, le déclin cognitif (MoCA), la gravité de la MP (échelle de Hoehn et Yahr) et la gravité de la dyskinésie (UDysRS) ont été examinés. L’association entre des facteurs et la gravité des symptômes de DIL a été évaluée à l’aide d’une analyse de régression univariée et d’une analyse de régression multivariée par élimination vers l’arrière.
L’âge moyen des patients atteints de DIL était de 59,9 ± 11,4 ans. Les résultats de l’analyse de régression univariée ont indiqué que le sexe masculin (β = −0,24 ; p = 0,04), l’IMC (β = −0,3 ; p = 0,005), le score à l’échelle de Hoehn et Yahr (β = 0,4 ; p = 0,002), le diabète sucré (β = 0,3 ; p = 0,018) et la dose de lévodopa par kilogramme de poids corporel (β = 0,37 ; p = 0,01) étaient des facteurs notables impliqués dans la gravité de la dyskinésie. Les résultats de l’analyse de régression univariée ont montré par ailleurs que l’absence de constipation (p = 0,04), l’hyperlipidémie (p = 0,04) et la dose quotidienne totale de lévodopa par kilogramme de poids corporel (p = 0,01) étaient associées à la gravité de la dystonie en fin de dose (end-dose dystonia).
Cette étude a révélé que le sexe féminin, une MP plus avancée, le diabète sucré, la dose quotidienne de lévodopa par kilogramme de poids corporel et l’IMC étaient associés à la gravité des symptômes de DIL. Elle suggère également que l’hyperlipidémie et l’absence de constipation étaient associées à la gravité de la dystonie en fin de dose.
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