Cardinal Motor Features of Parkinson’s Disease Coexist with Peak-Dose Choreic-Type Drug-Induced Dyskinesia.
JPD. 2018-06-13; 8(2): 323-331
DOI: 10.3233/JPD-181312
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1. J Parkinsons Dis. 2018;8(2):323-331. doi: 10.3233/JPD-181312.
Cardinal Motor Features of Parkinson’s Disease Coexist with Peak-Dose
Choreic-Type Drug-Induced Dyskinesia.
Goubault E(1)(2), Nguyen HP(1)(2), Bogard S(1)(2), Blanchet PJ(3)(4), Bézard
E(5)(6), Vincent C(7), Langlois M(8), Duval C(1)(1).
Author information:
(1)Département des Sciences de l’activité physique, Université du Québec à
Montréal, Montréal, Québec, Canada.
(2)Centre de Recherche de l’Institut universitaire de gériatrie de Montréal,
Montréal, Québec, Canada.
(3)Département de stomatologie, Faculté de médecine dentaire, Université de
Montréal, Montréal, QC, Canada.
(4)Département de médecine, CHU Montréal, Montréal, QC, Canada.
(5)Université de Bordeaux, Institut des Maladies Neurodégénératives, F-33000
Bordeaux, France.
(6)Centre National de la Recherche Scientifique Unité Mixte de Recherche 5293,
Institut des Maladies Neurodégénératives, F-33000 Bordeaux, France.
(7)Département de réadaptation, Faculté de médecine, Université Laval, Québec,
Québec, Canada.
(8)Département de médecine, Faculté de médecine, Université Laval, Québec,
Québec, Canada.
BACKGROUND: Clinical and anecdotal observations propose that patients with
Parkinson’s disease (PD) may show drug-induced dyskinesia (DID) concomitantly
with cardinal motor features. However, the extent of the concomitant presence of
DID and cardinal features remains to be determined.
OBJECTIVES: This cross-sectional study measured peak-dose choreic-type DID in a
quantitative manner in patients diagnosed with PD, and determined whether
symptoms such as tremor, bradykinesia, rigidity, postural instability or freezing
of gait (FoG) were still detectable in these patients.
METHODS: 89 patients diagnosed with PD were recruited and assessed using a
combination of quantitative measures using inertial measurement units to capture
DID, tremor, bradykinesia, and FoG. Clinical evaluations were also used to assess
rigidity and postural instability. Motor symptoms of PD were assessed 3 times
during the testing period, and a series of activities of daily living were
repeated twice, in between clinical tests, during which the level of DID was
quantified. Peak-dose was identified as the period during which patients had the
highest levels of DID. Levels of tremor, rigidity, bradykinesia, postural
instability, and FoG were used to determine the percentage of patients showing
these motor symptoms simultaneously with DID.
RESULTS: 72.4% of patients tested presented with measurable DID during the
experiment. Rest, postural and kinetic tremor (12.7% , 38.1% , and 15.9%
respectively), bradykinesia (28.6% ), rigidity (55.6% ), postural instability
(71.4% ) and FoG (9.5% ) were detected simultaneously with DID.
CONCLUSIONS: PD symptomatology remains present in patients showing peak-dose
choreic-type DID, illustrating the challenge facing physicians when trying to
avoid dyskinesia while attempting to alleviate motor symptoms.
DOI: 10.3233/JPD-181312
PMCID: PMC6027941
PMID: 29843253