Objective: We conducted a large-sample study to investigate the clinical characteristics and related risk factors of DDS in China. In addition, we further followed up on all the patients who reported DDS at baseline to track the conversion of DDS with the disease progression and treatment adjustment.

Background: There is a lack of large sample-size studies on the prevalence and outcome of Dopamine dysregulation syndrome (DDS) in Chinese Parkinson’s disease (PD) patients.

Method: A total of 706 patients with PD were included in the study. Patients were divided into DDS and non-DDS groups according to whether they met the diagnostic criteria for DDS. The outcome of DDS in patients with DDS was followed up by telephone.

Results: DDS was diagnosed in 29 of 706 (4.1%) patients. Compared to non-DDS patients, DDS patients had an early age of onset, longer disease duration, a high percentage of impulse control disorder, dyskinesia, and motor fluctuation, higher Hoehn-Yahr stage, and higher scores of non-motor symptoms. Higher levodopa equivalent daily dose (LEDD) (OR [95% CI] =1.47 [1.10, 2.00], P=0.010) and severer depressive symptoms (OR [95% CI] = 3.15 [1.39, 7.33], P=0.007) were risk factors for DDS in PD patients. After a mean follow-up of 2.94 ± 0.94 years, 24 patients with DDS were reached and only three patients had persistent DDS. Youden index and univariate logistic regression model found that baseline LEDD ≧ 950 mg/day was a effective predictor for persistent DDS.

Conclusion: High disease burden of DDS emphasized prevention of DDS in the clinic. Controlling LEDD was important for prevent persistent DDS and we provided a recommendation LEDD cutoff to prevent persistent DDS in Chinese PD patients.

Table 1

Table 2 and Table 3

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MDS Abstracts - https://www.mdsabstracts.org/abstract/risk-factors-and-outcome-of-dopamine-dysregulation-syndrome-in-a-large-chinese-parkinsons-disease-cohort/