Objective: To investigate the risk factors for the onset of dyskinesia in patients with Parkinson’s disease (PD) exhibiting wearing-off phenomena.
Background: Dyskinesia occurs during long-term treatment with levodopa in PD and impacts quality of life. Wearing-off is the first motor complication and its appearance is an important predictor of subsequent dyskinesia. However, few studies have examined the risk of developing dyskinesia in patients with PD exhibiting wearing-off phenomena.
Method: We investigated the risk factors for the onset of dyskinesia within 1 year in an observational study of Japanese patients with PD exhibiting wearing-off phenomena (J-FIRST). Risk factors were assessed by univariate and multivariable logistic regression analyses in patients without dyskinesia at baseline.
Results: Among 996 eligible patients exhibiting wearing-off phenomena, 450 had dyskinesia at baseline, 133 developed dyskinesia within 1 year, and 413 did not develop dyskinesia. Univariate analyses showed that significant risk factors for the onset of dyskinesia were female gender, long duration of PD symptoms, long duration of motor complications, young age of onset, low Movement Disorders Society–Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part I Item 3 (depressed mood) score, high MDS-UPDRS Part I Item 7 (sleep problems) score, high modified Hoehn and Yahr stage, high L-dopa dose/L-dopa equivalent dose, and administration of dopamine agonists, a catechol-O-methyltransferase (COMT) inhibitor, zonisamide, and istradefylline [Table1]. In the multivariable analysis, the significant risk factors for onset of dyskinesia within 1 year were female gender and administration of a dopamine agonist, a COMT inhibitor, and zonisamide [Table1]. The L-dopa equivalent dose tended to increase more rapidly in patients who developed dyskinesia than in patients who did not develop dyskinesia.
Conclusion: This observational study revealed that risk factors for onset of dyskinesia within 1 year in patients with PD exhibiting wearing-off phenomena were female gender and administration of dopamine agonists, a COMT inhibitor, and zonisamide.
To cite this abstract in AMA style:
T. Mishima, SW. Chiu, H. Saiki, T. Yamaguchi, Y. Shimo, T. Maeda, H. Watanabe, K. Kashihara, M. Nomoto, N. Hattori, Y. Tsuboi. Risk factors for the onset of dyskinesia in patients with Parkinson’s disease exhibiting wearing-off phenomena: A 1-year observational study in Japan (J-FIRST) [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/risk-factors-for-the-onset-of-dyskinesia-in-patients-with-parkinsons-disease-exhibiting-wearing-off-phenomena-a-1-year-observational-study-in-japan-j-first/. Accessed June 15, 2025.« Back to MDS Virtual Congress 2021
MDS Abstracts - https://www.mdsabstracts.org/abstract/risk-factors-for-the-onset-of-dyskinesia-in-patients-with-parkinsons-disease-exhibiting-wearing-off-phenomena-a-1-year-observational-study-in-japan-j-first/