The occurrence of motor fluctuations in parkinsonian patients treated long term with levodopa: Role of early treatment and disease progression

Tommaso Caraceni, Giulio Scigliano, Massimo Musicco

Research output: Contribution to journalArticle

Abstract

The aim of this study is to evaluate what factors influence the risk of occurrence of motor fluctuations in patients with Parkinson’s disease (PD) with particular reference to the role of early or delayed introduction of levodopa therapy during the course of the disease. One hundred twenty-five consecutive newly diagnosed patients with PD started levodopa treatment at the time of diagnosis and were followed for 2 to 10 years. During follow-up, 60 patients had wearing-off or early morning akinesia. We estimated the cumulative time-dependent risk of motor fluctuation occurrence through a multivariable analysis. The risk was lower for patients with tremor-predominant PD, for those with shorter disease duration prior to levodopa, and for those who were relatively older at levodopa initiation. Our results suggest that, as far as motor fluctuations are concerned, disease prognosis is not influenced by early levodopa treatment. These observations support the introduction of levodopa as soon as there is a subjective need for the patients to maintain their level of social and work performance.

Original languageEnglish
Pages (from-to)380-384
Number of pages5
JournalNeurology
Volume41
Issue number3
Publication statusPublished - 1991

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology
  • Neuroscience(all)

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