Objective: This study aimed to evaluate differences in LEDD among Parkinson’s disease (PD) patients based on disease duration categories from onset at RSCM Neurology Outpatient Clinic.
Background: PD is a progressive neurodegenerative disorder that mainstay treatment includes levodopa and other dopaminergic regimens. Levodopa Equivalent Daily Dose (LEDD) standardizes diverse dopaminergic regimens (Tomlinson et al., 2010). Several studies show LEDD escalation in intermediate PD (5-10 years from onset) followed by stabilization/reduction in advanced stages via therapies like deep brain stimulation (DBS). Indonesia data on LEDD patterns by disease duration remain limited.
Method: Cross-sectional study of PD patients at RSCM Neurology Clinic (Jan 2024-Dec 2025). Secondary data included dopaminergic medications types/doses and disease duration from onset, categorized as: 0-4 years (category 1), 5-9 years (category 2), and ≥10 years (category 3). Daily doses converted to LEDD using Tomlinson et al. (2010) formula. Kruskal-Wallis test assessed between-group LEDD differences (p<0.05 significant).
Results: Analyzed 118 PD observations. Duration distribution: category 1: 56 (47%), category 2: 41 (35%), category 3: 21 (18%). Median LEDD: 238 mg (cat 1), 399 mg (cat 2), 338 mg (cat 3). Kruskal-Wallis showed overall differences (p=0.000). Post-hoc: cat 1 vs 2 (p<0.05), cat 1 vs 3 (p<0.05), cat 2 vs 3 (p=0.056). LEDD increase from category 1 (238 mg) to 2 (399 mg) reflects PD progression, consistent with CALM-PD and STRIDE-PD trials showing dose escalation in intermediate stages. Notably, category 3 LEDD (338 mg) declined vs category 2, suggesting levodopa resistance or advanced strategies: DBS, apomorphine infusion, LCIG reducing total LEDD while controlling symptoms. RSCM offers radiofrequency lesioning led to dose reduction in advanced PD.
Conclusion: Significant LEDD escalation occurs from early (0-4y, 238 mg) to intermediate (5-9y, 399 mg) PD, with decline in advanced stages (≥10y, 338 mg) via advanced strategies. Findings support LEDD as PD treatment progression biomarker in clinical practice.
To cite this abstract in AMA style:
F. Abdat, A. Tiksnadi, D. Tungjungsari. Differences in Levodopa Equivalent Daily Dose (LEDD) Based on Disease Duration in Parkinson’s Disease Patients at RSCM – A Tertiary National Referral Hospital [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/differences-in-levodopa-equivalent-daily-dose-ledd-based-on-disease-duration-in-parkinsons-disease-patients-at-rscm-a-tertiary-national-referral-hospital/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/differences-in-levodopa-equivalent-daily-dose-ledd-based-on-disease-duration-in-parkinsons-disease-patients-at-rscm-a-tertiary-national-referral-hospital/