Age of Parkinson's disease onset as a predictor for the development of dyskinesia
Identifieur interne : 000413 ( Main/Corpus ); précédent : 000412; suivant : 000414Age of Parkinson's disease onset as a predictor for the development of dyskinesia
Auteurs : Stephen Ku ; Graham A. GlassSource :
- Movement Disorders [ 0885-3185 ] ; 2010-07-15.
English descriptors
- KwdEn :
Abstract
The risk of developing levodopa‐associated dyskinesia is known to vary inversely with the age of Parkinson's disease onset. This study quantifies dyskinesia risks for different Parkinson's onset ages in a patient population treated at the Parkinson's Disease Research, Education, and Clinical Center at the San Francisco Veterans Affairs Medical Center. Medical records were reviewed to determine age of Parkinson's onset, medication history, and dyskinesia onset. Dyskinesia risks were determined by using Kaplan‐Meier analysis. Cox proportional hazard models were used to compare age groups and to perform multivariate modeling. This study included 109 patients with Parkinson's, 105 of whom had onset of symptoms after 1989. At 5 years of levodopa treatment, the dyskinesia risk for patients with onset age 40–49 was 70%, decreasing to 42% for onset ages 50–59, 33% for onset ages 60–69, and 24% for onset ages 70–79. Pairwise comparisons between the 40–49 age group and the other age groups were statistically significant in time‐to‐event models. After 5 years of levodopa treatment, dyskinesia risks became uniformly high regardless of age of onset. These results suggest it is appropriate to use different baseline dyskinesia risks in clinical decision‐making for patients on the basis of their ages of onset. However, the most significant difference occurs between ages 40–49 and ages 50–79, and if more than 5 years of levodopa therapy are anticipated, dyskinesia risk may have less utility when deciding upon Parkinson's therapy. Drug studies for Parkinson's disease should also take age of Parkinson's onset into account when analyzing dyskinesia outcomes. © 2010 Movement Disorder Society
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DOI: 10.1002/mds.23068
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ISTEX:F598433AF0D9202088154346E0D8C4376AA41E73Le document en format XML
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This study quantifies dyskinesia risks for different Parkinson's onset ages in a patient population treated at the Parkinson's Disease Research, Education, and Clinical Center at the San Francisco Veterans Affairs Medical Center. Medical records were reviewed to determine age of Parkinson's onset, medication history, and dyskinesia onset. Dyskinesia risks were determined by using Kaplan‐Meier analysis. Cox proportional hazard models were used to compare age groups and to perform multivariate modeling. This study included 109 patients with Parkinson's, 105 of whom had onset of symptoms after 1989. At 5 years of levodopa treatment, the dyskinesia risk for patients with onset age 40–49 was 70%, decreasing to 42% for onset ages 50–59, 33% for onset ages 60–69, and 24% for onset ages 70–79. Pairwise comparisons between the 40–49 age group and the other age groups were statistically significant in time‐to‐event models. After 5 years of levodopa treatment, dyskinesia risks became uniformly high regardless of age of onset. These results suggest it is appropriate to use different baseline dyskinesia risks in clinical decision‐making for patients on the basis of their ages of onset. However, the most significant difference occurs between ages 40–49 and ages 50–79, and if more than 5 years of levodopa therapy are anticipated, dyskinesia risk may have less utility when deciding upon Parkinson's therapy. Drug studies for Parkinson's disease should also take age of Parkinson's onset into account when analyzing dyskinesia outcomes. © 2010 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Stephen Ku MS</name><affiliations><json:string>School of Medicine, University of California San Francisco, San Francisco, California, USA</json:string><json:string>Parkinson's Disease Research, Education, and Clinical Center, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA</json:string></affiliations></json:item><json:item><name>Graham A. Glass MD</name><affiliations><json:string>Parkinson's Disease Research, Education, and Clinical Center, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA</json:string><json:string>Department of Neurology, University of California, San Francisco, California, USA</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>dyskinesia</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>age of onset</value></json:item></subject><articleId><json:string>MDS23068</json:string></articleId><language><json:string>eng</json:string></language><abstract>The risk of developing levodopa‐associated dyskinesia is known to vary inversely with the age of Parkinson's disease onset. This study quantifies dyskinesia risks for different Parkinson's onset ages in a patient population treated at the Parkinson's Disease Research, Education, and Clinical Center at the San Francisco Veterans Affairs Medical Center. Medical records were reviewed to determine age of Parkinson's onset, medication history, and dyskinesia onset. Dyskinesia risks were determined by using Kaplan‐Meier analysis. Cox proportional hazard models were used to compare age groups and to perform multivariate modeling. This study included 109 patients with Parkinson's, 105 of whom had onset of symptoms after 1989. At 5 years of levodopa treatment, the dyskinesia risk for patients with onset age 40–49 was 70%, decreasing to 42% for onset ages 50–59, 33% for onset ages 60–69, and 24% for onset ages 70–79. Pairwise comparisons between the 40–49 age group and the other age groups were statistically significant in time‐to‐event models. After 5 years of levodopa treatment, dyskinesia risks became uniformly high regardless of age of onset. These results suggest it is appropriate to use different baseline dyskinesia risks in clinical decision‐making for patients on the basis of their ages of onset. However, the most significant difference occurs between ages 40–49 and ages 50–79, and if more than 5 years of levodopa therapy are anticipated, dyskinesia risk may have less utility when deciding upon Parkinson's therapy. 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Disord.</title><idno type="pISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><idno type="DOI">10.1002/(ISSN)1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2010-07-15"></date><biblScope unit="volume">25</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="1177">1177</biblScope><biblScope unit="page" to="1182">1182</biblScope></imprint></monogr><idno type="istex">F598433AF0D9202088154346E0D8C4376AA41E73</idno><idno type="DOI">10.1002/mds.23068</idno><idno type="ArticleID">MDS23068</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2010</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>The risk of developing levodopa‐associated dyskinesia is known to vary inversely with the age of Parkinson's disease onset. This study quantifies dyskinesia risks for different Parkinson's onset ages in a patient population treated at the Parkinson's Disease Research, Education, and Clinical Center at the San Francisco Veterans Affairs Medical Center. Medical records were reviewed to determine age of Parkinson's onset, medication history, and dyskinesia onset. Dyskinesia risks were determined by using Kaplan‐Meier analysis. Cox proportional hazard models were used to compare age groups and to perform multivariate modeling. This study included 109 patients with Parkinson's, 105 of whom had onset of symptoms after 1989. At 5 years of levodopa treatment, the dyskinesia risk for patients with onset age 40–49 was 70%, decreasing to 42% for onset ages 50–59, 33% for onset ages 60–69, and 24% for onset ages 70–79. Pairwise comparisons between the 40–49 age group and the other age groups were statistically significant in time‐to‐event models. After 5 years of levodopa treatment, dyskinesia risks became uniformly high regardless of age of onset. These results suggest it is appropriate to use different baseline dyskinesia risks in clinical decision‐making for patients on the basis of their ages of onset. However, the most significant difference occurs between ages 40–49 and ages 50–79, and if more than 5 years of levodopa therapy are anticipated, dyskinesia risk may have less utility when deciding upon Parkinson's therapy. Drug studies for Parkinson's disease should also take age of Parkinson's onset into account when analyzing dyskinesia outcomes. © 2010 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Parkinson's disease</term></item><item><term>dyskinesia</term></item><item><term>age of onset</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2009-07-13">Received</change><change when="2010-02-05">Registration</change><change when="2010-07-15">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/F598433AF0D9202088154346E0D8C4376AA41E73/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. 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This study quantifies dyskinesia risks for different Parkinson's onset ages in a patient population treated at the Parkinson's Disease Research, Education, and Clinical Center at the San Francisco Veterans Affairs Medical Center. Medical records were reviewed to determine age of Parkinson's onset, medication history, and dyskinesia onset. Dyskinesia risks were determined by using Kaplan‐Meier analysis. Cox proportional hazard models were used to compare age groups and to perform multivariate modeling. This study included 109 patients with Parkinson's, 105 of whom had onset of symptoms after 1989. At 5 years of levodopa treatment, the dyskinesia risk for patients with onset age 40–49 was 70%, decreasing to 42% for onset ages 50–59, 33% for onset ages 60–69, and 24% for onset ages 70–79. Pairwise comparisons between the 40–49 age group and the other age groups were statistically significant in time‐to‐event models. After 5 years of levodopa treatment, dyskinesia risks became uniformly high regardless of age of onset. These results suggest it is appropriate to use different baseline dyskinesia risks in clinical decision‐making for patients on the basis of their ages of onset. However, the most significant difference occurs between ages 40–49 and ages 50–79, and if more than 5 years of levodopa therapy are anticipated, dyskinesia risk may have less utility when deciding upon Parkinson's therapy. Drug studies for Parkinson's disease should also take age of Parkinson's onset into account when analyzing dyskinesia outcomes. © 2010 Movement Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p>Potential conflict of interest: Nothing to report.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Age of Parkinson's disease onset as a predictor for the development of dyskinesia</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Dyskinesia Risk by Age of Parkinson's Onset</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Age of Parkinson's disease onset as a predictor for the development of dyskinesia</title></titleInfo><name type="personal"><namePart type="given">Stephen</namePart><namePart type="family">Ku</namePart><namePart type="termsOfAddress">MS</namePart><affiliation>School of Medicine, University of California San Francisco, San Francisco, California, USA</affiliation><affiliation>Parkinson's Disease Research, Education, and Clinical Center, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Graham A.</namePart><namePart type="family">Glass</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Parkinson's Disease Research, Education, and Clinical Center, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA</affiliation><affiliation>Department of Neurology, University of California, San Francisco, California, USA</affiliation><description>Correspondence: Department of Neurology, UCSF Medical Center, San Francisco, CA 94143</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2010-07-15</dateIssued><dateCaptured encoding="w3cdtf">2009-07-13</dateCaptured><dateValid encoding="w3cdtf">2010-02-05</dateValid><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="tables">3</extent><extent unit="references">17</extent><extent unit="words">4551</extent></physicalDescription><abstract lang="en">The risk of developing levodopa‐associated dyskinesia is known to vary inversely with the age of Parkinson's disease onset. This study quantifies dyskinesia risks for different Parkinson's onset ages in a patient population treated at the Parkinson's Disease Research, Education, and Clinical Center at the San Francisco Veterans Affairs Medical Center. Medical records were reviewed to determine age of Parkinson's onset, medication history, and dyskinesia onset. Dyskinesia risks were determined by using Kaplan‐Meier analysis. Cox proportional hazard models were used to compare age groups and to perform multivariate modeling. This study included 109 patients with Parkinson's, 105 of whom had onset of symptoms after 1989. At 5 years of levodopa treatment, the dyskinesia risk for patients with onset age 40–49 was 70%, decreasing to 42% for onset ages 50–59, 33% for onset ages 60–69, and 24% for onset ages 70–79. Pairwise comparisons between the 40–49 age group and the other age groups were statistically significant in time‐to‐event models. After 5 years of levodopa treatment, dyskinesia risks became uniformly high regardless of age of onset. These results suggest it is appropriate to use different baseline dyskinesia risks in clinical decision‐making for patients on the basis of their ages of onset. However, the most significant difference occurs between ages 40–49 and ages 50–79, and if more than 5 years of levodopa therapy are anticipated, dyskinesia risk may have less utility when deciding upon Parkinson's therapy. Drug studies for Parkinson's disease should also take age of Parkinson's onset into account when analyzing dyskinesia outcomes. © 2010 Movement Disorder Society</abstract><note type="content">*Potential conflict of interest: Nothing to report.</note><subject lang="en"><genre>Keywords</genre><topic>Parkinson's disease</topic><topic>dyskinesia</topic><topic>age of onset</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. 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