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Title of Journal: J Neurol

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Abbravation: Journal of Neurology

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Springer Berlin Heidelberg

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DOI

10.1007/s00595-009-4145-z

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1432-1459

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Clinical phenotype and risk of levodopainduced dy

Authors: Alessandra Nicoletti Giovanni Mostile Giuseppe Nicoletti Gennarina Arabia Giovanni Iliceto Paolo Lamberti Roberto Marconi Letterio Morgante Paolo Barone Aldo Quattrone Mario Zappia
Publish Date: 2016/03/10
Volume: 263, Issue: 5, Pages: 888-894
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Abstract

It is unclear whether patients with different clinical phenotypes of Parkinson’s disease PD differ in their risk of developing levodopainduced dyskinesia We evaluated the possible association between clinical phenotypes and risk of levodopainduced dyskinesia in PD patients using a case–control design The FRAGAMP study is a large Italian multicenter study Patients affected by PD diagnosed according to the Gelb’s criteria were enrolled and underwent a facetoface interview Clinical scales were used to evaluate motor and cognitive impairment Presence of dyskinesia was assessed by the item 32 of the UPDRS section IV On the basis of the most prominent motor symptoms at onset PD patients were classified as tremordominant akineticrigid or mixed type 485 PD patients 292 men mean age 656 ± 98 were enrolled in the study of whom 128 264  presented levodopainduced dyskinesia Of the 485 patients 311 641  were classified as tremordominant 104 214  as AkineticRigid and 70 144  as mixed type Multivariate logistic regression analysis showed a significant negative association between tremordominant phenotype and levodopainduced dyskinesia adjusted OR 048 95  CI 023–100 p value 005 When analysis was stratified by age at onset a stronger negative association was found among the late onset 50 years PD patients OR 028 95  CI 011–070 p value 0007 while no association was found among patients with an early onset Our findings support the hypothesis that the occurrence of resting tremor as an initial manifestation of PD may predict a lower probability of developing levodopainduced dyskinesia

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