Incidence of motor fluctuations in a retrospective cohort of Mexican patients with Parkinson’s disease
Main Article Content
Keywords
Parkinson’s disease, Antiparkinson agents, Levodopa
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.
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