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, philhyu Lee

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE: To assess the relationship between the development of levodopa-induced dyskinesia (LID) and longitudinal changes in cognition. METHODS: In 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. RESULTS: Neuropsychological 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. CONCLUSIONS: These 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
JournalNeurology
Volume92
Issue number13
DOIs
Publication statusPublished - 2019 Mar 26

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Dyskinesias
Levodopa
Parkinson Disease
Dementia
Cognition
Confidence Intervals
Sex Education
Executive Function
Survival Analysis
Linear Models

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. (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
Yoo, Han Soo ; Chung, Seok Jong ; Lee, Yang Hyun ; Lee, Hye Sun ; Ye, Byoung Seok ; Sohn, Young H. ; Lee, philhyu. / Levodopa-induced dyskinesia is closely linked to progression of frontal dysfunction in PD. In: Neurology. 2019 ; Vol. 92, No. 13. pp. e1468-e1478.
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abstract = "OBJECTIVE: To assess the relationship between the development of levodopa-induced dyskinesia (LID) and longitudinal changes in cognition. METHODS: In 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. RESULTS: Neuropsychological 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. CONCLUSIONS: These results demonstrated that LID was closely associated with the progression of cognitive decline, especially frontal executive dysfunction, and the development of PD dementia.",
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Yoo, HS, Chung, SJ, Lee, YH, Lee, HS, Ye, BS, Sohn, YH & Lee, P 2019, 'Levodopa-induced dyskinesia is closely linked to progression of frontal dysfunction in PD', Neurology, vol. 92, no. 13, pp. e1468-e1478. https://doi.org/10.1212/WNL.0000000000007189

Levodopa-induced dyskinesia is closely linked to progression of frontal dysfunction in PD. / Yoo, Han Soo; Chung, Seok Jong; Lee, Yang Hyun; Lee, Hye Sun; Ye, Byoung Seok; Sohn, Young H.; Lee, philhyu.

In: Neurology, Vol. 92, No. 13, 26.03.2019, p. e1468-e1478.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Levodopa-induced dyskinesia is closely linked to progression of frontal dysfunction in PD

AU - Yoo, Han Soo

AU - Chung, Seok Jong

AU - Lee, Yang Hyun

AU - Lee, Hye Sun

AU - Ye, Byoung Seok

AU - Sohn, Young H.

AU - Lee, philhyu

PY - 2019/3/26

Y1 - 2019/3/26

N2 - OBJECTIVE: To assess the relationship between the development of levodopa-induced dyskinesia (LID) and longitudinal changes in cognition. METHODS: In 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. RESULTS: Neuropsychological 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. CONCLUSIONS: These results demonstrated that LID was closely associated with the progression of cognitive decline, especially frontal executive dysfunction, and the development of PD dementia.

AB - OBJECTIVE: To assess the relationship between the development of levodopa-induced dyskinesia (LID) and longitudinal changes in cognition. METHODS: In 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. RESULTS: Neuropsychological 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. CONCLUSIONS: These results demonstrated that LID was closely associated with the progression of cognitive decline, especially frontal executive dysfunction, and the development of PD dementia.

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