Levodopa-induced dyskinesia is closely linked to progression of frontal dysfunction in PD

Han Soo Yoo, Seok Jong Chung, Yang Hyun Lee, Hye Sun Lee, Byoung Seok Ye, Young H. Sohn, Phil Hyu Lee

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ObjectiveTo assess the relationship between the development of levodopa-induced dyskinesia (LID) and longitudinal changes in cognition.MethodsIn this retrospective cohort study, we recruited 119 patients with Parkinson disease (PD) who underwent baseline and follow-up neuropsychological evaluations and were treated with levodopa for >5 years. On the basis of LID development, the patients were classified as patients with LID (PD-LID+, n = 38) or without LID (PD-LID-, n = 81) within 5 years of levodopa administration. After adjusting for age, sex, years of education, body mass index, motor severity at baseline, and levodopa increment per year, we compared the rates of cognitive decline using linear mixed model and dementia conversion using survival analysis between the groups.ResultsNeuropsychological performances and the percentage of patients with mild cognitive impairment (MCI) at baseline did not differ between the groups. The PD-LID+ group showed faster declines in frontal executive function (p = 0.002) and global cognitive function. The conversion rate to dementia was significantly higher in the PD-LID+ group than in the PD-LID- group (adjusted hazard ratio [HR] 3.94, 95% confidence interval [CI] 1.76-8.82). Patients with MCI in the PD-LID+ group had a higher risk of PD dementia conversion than those with normal cognition (adjusted HR 6.08, 95% CI 1.25-29.56) or MCI (adjusted HR 4.05, 95% CI 1.14-14.43) in the PD-LID- group.ConclusionsThese results demonstrated that LID was closely associated with the progression of cognitive decline, especially frontal executive dysfunction, and the development of PD dementia.

Original languageEnglish
Pages (from-to)E1468-E1478
Issue number13
Publication statusPublished - 2019 Mar 26


All Science Journal Classification (ASJC) codes

  • Clinical Neurology

Cite this

Yoo, H. S., Chung, S. J., Lee, Y. H., Lee, H. S., Ye, B. S., Sohn, Y. H., & Lee, P. H. (2019). Levodopa-induced dyskinesia is closely linked to progression of frontal dysfunction in PD. Neurology, 92(13), E1468-E1478. https://doi.org/10.1212/WNL.0000000000007189