Levodopa-Induced dyskinesia in Latin America: Prevalence and associated clinical factors in the LARGE-PD cohort.
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Chaparro-Solano Henry Mauricio, Teixeira-Dos-Santos Daniel, Waldo Emily, Leal Thiago P, Inca-Martinez Miguel, Alcauter Sarael, Medina-Rivera Alejandra, Ruiz-Contreras Alejandra E, Cornejo-Olivas Mario, Mejia-Rojas Koni, Armas Cintia, Chana-Cuevas Pedro, Rojas Natalia, Orozco Jorge L, Ospina Beatriz Munoz, Aguillon David, Buritica Omar, Masmela Sonia Moreno, Tumas Vitor, Schuh Artur Fs, Rieder Carlos Roberto, Santos-Lobato Bruno Lopes, Duarte Juliana S, Peña Martínez Susana L, Rodríguez-Violante Mayela, Hernández-Medrano Ana Jimena, Gatto Emilia M, Da Prat De Magalhaes Gustavo Andres, Arboleda Gonzalo, Kauffman Marcelo Andres, Rodriguez-Quiroga Sergio Alejandro, Vinuela Angel, Espinal Martinez Alan Osvaldo, Braga-Neto Pedro, Camargos Sarah, Fernandez-Toledo Elias, Avila Cesar Luis, Cardoso Francisco Eduardo, Olguin Patricio, Borges Vanderci, Müller María Valentina, Merello Marcelo, Rosso Ana, Martinez-Ramirez Daniel, Adamec Dario Sergio, Tela Marcela Susana, Letro Grace Helena, Nicaretta Denise H, Mata Ignacio F, Latin American Research consortium on the Genetics of Parkinson's Disease (LARGE-PD)
Аннотация
BackgroundAlthough levodopa is the gold standard treatment for Parkinson's disease (PD), its chronic use is associated with levodopa-induced dyskinesia (LID), a motor complication that impacts prognosis, quality of life, and treatment costs. Most known LID-associated factors have been identified in European-descendant populations.ObjectivesTo describe the epidemiology of LID in Latin American and Caribbean (LATAM) countries and assess the relevance of known and novel LID-associated factors in this population.MethodsWe conducted a cross-sectional study using data from the Latin American Research consortium on the Genetics of Parkinson's Disease (LARGE-PD). We included PD patients with information on LID status and levodopa use from eight LATAM countries. LID prevalence was calculated overall and by country. Countries were compared on demographic and clinical variables. Logistic regression was used to identify associations with LID.ResultsA total of 3695 PD patients (58.8% male) were included. Overall LID prevalence was 25.4% [95% CI: 24.06-26.87], ranging from 9.3% in Colombia to 45.1% in Puerto Rico. Prevalence increased progressively with longer disease duration. Country comparisons showed that not all known LID-associated factors explained prevalence differences. In logistic regression, fast disease progression was significantly associated with LID (OR: 1.55, 95%CI: 1.16-2.07), while sex was not (OR: 1.02, 95%CI: 0.87-1.18).ConclusionsThis is the largest study on LID epidemiology in LATAM. While some known risk factors remain relevant, others, like sex, do not, underscoring the need for population-specific studies. Future work should integrate environmental, clinical, and genetic data to better understand LID mechanisms.