Objective: The aim of this study was to determine which of drug-induced dyskinesia (DID) or other symptoms of Parkinson’s disease (PD) had the most impact on activities of daily living (ADL) in patients experiencing peak-dose, choreic-type DID.

Background: The true impact of DID, or any remaining parkinsonian symptoms present with DID, on the daily activities of patients with PD remains to be determined.

Methods: One hundred and twenty-one patients diagnosed with PD (fifty-three females, 67.2 ± 8.6 years old) and known to experience peak-dose, choreic-type DID were recruited to perform a series of ADL having different amplitude and velocity characteristics. Levels of DID, tremor, bradykinesia, and freezing of gait were measured using 17 inertial measurement units positioned on each body segment, while rigidity and postural instability were assessed using clinical evaluations. Cognition was also assessed using the mini-mental state examination. Success criteria were set for each ADL using the number of errors and the amount of time needed to perform the task measured in a cohort of 69 age-, gender-matched healthy controls (thirty females, 68.1 ± 7.7 years old). Levels of symptomatology of patients were used in binary logistic regression models to identify symptoms influencing success or failure for each ADL. Receiver operating characteristic curves were computed on culprit symptoms, and Youden indexes were calculated to determine the critical level of symptomatology at which the performance significantly changed.

Results: Results show that 97.7% of patients who presented with DID during the experiment (88 patients out of 121) also presented with at least one other motor symptom. On average, patients took significantly more time and had more errors during ADL. Binary logistic regression models revealed that higher levels of DID were associated with better performance in many tasks and to lower performance in only one task, whereas the presence of other symptoms of Parkinson’s disease such as postural instability, tremor, rigidity, or cognitive impairment decreased significantly the odds of success.

Conclusions: Residual symptoms of PD are more problematic than DID in the performance of ADL for patients experiencing mild to moderate peak-dose, choreic-type DID.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/what-is-the-relationship-between-dyskinesia-and-performance-of-activities-of-daily-living-in-patients-with-parkinsons-disease/