Journal of Movement Disorders

Original Article

Less Pulsatile Levodopa Therapy (6 Doses Daily) Is Associated with a Reduced Incidence of Dyskinesia: Mark M. Lin, Robert Laureno; J Mov Disord. 2019;12(1):37-42. Published online January 30, 2019; DOI: https://doi.org/10.14802/jmd.18046

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Objective
To evaluate whether less pulsatile levodopa therapy (LPT) can reduce the development of levodopa-induced dyskinesia (LID).
Methods
This is a retrospective cohort study of patients with Parkinson’s disease at the movement disorders clinic of Medstar Washington Hospital Center. The study was not blinded or randomized. Patients were seen between August 2002 and August 2018. During these years, we treated patients with less pulsatile (6 doses daily) levodopa treatment to reduce LID. Occurrence of LID was recorded.
Results
Ninety-five patients with Parkinson’s disease taking levodopa were divided into two groups: 1) patients who were initially managed on LPT or who switched from traditional therapy (TT) (n = 61) (mean disease duration: 7.7 ± 4.8 years, mean levodopa duration: 5.6 ± 4.5 years and mean observation time: 4.3 ± 3.4 years), and 2) patients on TT throughout the observation period or until they developed dyskinesia (n = 34) (mean disease duration: 8.3 ± 3.8 years, mean levodopa duration: 6.2 ± 4.2 years and mean observation time: 4.1 ± 3.4 years). Three of the 61 LPT patients developed dyskinesia during the observation period. One of the patients developed dyskinesia after being switched to pulsatile doses by another doctor. In the other two, dyskinesia was minimal. In contrast to this 4.9% cumulative incidence, dyskinesia occurred in 50% (17/34) of TT patients, an incidence similar to that in published data (p < 0.001).
Conclusion
Less pulsatile levodopa with 6 daily doses was associated with a low incidence of LID. Further study of this method of treatment is warranted.

Citations

Citations to this article as recorded by

Reduced Plasma Levodopa Fluctuations with More Frequent Administration of a Novel Carbidopa/Levodopa Functionally Scored Tablet
Thomas N. Chase, Ahmad AL‐Sabbagh, Minako Koga, Kathleen Clarence‐Smith
Clinical Pharmacology in Drug Development.2024; 13(4): 380. CrossRef
Dopamine D1 Agonists: First Potential Treatment for Late-Stage Parkinson’s Disease
Mechelle M. Lewis, Lauren J. Van Scoy, Sol De Jesus, Jonathan G. Hakun, Paul J. Eslinger, Julio Fernandez-Mendoza, Lan Kong, Yang Yang, Bethany L. Snyder, Natalia Loktionova, Sridhar Duvvuri, David L. Gray, Xuemei Huang, Richard B. Mailman
Biomolecules.2023; 13(5): 829. CrossRef
Classification of l-DOPA pharmacokinetics shapes and creating a predictive model
Noriko Nishikawa, Hirtotaka Iwaki, Yohei Mukai, Yuji Takahashi
Parkinsonism & Related Disorders.2023; 114: 105798. CrossRef
Personalized Medicine Approach in Treating Parkinson’s Disease, Using Oral Administration of Levodopa/Carbidopa Microtablets in Clinical Practice
Helga María Grétarsdóttir, Erik Widman, Anders Johansson, Dag Nyholm
Journal of Personalized Medicine.2021; 11(8): 720. CrossRef
Current Knowledge on the Background, Pathophysiology and Treatment of Levodopa-Induced Dyskinesia—Literature Review
Michał Hutny, Jagoda Hofman, Aleksandra Klimkowicz-Mrowiec, Agnieszka Gorzkowska
Journal of Clinical Medicine.2021; 10(19): 4377. CrossRef
Pallidal versus subthalamic nucleus deep brain stimulation for levodopa‐induced dyskinesia
Shi‐Ying Fan, Kai‐Liang Wang, Wei Hu, Robert S. Eisinger, Alexander Han, Chun‐Lei Han, Qiao Wang, Shimabukuro Michitomo, Jian‐Guo Zhang, Feng Wang, Adolfo Ramirez‐Zamora, Fan‐Gang Meng
Annals of Clinical and Translational Neurology.2020; 7(1): 59. CrossRef
A Stage-Based Approach to Therapy in Parkinson’s Disease
Claudia Carrarini, Mirella Russo, Fedele Dono, Martina Di Pietro, Marianna G. Rispoli, Vincenzo Di Stefano, Laura Ferri, Filomena Barbone, Michela Vitale, Astrid Thomas, Stefano Luca Sensi, Marco Onofrj, Laura Bonanni
Biomolecules.2019; 9(8): 388. CrossRef
The Gut Microbiome: A Therapeutically Targetable Site of Peripheral Levodopa Metabolism
Eoin Mulroy, Kailash P. Bhatia
Movement Disorders Clinical Practice.2019; 6(7): 547. CrossRef

Case Report

Rhabdomyolysis Related to Dyskinesia in Parkinson’s Disease: Hesna Bekta, Orhan Deniz, adiye Temel, Hava Dnmez Keklikolu, ener Akyol; J Mov Disord. 2014;7(1):25-27. Published online April 30, 2014; DOI: https://doi.org/10.14802/jmd.14006

20,617 View
87 Download
4 Web of Science
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Abstract PDF

Rhabdomyolysis is a life threatening syndrome. It accounts for an estimated 8% to 15% of cases of acute renal failure and is associated with a mortality rate of 5%. In movement disorders, various causes of rhabdomyolysis have been reported including status dystonicus, myoclonus, generalized chorea and parkinsonism-hyperprexia syndrome in Parkinson’s disease (PD). Levodopa-induced dyskinesia leading to rhabdomyolysis is a very rare phenomenon in PD. We report a case of 76 years old PD patient with dyskinesia and rhabdomyolysis.

Citations

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Rhabdomyolysis secondary to severe tic fits
Ka Loong Kelvin Au, Shannon Chiu, Irene A Malaty
BMJ Case Reports.2021; 14(3): e239874. CrossRef
Rhabdomyolysis Associated with Severe Levodopa-Induced Dyskinesia in Parkinson’s Disease: A Report of Two Cases and Literature Review
Yuvadee Pitakpatapee, Jindapa Srikajon, Tanita Sangpeamsook, Prachaya Srivanitchapoom
Tremor and Other Hyperkinetic Movements.2021;[Epub] CrossRef
Assessment of plasma creatine kinase as biomarker for levodopa-induced dyskinesia in Parkinson’s disease
Anna Delamarre, François Tison, Qin Li, Monique Galitzky, Olivier Rascol, Erwan Bezard, Wassilios G. Meissner
Journal of Neural Transmission.2019; 126(6): 789. CrossRef
Levodopa-induced dyskinesia: clinical features, incidence, and risk factors
Tai N. Tran, Trang N. N. Vo, Karen Frei, Daniel D. Truong
Journal of Neural Transmission.2018; 125(8): 1109. CrossRef

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