The prevalence of non-troublesome dyskinesia in Parkinson's disease

Introduction Levodopa-induced dyskinesia is a common complication of long-term treatment of Parkinson's disease (PD), but its impact on daily activities is somewhat controversial. This study investigated prevalence and severity of dyskinesia, particularly non-troublesome dyskinesia, to provide insights into its significance for long-term PD management. Methods We reviewed electronic medical records of 2571 PD patients, who had been followed up at Seoul National University Hospital and were seen between January 2016 and June 2017. Dyskinesia severity had been assessed during follow-up and were recorded with the highest score by considering its impact on functioning (0 = no dyskinesia, 1 = minimal with patient unware, 2 = mild disability, 3 = moderate disability, 4 = severe disability). Results The prevalence of dyskinesia increased progressively with longer PD duration; 8.2% in the group with disease duration of 0–5 years, 40.7% for 6–10 years, 66.0% for 11–15 years, 74.6% for 16–20 years, and 83.2% for 21 years or more. The prevalence of dyskinesia scores ≥2 also increased with disease duration, with rates of 6.3% for 0–5 years, 31.9% for 6–10 years, 54.8% for 11–15 years, 62.9% for 16–20 years and 73.7% for 21 or more years. Conclusion Despite the increasing prevalence and severity of dyskinesia with longer PD duration, the study found that less than non-troublesome dyskinesia remained at approximately 26.3% even after more than 21 years of disease duration. These findings suggest that dyskinesia may not be a troublesome for many PD patients even in long-term.