Parkinsonian Symptoms, Not Dyskinesia, Negatively Affect Active Life Participation of Dyskinetic Patients with Parkinson’s Disease.
Tremor and Other Hyperkinetic Movements. 2020-01-01; 10(1):
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1. Tremor Other Hyperkinet Mov (N Y). 2020 Jul 8;10:20. doi: 10.5334/tohm.403.
Parkinsonian Symptoms, Not Dyskinesia, Negatively Affect Active Life
Participation of Dyskinetic Patients with Parkinson’s Disease.
Goubault E(1), Bogard S(2)(3), Blanchet PJ(4)(5), Bézard E(6)(7), Vincent C(8),
Martino D(9), Sarna J(10), Monchi O(10), Duval C(2)(3).
(1)Laboratoire de Simulation et Modélisation du Mouvement,École de Kinésiologie
et des sciences de l’activité physique, Université de Montréal, Rue
Jacques-Tétreault, Laval, Québec, CA.
(2)Département des Sciences de l’activité physique, Université du Québec à
Montréal, Montréal, Québec, CA.
(3)Centre de Recherche de l’Institut universitaire de gériatrie de Montréal,
Montréal, Québec, CA.
(4)Département de stomatologie, Faculté de médecine dentaire, Université de
Montréal, Montréal, Québec, CA.
(5)Département de médecine, CHU Montréal, Montréal, QC, CA.
(6)Université de Bordeaux, Institut des Maladies Neurodégénératives, Bordeaux,
(7)Centre National de la Recherche Scientifique Unité Mixte de Recherche,
Institut des Maladies Neurodégénératives, Bordeaux, FR.
(8)Département de réadaptation, Faculté de médecine, Université Laval, Québec,
(9)Cumming School of Medicine, Department of Clinical Neurosciences, University
of Calgary, CA.
(10)Hotchkiss Brain Institute, Department of Clinical Neurosciences, University
of Calgary, Calgary, Alberta, CA.
Background: The impact of slight-to-moderate levodopa-induced dyskinesia (LID) on
the level of participation in active life in patients with Parkinson’s disease
(PD) has never been objectively determined.
Methods: Levels of LID, tremor and bradykinesia were measured during best-ON
state in 121 patients diagnosed with PD and having peak-dose LID using inertial
sensors positioned on each body limb. Rigidity and postural instability were
assessed using clinical evaluations. Cognition and depression were assessed using
the MMSE and the GDS-15. Participation in active life was assessed in patients
and in 69 healthy controls using the Activity Card Sort (ACS), which measures
levels of activity engagement and activities affected by the symptomatology.
Outcome measures were compared between patients and controls using ANCOVA,
controlling for age or Wilcoxon-Mann-Whitney tests. Spearman correlations and
multivariate analyses were then performed between symptomatology and ACS scores.
Results: Patients had significantly lower activity engagement than controls and
had significantly affected activities. LID was neither associated with activity
engagement nor affected activities. Higher levels of tremor, postural
instability, cognitive decline and depression were associated with lower activity
engagement and higher affected activities. Multivariate analyses revealed that
only tremor, postural instability and depression accounted significantly in the
variances of these variables.
Discussion: Slight-to-moderate LID had little impact compared to other symptoms
on the level of participation in active life, suggesting that other symptoms
should remain the treatment priority to maintain the level of participation of
patients in an active lifestyle.
Copyright: © 2020 The Author(s).
Conflict of interest statement: EB has equity stake in Motac holding Ltd and
receives consultancy payments from Motac Neuroscience Ltd, companies which
preclinical activity has no relationship with the present study. The other
authors have no conflict of interest to report.