title: [Incidence of motor fluctuations in a retrospective cohort of Mexican patients with Parkinson's disease].
abstract: BACKGROUND
  motor fluctuations induced by dopamine replacement therapy are among the main complications of the treatment of patients with Parkinson's disease. Our objective was to determine the incidence of motor fluctuations in a retrospective cohort of Mexican patients with Parkinson's disease.
  
  
  METHODS
  we reviewed the files of 584 cases of Parkinson's disease patients treated at the National Institute of Neurology and Neurosurgery between 1990 and 2010. We registered the demographic and clinical data to analyze the disease course.
  
  
  RESULTS
  the follow-up was of 4736 person-years. 33.9 % of patients (n = 198) had motor fluctuations at some point in the evolution of the disease. The rate of person-time incidence was 43 cases per 1000 person-years. The daily dose of levodopa equivalents greater than 600 mg/d and the use of levodopa were the main risk factors for early development of motor fluctuations (HR 1.40 [95 % CI = 1.07 to 1.83, p < 0.001] and HR 1.61 [95 % CI = 1.17 to 2.23, p = 0.004], respectively).
  
  
  CONCLUSIONS
  the main determinants of early development of motor fluctuations are the levodopa equivalent daily dose and the quantity and early use of levodopa.
authors.affiliation: Laboratorio Clínico de Enfermedades Neurodegenerativas, Instituto Nacional de Neurología y Neurocirugía, Secretaría de Salud, Distrito Federal, México.
authors.forename: Amin
authors.initials: A
authors.lastname: Cervantes-Arriaga
authors.forename: Mayela
authors.initials: M
authors.lastname: Rodríguez-Violante
authors.forename: Petra
authors.initials: P
authors.lastname: Yescas
authors.forename: Elisa
authors.initials: E
authors.lastname: Alonso-Vilatela
mesh_terms: D015331:Cohort Studies; D004298:Dopamine / Q000009:adverse effects* / Q000627:therapeutic use; D004409:Dyskinesia, Drug-Induced / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D004298:Dopamine