Impact of the motor complications of Parkinson's disease on the quality of life.
The impact of motor complications of Parkinson's disease (PD), especially levodopa-induced dyskinesias, on quality of life (QL) was studied in 143 patients with PD. All were evaluated on the Hoehn and Yahr (H&Y) scale, and the Motor part of the Unified Parkinson's Disease Rating Scale (UPDRS). Motor complications were analyzed using the UPDRS Parts IV(A) and IV(B) and the Abnormal Involuntary Movement Scale. A specific Parkinson's disease quality of life questionnaire (39-item version, PDQ-39) was used. Motor complications significantly worsened the PDQ-39 Summary Index (PDQ-SI) of patients with PD. The dimensions of Mobility, Activities of Daily Living, Stigma, and Communication were the most strongly affected. "Peak dose" dyskinesia decreased Mobility, Emotional Well-Being, and Cognition, whereas biphasic dyskinesia affected Mobility, Stigma, Communication, and Activities of Daily Living. Morning akinesia, end-of-dose fluctuations, and "unpredictable offs" decreased QL on the dimensions of Mobility, Activities of Daily Living, Stigma, and Communication. Nocturnal akinesia led to a deterioration of all dimensions of the PDQ-39. Thus, motor complications and especially nocturnal akinesia and biphasic dyskinesias worsened the QL of PD patients.
Chapuis
Stéphane
S
Service de Neurologie, Centre Hospitalier Vichy, France. stephane.chapuis@ch-vichy.fr
Ouchchane
Lemlih
L
Metz
Olivier
O
Gerbaud
Laurent
L
Durif
Franck
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000009:adverse effects; D004409:Dyskinesia, Drug-Induced / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D007980:Levodopa / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology* / Q000523:psychology; D009460:Neurologic Examination; D010300:Parkinson Disease / Q000503:physiopathology* / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
D000978:Antiparkinson Agents; D007980:Levodopa