title: Quality of life in early Parkinson's disease: impact of dyskinesias and motor fluctuations.
abstract: The impact of dyskinesias and motor fluctuations on quality of life (QOL) at various stages in the course of Parkinson's disease (PD) is not well understood. In 301 subjects with early PD enrolled in a clinical trial (CALM-PD), we quantified the impact of motor complications on QOL and investigated how this changes over time. We also compared QOL related to demographic and treatment characteristics. The presence of dyskinesias was associated with visual analogue scale (VAS) scores 3.0 of 100 points higher (better) than those without dyskinesias in years 1 to 2, even when adjusting for Unified Parkinson's Disease Rating Scale (UPDRS) motor scores. The positive association between dyskinesias and QOL scores was more marked in older patients. In years 3 to 4, dyskinesias no longer had a significant relationship with QOL. Younger subjects had higher VAS scores. Gender, motor fluctuations, and treatment regimen had no significant association with QOL, although a trend was found toward a small negative effect of motor fluctuations on QOL. We conclude that motor complications that occur within the first 4 years of treatment of PD do not have a significant negative effect on quality of life as measured by a visual analogue scale for most patients.
authors.affiliation: Division of Neurology, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Connie
authors.initials: C
authors.lastname: Marras
authors.forename: Anthony
authors.initials: A
authors.lastname: Lang
authors.forename: Murray
authors.initials: M
authors.lastname: Krahn
authors.forename: George
authors.initials: G
authors.lastname: Tomlinson
authors.forename: Gary
authors.initials: G
authors.lastname: Naglie
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use*; D052160:Benzothiazoles; D002230:Carbidopa / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D004338:Drug Combinations; D004409:Dyskinesia, Drug-Induced / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006801:Humans; D007980:Levodopa / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000187:drug effects; D010147:Pain Measurement; D010300:Parkinson Disease / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D000077487:Pramipexole; D011788:Quality of Life / Q000523:psychology*; D013844:Thiazoles / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000978:Antiparkinson Agents; D052160:Benzothiazoles; D004338:Drug Combinations; D013844:Thiazoles; C009265:carbidopa, levodopa drug combination; D007980:Levodopa; D000077487:Pramipexole; D002230:Carbidopa